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Women Health - PreEclampsia

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Pre-eclampsia screening and predictive test

Pre-eclampsia screening

The advantage of early detection of pre-eclampsia is the possibility to initiate low-dose aspirin therapy before Week 16 of amenorrhoea and/or to implement close monitoring of the pregnancy. This screening, during the 1st trimester of pregnancy, combines PAPP-A and PIGF assays (Delfia Xpress™ system, Perkin Elmer). The risk of PE is calculated by the software (Predictor™) using the levels of PAPP-A and PIGF, biophysical measurements (blood pressure, uterine artery Doppler scan), demographic information on the patient (BMI, geographic origin, smoker/non-smoker, etc.), her medical history (number of prior viable pregnancies, PE, and high blood pressure), and the ongoing pregnancy (gestational age, the date of the ultrasound, and the CRL).

Pre-eclampsia predictive test

This test is for symptomatic patients beyond Week 24 of amenorrhea. The use of the sFlt-1/PlGF ratio allows the occurrence of pre-eclampsia (PE) to be predicted within 1 to 4 weeks. This ratio can help the doctor decide whether to keep the patient at home to or bring them in to the hospital, as well as adjust treatment and anticipate foetal-maternal complications.

The placental growth factor (PIGF) and sFlt-1 antiangiogenic factor are biomarkers that are closely linked to PE. An imbalance in the concentration of these two markers occurs several weeks before the first clinical signs of pre-eclampsia. As such, an increased sFlt-1/PlGF ratio is associated with a risk of pre-eclampsia.

Resources

Focus 50Pre-Eclampsia
Focus on – Care and Management of Pre-Eclampsia
Focus on – Pre-eclampsia prediction screening during the first trimester