Screening for Preeclampsia in Africa: Feasibility, Adaptation, and Implementation

Manel Mendoza of The Fetal Medicine Foundation in the United Kingdom will validate the safety and efficacy of giving aspirin prophylaxis to 30% of pregnant women at high risk of preeclampsia and discontinuing treatment before the end of pregnancy. Through collaborations, pregnant women at hospitals in Ghana, Senegal, and The Gambia will be screened in the first trimester for preeclampsia risk based on a combination of biomarkers and maternal characteristics. After the feasibility and suitability of this screening is validated, cohorts in the same three countries will be enrolled in a randomized controlled trial testing for non-inferiority of stopping aspirin treatment at 24-28 weeks of gestation versus at the end of pregnancy. These trials build on results from equivalent existing clinical trials in Spain and the United Kingdom. The shorter treatment duration could reduce the risk of negative side-effects and simplify treatment compliance.