International Journal of Medical Discoveries

Background: The field of maternal–fetal medicine requires evidence-based and timely clinical decision making to maximize maternal health, fetal growth, and neonatal outcome. Laboratory information is very important in making these decisions for endocrine evaluation, therapeutic drug monitoring, toxicological purposes and biomarker diagnosis. Conventional analytical techniques often have limitations in specificity, sensitivity and multiplexing ability, which can result in delayed diagnosis and decreased diagnostic confidence. Liquid chromatography–tandem mass spectrometry (LC-MS/MS) has become a powerful analytical platform providing a high level of accuracy and clinically relevant information from a variety of biological matrices. It has been commonly used in the clinical laboratory but its contribution to overall clinical decision making in maternal–fetal medicine has not been fully evaluated. Objective: This study undertook a systematic review and summarization of the LC-MS/MS analytical performance, diagnostic applications, laboratory implementation, and translation to clinical practice in maternal–fetal medicine. Methods: A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Analytical performance, laboratory workflow, development of assays, quality assurance, automation, standardization and clinical applications in the context of endocrine assessment, therapeutic drug monitoring, biomarker analysis and toxicological testing were all synthesized. Findings: The literature reviewed indicates that LC-MS/MS techniques are consistently more specific, sensitive, accurate, and multiplex in their analytical capabilities than traditional laboratory techniques. Conclusion: The future of maternal–fetal laboratory medicine is shifting from individual analytical testing to clinical decision support, and this is becoming possible with the help of LC-MS/MS. It provides accurate, repeatable and clinically relevant measurements to various diagnostic areas, enhancing the precision diagnosis, personalized care of the patient and facilitation evidence-based decision making during pregnancy and neonatal care.