Fetal Medicine Foundation (FMF) Risk Algorithm
Overview
The FMF algorithm integrates maternal history, ultrasound, and biochemical markers to assess the risk for conditions such as preeclampsia, trisomies, and fetal growth restriction in the first trimester.
First-Trimester Markers
The following are key markers used:
- Nuchal translucency (NT)
- Nasal bone (NB)
- Yolk sac (if early)
- Ductus venosus Doppler
- Tricuspid regurgitation
- Biochemical: PAPP-A and free β-hCG
Risk Calculation Model
FMF uses Bayesian risk assessment, combining prior maternal risk with likelihood ratios derived from scan findings and biochemical values.
Uterine Artery Doppler
Uterine artery Doppler assesses resistance to blood flow and helps predict risk for preeclampsia. It is recommended for high-risk pregnancies but not essential in low-risk, asymptomatic cases.
Clinical Application
The FMF risk assessment guides early intervention strategies such as aspirin prophylaxis, early anomaly scanning, and serial fetal monitoring in high-risk groups.
Screening Outcomes
FMF screening improves early detection of chromosomal abnormalities and preeclampsia, offering an alternative or complement to non-invasive prenatal testing (NIPT).
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