Which feature on antenatal assessment carries the strongest predictive weight in first-trimester screening models for preterm pre-eclampsia?

• A Elevated serum free beta-hCG at 11 to 13 weeks
• B Low maternal serum inhibin A
• C Increased uterine artery pulsatility index with notching on Doppler ✓
• D High fetal nuchal translucency thickness

Explanation

Raised mean uterine artery pulsatility index with early diastolic notching directly reflects failed spiral artery remodelling and is the strongest imaging marker in combined first-trimester algorithms such as those used in the ASPRE trial alongside MAP and PlGF. Free beta-hCG is typically low rather than elevated in pre-eclampsia screening, low inhibin A is not the pattern seen, and increased nuchal translucency predicts aneuploidy and cardiac defects, not hypertensive disease.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.