Placental Function Assessment is now part of the
combined First Trimester Screen
A Placental Function Assessment is now part of the combined First Trimester Screen for singleton pregnancies offered through the ERA program and is available at all four FTS sites.
Successful development and implantation of the placenta has a direct impact on the developing fetus(es) through optimized delivery of nutrients and oxygen as well as through removal of waste and carbon dioxide. Placental function assessment is performed through assessment of maternal biochemistry, placental ultrasound, uterine artery Doppler, and umbilical artery Doppler measurement. Placental insufficiency may be associated with adverse pregnancy outcomes such as small for gestational age and preeclampsia.
Placental function assessment has already been offered through the ERA program as part of low PAPP-A identification and follow up. We are very pleased to now have this include preeclampsia screening starting late fall of 2023.
Who can have Placental Function Assessment?
Individuals pregnant with a singleton, between 11 and 14 weeks gestation, will have a placental function assessment included with their FTS.
Do patients need to do anything different?
No - patients will still have the same blood draw between 11+0 and 13+6 weeks and a nuchal translucency ultrasound. When they present for their ultrasound, they will have a more detailed review of their health history, their blood pressure measurements done, as well as an assessment of the uterine artery Dopplers.
Please use the updated First Trimester Combined Screen requisition
This requisition is available through Alberta Precision Labs: REQ9080FTS First Trimester Combined Screen FTS Blood Work (albertahealthservices.ca)
This requisition contains the updated patient demographics required for the FTS risk calculation and placental function assessment.
FTS and Placental Function Assessment
-
FTS Bloodwork
Using the FTS requisition (updated link above), your patient should have their blood work drawn after 11 weeks gestation and at least 3 days prior to her NT ultrasound appointment.
-
History and Assessment
Your patient will meet with a nurse to review their medical and obstetrical history. They will also have her blood pressure taken in both arms and the average MAP determined.
-
Ultrasound
The nuchal translucency ultrasound will be completed as well as measurements of the uterine artery dopplers through EFW Radiology.
-
Review of results
The risk of developing placental dysfunction is determined through an assessment of maternal characteristics and health history, the MAP, biochemistry results, and ultrasound measurements. Prior to leaving, your patient will receive their results for both the First Trimester Screen and a Preeclampsia screen. If their preeclampsia screen is positive, they will be encouraged to contact you in regards to starting aspirin.
FAQs
-
A risk of >1/100 means that your patient is at a low risk of developing preeclampsia before 37 weeks.
Your patient should still have regular blood pressure monitoring as part of her prenatal care.
-
Screening >1/100 is considered high risk for developing preeclampsia prior to 37 weeks gestation.
Initiating low dose aspirin at bedtime (ASA 162mg po qhs) prior to 16 weeks is recommended to prevent or delay the development of early onset preeclampsia.
-
Yes - low dose aspirin is safe in pregnancy. For detailed information on aspirin use for the prevention / delay of early onset preeclampsia please visit the Preeclampsia Foundation website.
-
Please contact the Early Risk Assessment Program Coordinator at 403-943-8382