Pregnancy: New method for early detection of dangerous preeclampsia

Pregnancy: New method for early detection of dangerous preeclampsia



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Risk of pre-eclampsia can be better estimated using the new method
Some women develop so-called pre-eclampsia in the course of pregnancy - colloquially known as pregnancy poisoning. If this is recognized too late, the worst risk is the death of mother and child. A current study has now identified certain ratios of messenger substances that form a reliable indicator of the occurrence of the disease.

In the international multicenter study, researchers "could now show that the ratio of certain messenger substances in the blood of pregnant women can reliably preclude preeclampsia and predict impending complications," reports the Charité Universitätsmedizin Berlin. With significant participation by Charité obstetricians, new approaches to predict the disease and its course have been developed. The researchers published their results in the current edition of the “New England Journal of Medicine”.

The disease has so far been difficult to predict
According to the scientists, the causes of pre-eclampsia have not yet been fully clarified. The multi-organ disease is one of the main causes of complications during the second half of pregnancy. Around two to five percent of all expectant mothers are affected by the disease, with hypertension and an increased excretion of protein in the urine being typical features. Pregnancy poisoning is often recognized too late and, in the worst case, can lead to the death of mother and child. Based on the increased blood pressure and protein excretion in the urine, the disease and the complications it causes can only be predicted with imprecision, the doctors explain. In the current study, however, it had now been possible to "determine a so-called cut-off value for the sFlt-1 / PlGF quotient, which can rule out the disease reliably within a week and also predict the occurrence of the disease and the complications resulting from it," reports the Charité.

More than 1,200 pregnant women were examined
According to the researchers, the ratio of the proteins sFlt-1 and PlGF, which are both produced in the placenta and circulate in the mother's blood, plays an important role in the development of the disease. This quotient can be determined by a blood test. Even in the absence of symptoms, he provides clues as to whether a woman will develop preeclampsia or complications caused by it. As part of their study, the researchers examined the significance of the new indicator on a total of 1,273 pregnant women suspected of having preeclampsia. The “sFlt-1 / PlGF ratio in the blood was determined for all participants using a serum test,” the Charité announced. If the value was below 38, preeclampsia could be ruled out “with almost a 100 percent probability within a week,” according to the researchers.

Safety for pregnant women
Exceeding the value of 38 had a probability of 36.7 percent within the next four weeks of pre-eclampsia. The risk of developing maternal or child complications from preeclampsia within the next four weeks was predicted with 65.5 percent accuracy. "The main problem with preeclampsia is that the symptoms are often not clear or the clinical picture is unclear," explains Dr. Stefan Verlohren from the Department of Obstetrics at the Charité, corresponding author of the study. The sFlt-1 / PlGF quotient can help "better estimate the likelihood of the disease occurring or its course." In this way "it can be avoided that a pregnant woman is given birth too early or treated too late." Above all, be it now possible to rule out the disease safely for a week and this contributes decisively to the reassurance of the patients. (fp)

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