First Trimester Combined Screening — Extended (with Preeclampsia)

The extended first-trimester combined screening at G-CENTRUM Olomouc builds on the basic chromosomal risk assessment by adding preeclampsia screening — a critical distinction for women at higher risk of developing this serious blood pressure complication later in pregnancy. In addition to the PAPP-A and free β-hCG blood markers and the nuchal translucency ultrasound, the extended version includes measurement of PlGF (placental growth factor) in the blood, uterine artery Doppler flow measurement by ultrasound, and blood pressure assessment. These additional data points allow calculation of a personalised preeclampsia risk score alongside the chromosomal risk figures.

Preeclampsia affects 2–5% of pregnancies and is a leading cause of maternal and perinatal morbidity worldwide. First-trimester preeclampsia screening — when integrated with the standard chromosomal screening — allows identification of high-risk women at 11–14 weeks, when prophylactic low-dose aspirin is most effective at reducing risk of preterm preeclampsia (the more severe early-onset form). G-CENTRUM Olomouc's extended first-trimester screening follows the Fetal Medicine Foundation (FMF) protocol, which combines four elements into a single algorithmic risk score: 1. Maternal biophysical factors and history (age, weight, ethnicity, obstetric history, blood pressure at 11–14 weeks) 2. Biochemical marker — PlGF (placental growth factor): low levels of this placenta-derived protein at 11–14 weeks are strongly predictive of placental insufficiency and preterm preeclampsia 3. Uterine artery Doppler: the pulsatility index of the uterine arteries is measured by ultrasound; elevated resistance indicates impaired placentation 4. All standard chromosomal screening elements (PAPP-A, free β-hCG, nuchal translucency) The combined algorithm detects approximately 75–95% of cases of preterm preeclampsia at a 10% screen-positive rate — allowing the clinic to recommend prophylactic aspirin 150mg from week 16 to women who screen positive, a strategy that reduces preterm preeclampsia risk by approximately 62%. The extended screening also includes the full chromosomal risk calculation for Trisomy 21, 18, and 13. For an additional 200 Kč over the basic screen, women at risk of either preeclampsia or chromosomal conditions can complete both assessments in the same two-step visit pathway.