OP13.09: Algorithmic approach to prediction of PE using the FMF risk calculator and comparing the effect of Aspirin on the incidence of PE in high‐risk women

The aim of the study is to assess the prediction of PE using FMF risk calculator for PE screening and assess the effect of Aspirin in the high-risk population. This is a retrospective study of mothers with singleton pregnancy and known outcomes from a tertiary fetal care centre in South India from 2015 - 2023. Those without structural and chromosomal anomalies were included in the study. All mothers included in the study had a scan between 11+0 to 13+6 weeks and a complete first trimester screening and risk assessment as per FMF protocol. All scans were done by FMF certified operators. Patient's complete history, BMI, Mean arterial pressure (MAP) were entered in Astraia. The PE risk calculation was done based on parameters entered in Astraia. CRL and Uterine artery Doppler was measured in all. Serum markers-beta hCG, PAPP-A and PLGF was offered to all. Some declined, the risk calculation was done even without these markers. 326/2742 (11.8%) mothers had PE risk >1:100 and were advised Aspirin 150mg till 36 weeks. 10/326 (3.1%) developed PE-5 taking only 75mgs of Aspirin, delivered babies < 32 weeks with birthweight < 1500g. 1 was a neonatal death due to severe FGR. Other 5 on Aspirin 150mg delivered babies >34 weeks weighing >2000g. In women with PE risk < 1:100, 16/2416 (0.7%) developed PE. 4 delivered < 34 weeks and 6 had babies < 1500g. Based on the analysis, positive LR for PE after screen positive result was 3.3 (CI 87.1 – 89.55%). Hence, these mothers must be advised Aspirin 150mg as per the guidelines. Our study confirms FMF algorithm for PE risk calculation is very much feasible and be used in all NT scans irrespective of biochemical markers. The PE prediction can be calculated with basic details of maternal history, BMI, MAP, UAD-PI and CRL. Mothers who didn't adhere to prescribed Aspirin dose, likely contributed to preterm deliveries and low birthweight babies in the “high risk” group. This approach has significantly reduced the incidence of PE in our institute since 2015.