A new blood test is helping doctors predict the risk of preeclampsia earlier in pregnancy. It's a common complication of pregnancy involving high blood pressure.
But Dr. Angela Angel, an obstetrician-gynecologist at Texas Health Dallas, said doctors keep a constant watch for the condition.
Dr. Angel: So, if preeclampsia goes untreated, a patient can have a seizure, they can have a stroke, and they can have something called placental abruption, where the placenta separates from the uterus, and that can cause fetal loss or fetal death.
So, it causes both fetal and maternal morbidity and mortality if it's not treated.
Baker: It comes late-term though, doesn't it?
Dr. Angel: After 20 weeks.
Baker: And that makes early detection of it difficult?
Dr. Angel: Detection is important so that we can start to manage it.
Baker: Are there risk factors, signs, symptoms that you can look for early that can help you detect it?
Dr. Angel: There are some patients that are at high risk for preeclampsia, patients who have a history of it in a prior pregnancy, patients with chronic hypertension, or that take medication for hypertension before they get pregnant.
If they have kidney disease, autoimmune diseases like lupus, multiple gestation, like twins and triplets, maternal obesity is also a risk factor.
Baker: So, if they have those symptoms then they stand a good chance perhaps of developing preeclampsia?
Dr. Angel: It doesn't guarantee that they're going to develop preeclampsia, but it does put them at a higher risk for developing it.
Baker: So how does this new blood test change things around?
Dr. Angel: This blood test helps us distinguish between those that have a mild case and that we can wait on delivery versus someone who is at risk for developing a severe case of it, and they need to be managed more aggressively, maybe even delivery.
Baker: How does the test work?
Dr. Angel: So simple blood test on mom, and it measures the levels of two placental biomarkers.
And there's a ratio that is developed. If this ratio is greater than 40, then that predicts within the next two weeks that the patient in question will develop a severe case of preeclampsia and likely need delivery.
Baker: Is the test pretty accurate?
Dr. Angel: It is that as with any test, there's always going to be a false positive rate and a false negative rate, but it has been very accurate.
Baker: Enough to maybe call this, what, maybe a game-changer in all of this?
Dr. Angel: It absolutely is a game changer.
Previous to this blood test, we would manage all of our patients the same.
This test distinguishes between the ones who are destined to get sicker sooner and faster versus the patients that we can manage a little bit longer and get them farther into their pregnancy before we have to intervene with delivery.
Baker: So, once you're able to detect this high risk, what then?
Dr Angel: The management is bed rest.
So, we place them on bed rest because when patients are laying on one side or the other, typically their left side is preferred. Their blood pressure will be markedly better.
And so rather than taking a blood pressure medicine and still going about their business and going to work and caring for other children and walking around, we put patients on bedrest to drop their blood pressure.
And the difference can be, do we put them on bed rest at home where they can't be monitored, or do we bring them into the hospital and we keep them on bad rest where they are monitored by medical professionals?
RESOURCES:
New blood test accurately predicts preeclampsia
Mirvie announces results from new simple blood test to predict preeclampsia risk
Cedars-Sinai Study Leads FDA to Approve Test for Preeclampsia in Preterm Pregnancies
