Background: Preeclampsia (PE) remains one of the leading causes ofmaternal death. Preeclampsia affects approximately 6% of all pregnanciesand is associated with increased prenatal morbidity and mortality.Objective To evaluate whether first trimester maternal serum placentaprotein 13 (PP13) can predict pre-eclampsia among women with a priorihigh risk .Method: This was a nested case–control study included 30 patients withincreased risk for preeclampsia and 60 patients with normal pregnancies at11-14 weeks of gestation .Venous blood samples were collected . SerumPP13 concentrations were measured by enzyme-linked immunosorbentassay . PP13 multiples of medians were calculated and adjusted for bodymass index, maternal age and parity. PP13 levels was compared betweenwomen who developed pre-eclampsia and controlsResults: Levels of PP13 were not found to differ between control andaffected pregnancies. PP13 multiples of median (MoMs) for controls andpre-eclampsia cases were 1.0 (0.51) and 1.7 (0.85), respectively (P = 0.4).Conclusion: Screening test based only on maternal history or placentalprotein 13(PP13) testing is inefficient in predicting preeclampsia in highrisk females