Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic review
Background: Preeclampsia (PE) is a multisystem disease of pregnancy representing a major cause of maternal and perinatal morbidity and mortality. Early identification of pregnancies at risk of developing PE is crucial for implementing preventive strategies. The effectiveness of PE screening in the f...
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IMR Press
2021-08-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/48/4/10.31083/j.ceog4804130 |
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| author | Silvia Amodeo Giulia Bonavina Anna Seidenari Paolo Ivo Cavoretto Antonio Farina |
| author_facet | Silvia Amodeo Giulia Bonavina Anna Seidenari Paolo Ivo Cavoretto Antonio Farina |
| author_sort | Silvia Amodeo |
| collection | DOAJ |
| description | Background: Preeclampsia (PE) is a multisystem disease of pregnancy representing a major cause of maternal and perinatal morbidity and mortality. Early identification of pregnancies at risk of developing PE is crucial for implementing preventive strategies. The effectiveness of PE screening in the first trimester is widely recognized and endorsed by several guidelines, but unfortunately real-world implementation of this practice within local settings remains difficult. Methods: We performed a systematic review of the literature to understand the critical issues hampering the implementation of PE screening procedures in Italy. All studies on first trimester PE screening in the Italian population were eligible for inclusion. Key-concepts relevant for implementation of PE screening in Italy were extracted and analysed qualitatively. Results: Nine articles were selected and included. Lack of evidence concerning the topic of PE screening in Italy was shown. Major critical issues found encompassed health-care personnel education, training of sonographers, economic coverage for biochemical markers and adjustment of algorithms based on population characteristics. Conclusions: Identification and adaptation of specific protocols to local settings and population characteristics is critical for successful implementation of early PE screening in Italy. This process has the potential to improve pregnancy outcomes and to save valuable health-care resources, particularly scarce in the COVID-19 era. There is an urgent need for research studies on specific local populations focussing on subtle details capable of maximizing PE screening uptake. This action will likely potentiate PE screening implementation reducing the burden and the cost of perinatal and maternal complications. |
| format | Article |
| id | doaj-art-e726058b3c834dfa8cd8e4f7694f41ce |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2021-08-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-e726058b3c834dfa8cd8e4f7694f41ce2025-08-20T03:48:32ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-08-0148481281910.31083/j.ceog4804130S0390-6663(21)00125-1Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic reviewSilvia Amodeo0Giulia Bonavina1Anna Seidenari2Paolo Ivo Cavoretto3Antonio Farina4Department of Health Promotion, Division of Obstetrics and Gynecology, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, ItalyGynecology and Obstetrics Department, I.R.C.C.S. San Raffaele Hospital, University Vita-Salute, 20132 Milan, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40121 Bologna, ItalyGynecology and Obstetrics Department, I.R.C.C.S. San Raffaele Hospital, University Vita-Salute, 20132 Milan, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40121 Bologna, ItalyBackground: Preeclampsia (PE) is a multisystem disease of pregnancy representing a major cause of maternal and perinatal morbidity and mortality. Early identification of pregnancies at risk of developing PE is crucial for implementing preventive strategies. The effectiveness of PE screening in the first trimester is widely recognized and endorsed by several guidelines, but unfortunately real-world implementation of this practice within local settings remains difficult. Methods: We performed a systematic review of the literature to understand the critical issues hampering the implementation of PE screening procedures in Italy. All studies on first trimester PE screening in the Italian population were eligible for inclusion. Key-concepts relevant for implementation of PE screening in Italy were extracted and analysed qualitatively. Results: Nine articles were selected and included. Lack of evidence concerning the topic of PE screening in Italy was shown. Major critical issues found encompassed health-care personnel education, training of sonographers, economic coverage for biochemical markers and adjustment of algorithms based on population characteristics. Conclusions: Identification and adaptation of specific protocols to local settings and population characteristics is critical for successful implementation of early PE screening in Italy. This process has the potential to improve pregnancy outcomes and to save valuable health-care resources, particularly scarce in the COVID-19 era. There is an urgent need for research studies on specific local populations focussing on subtle details capable of maximizing PE screening uptake. This action will likely potentiate PE screening implementation reducing the burden and the cost of perinatal and maternal complications.https://www.imrpress.com/journal/CEOG/48/4/10.31083/j.ceog4804130preeclampsiapredictionscreeningfirst trimestermean arterial pressureuterine artery pulsatility indexplacental growth factorpregnancy associated plasma protein-a |
| spellingShingle | Silvia Amodeo Giulia Bonavina Anna Seidenari Paolo Ivo Cavoretto Antonio Farina Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic review Clinical and Experimental Obstetrics & Gynecology preeclampsia prediction screening first trimester mean arterial pressure uterine artery pulsatility index placental growth factor pregnancy associated plasma protein-a |
| title | Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic review |
| title_full | Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic review |
| title_fullStr | Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic review |
| title_full_unstemmed | Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic review |
| title_short | Real-world implementation and adaptation to local settings of first trimester preeclampsia screening in Italy: a systematic review |
| title_sort | real world implementation and adaptation to local settings of first trimester preeclampsia screening in italy a systematic review |
| topic | preeclampsia prediction screening first trimester mean arterial pressure uterine artery pulsatility index placental growth factor pregnancy associated plasma protein-a |
| url | https://www.imrpress.com/journal/CEOG/48/4/10.31083/j.ceog4804130 |
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