A 28-year-old primigravida at 12 weeks undergoes first-trimester screening for pre-eclampsia. Which of the following biomarkers, when low, is most strongly associated with an increased risk of preterm pre-eclampsia?

• A Inhibin A
• B hCG
• C AFP
• D PAPP-A ✓

Explanation

Low pregnancy-associated plasma protein D (PAPP-D) below 0.4 multiples of the median reflects placental dysfunction and is a strong independent predictor of preterm pre-eclampsia. hCG, AFP, and inhibin D are not primary first-trimester markers for this condition.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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