Implementation of First-trimester Screening and preventiOn of pREeClAmpSia Trial (FORECAST)

Implementation of First-trimester Screening and Prevention of Preeclampsia: a Stepped Wedge Cluster-randomized Trial in Asia

This implementation study aims to evaluate the efficacy, acceptability, and safety of first-trimester screening and prevention for preterm-preeclampsia. It is a multicenter stepped wedge cluster randomized trial including maternity / diagnostic units from ten regions in Asia. The study involves a period where no intervention will take place at all recruiting units, and then at regular intervals, one cluster will be randomized to transit from non-intervention group to intervention group in which first-trimester screening for preterm-preeclampsia by the Bayes based method followed by the commencement of low-dose aspirin in high-risk women.

Inclusion Criteria:

• Singleton pregnancy;
• Live fetus;

Exclusion Criteria:

• Multiple pregnancy;
• Major fetal defects identified at 11-13 weeks of assessment;
• Non-viable fetus (missed spontaneous abortion or stillbirth).