ArticleCureus2025
First-Trimester Preeclampsia Screening During the COVID-19 Pandemic: A Quality Improvement Comparison of the National Institute for Health and Care Excellence (NICE) Guidelines vs. Simplified Fetal Medicine Foundation Algorithm.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
objectiveTo evaluate the effectiveness of the National Institute for Health and Care Excellence (NICE) guidelines versus the mini-combined test for preeclampsia screening at 11-14 weeks of gestation, considering COVID-19 restrictions.
methodsThis study included women ≥18 years old with singleton pregnancies attending routine antenatal visits between May 1 and September 1, 2021. Data collected included maternal characteristics, medical history, uterine artery pulsatility index (PI), and pregnancy-associated plasma protein-A (PAPP-A) levels. Both NICE and Fetal Medicine Foundation (FMF) methods were used to classify high and low-risk cases.
resultsThe mini-combined method showed 50% sensitivity and 89.9% specificity at a 1:100 cutoff for all preeclampsia cases. An optimal cutoff of 1:165.5 yielded 70.5% sensitivity and 80.9% specificity. NICE's method demonstrated 22.7% sensitivity and 90.9% specificity.
conclusionThe mini-combined screening method using the FMF algorithm outperforms the NICE method in preeclampsia screening. Implementing the full FMF method, including mean arterial pressure (MAP) and placental growth factor (PLGF), is recommended based on superior performance and international literature support.
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