B·R·A·H·M·S – Maternal and Placental Health

Perform early risk assessment with the complete prenatal screening biomarker portfolio

Explore B·R·A·H·M·S prenatal care

Trusted preeclampsia risk and chromosomal abnormality screening assays

The difference that screening for preeclampsia and chromosomal abnormalities can make to pregnant patients and their families cannot be overstated. Serum biomarkers play a key role in assessing risk and diagnosing pregnancy disorders. This can significantly improve a prognosis for preeclampsia and help prepare families for aneuploidy conditions such as Down syndrome.

 

Thermo Scientific is the provider of a complete prenatal screening portfolio including the B·R·A·H·M·S KRYPTOR GOLD and B·R·A·H·M·S KRYPTOR prenatal screening assays – both of which fulfill the requirements set out by the Fetal Medical Foundation for the biochemical screening of preeclampsia and chromosomal abnormalities.

  Informational: This product is not available for purchase by the general public

Why medical professionals choose B·R·A·H·M·S for prenatal screening

  • B·R·A·H·M·S is the gold standard for preeclampsia screening covering the first trimester as well as improved diagnosis and prognosis of preeclampsia in the second trimester after 20 weeks of gestation.
  • B·R·A·H·M·S provides reliable results for trisomy disorders, including first and second-trimester aneuploidy conditions as well as neural tube defect screening for chromosomal abnormalities.
  • B·R·A·H·M·S offers high precision results on eight biomarker assays, measuring AFP, Free β hCG, hCG+β, Inhibin A, PAPP-A, PlGF, sFlt-1 and uE3.
  • The B·R·A·H·M·S Fast Screen pre 1 plus software uses trisomy and preeclampsia algorithms to provide reliable and effective risk calculation.

Preeclampsia – Screen early to act early

Preeclampsia is a life-threatening pregnancy disorder that affects between 2 to 8% of pregnant women1.. Early detection is critical to patient outcomes. Thermo Fisher Scientific supports early risk assessment in the first trimester, in addition to improved diagnosis and prediction after 20 weeks gestation with B·R·A·H·M·S biomarkers. 

First-trimester preeclampsia screening

First-trimester screening for preeclampsia should occur between 11 weeks and 14 weeks of pregnancy. The recommended screening strategy combines the measurement of Thermo Scientific B·R·A·H·M·S serum biomarkers PlGF and PAPP-A, together with a patient’s maternal characteristics, mean arterial pressure and uterine artery Doppler.

This screening strategy results in a more than 90% detection rate and is recommended for every pregnant woman2,3. Preventative measurements can then be prescribed to high-risk patients– to reduce the risk of developing preeclampsia with higher efficacy4. 

Preeclampsia diagnosis and prognosis

The diagnosis and prognosis of preeclampsia can be significantly improved by using Thermo Scientific B·R·A·H·M·S serum biomarkers sFlt-1 and PlGFin addition to routine clinical procedures after 20 weeks of gestation.

The first clinical signs of preeclampsia – such as the new onset of hypertension – start to show in the second trimester, with about 10% of all pregnant women experiencing signs and symptoms after 20 weeks’ gestation. Yet only one-fifth of these women will develop pre-eclampsia5. 

While routine assessments measure blood pressure and proteinuria in the second trimester, these offer limited specificity in predicting preeclampsia in symptomatic women. This is why the use of Thermo Scientific B·R·A·H·M·S serum biomarkers sFlt-1 and PlGFin is recommended for improved diagnosis and prognosis. 

Aneuploidy screening: Biomarkers to detect down syndrome

Down syndrome (Trisomy 21) can be detected early with a combined screening approach as recommended by the Fetal Medical Foundation UK in the first semester, followed by biomarker screening in the second trimester. Aneuploidy screening biomarkers can also indicate risk for neural tube defects such as spina bifida.

Combined screening for the first trimester

A combined screening approach in the first trimester that involves Free β hCG (human chorionic gonadotropin) and PAPP-A (pregnancy-associated plasma protein A) can identify over 90% of trisomy 21 (Down syndrome) cases and more than 95% of trisomies 18 (Edwards syndrome) and 13 (Patau syndrome)6. Read more about cell-free DNA prenatal screening.

The combined screening is a non-invasive test that draws on medical history, ultrasound and serum biomarkers to identify aneuploidy or neural tube defects. The performance of this combined screening can be enhanced by including measurements of serum PlGF (placental growth factor) and AFP (alpha fetoprotein)7. 

Download our brochure about early detection of complications in pregnancy.

Second trimester screening for fetal trisomies

Second-trimester trisomy screening combines the biomarkers AFP, Free β hCG or hCG+β, uE3 (unconjugated estriol) and inhibin A (quad test) with maternal characteristics. In addition, the AFP value measured in weeks 15-20 of gestation will indicate a risk for neural tube defects.

Download our literature review about contingent screening.

High-precision prenatal KRYPTOR biomarker assays

The B·R·A·H·M·S prenatal screening biomarkers comprise of eight KRYPTOR high-precision assays for the accurate detection of preeclampsia, trisomy and neural tube defects in pregnancy.

 

Automated assays on KRYPTOR for prenatal screening include:

Reliable risk calculation with B·R·A·H·M·S prenatal software

The CE marked B·R·A·H·M·S Fast Screen pre 1 plus software is a robust and effective clinical software for prenatal screening.

Using algorithms based on FMF data, B·R·A·H·M·S Fast Screen pre I plus is designed to ensure the convenience of data entry, risk calculation and reporting for laboratories with both low and high data throughput. It is made to be used with B·R·A·H·M·S KRYPTOR Analysers and assays.

Resources and references

Prenatal Screening Webinars

The latest webinars including topics:

  • Prediction of pre-eclampsia in 3rd trimester
  • Improved pre-eclampsia management with sFlt-1/PlGF ratio
  • Preeclampsia screening and prevention: tips and considerations
  • Improve patient management with First Trimester Screening
References:

1. L. Ghulmiyyah and B. Sibai, “Maternal Mortality From Preeclampsia/Eclampsia” Semin. Perinatol., vol. 36, no. 1, pp. 56–59, 2012.

2. N. O’Gorman et al., “Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation.” Am. J. Obstet. Gynecol., vol. 214, no. 1, p. 103.e1-103.e12, Jan. 2016.

3. L. C. Poon and K. H. Nicolaides, “First-trimester maternal factors and biomarker screening for preeclampsia” Prenat. Diagn., vol. 34, no. 7, pp. 618–627, 2014.

4. D. L. Rolnik et al., “Early screening and prevention of preterm preeclampsia with aspirin: time for clinical implementation.” Ultrasound Obstet. Gynecol., vol. 50, no. 5, pp. 551–556, 2017.

5. F. Milne et al., “Assessing the onset of preeclampsia in the hospital day unit: summary of the preeclampsia guideline (PRECOG II).” BMJ, vol. 339, no. 7721, p. b3129, Sep. 2009.

6. Kagan KO et al. Hum Reprod 2008; 23: 1968-1975.

7. Kagan KO et al. Ultrasound Obstet Gynecol 2012; 40(5): 530-5.

8. M. M. Gil, V. Accurti, B. Santacruz, M. N. Plana, and K. H. Nicolaides, “Analysis of cell-free DNA in maternal blood in screening for aneuploidies: updated meta-analysis.,” Ultrasound Obstet. Gynecol., vol. 50, no. 3, pp. 302–314, Sep. 2017.

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