Comparison of FMF and NICE Algorithms in Early Preeclampsia Screening at 11-13 Weeks Gestation

Background:Approximately 3% of pregnant women develop preeclampsia at some time during their pregnancy. Preeclampsia is a common cause of maternal and fetal morbidity and mortality worldwide. Currently there are 3 assessment tools for preeclampsia: the National Institute for Health and Care Excellence (NICE) guidelines, the American College of Obstetricians and Gynecologist (ACOG) and the Fetal Medicine Foundation (FMF) algorithm. Both NICE and ACOG guidelines use maternal demographics and medical history as a screening tool. The more recent approach, FMF uses Bayes theorem utilizes biophysical and biochemical markers in addition to maternal risk factors. Methods: An exhaustive search of the available medical literature was performed using the search engines MEDLINE- PubMed, Google Scholar, and Science of Web. Keywords included: “Preeclampsia” AND “NICE guidelines AND fetal medicine foundation and “Preeclampsia screening guidelines”. The GRADE Working Group was used to assess the quality of relevant studies. Results: During the search, 2 articles were found to meet the eligibility criteria. Both were prospective multicenter cohort studies. Conclusion: The FMF algorithm which combines maternal factors with biophysical and biochemical markers is superior in screening for preeclampsia during weeks 11-13 gestation compared to the NICE algorithm. The quality of evidence is at a low to very low due to risk of publication bias and incomplete blinding