MedUni Vienna: Pre-eclampsia in pregnant women can be diagnosed exactly through a blood test

Pre-eclampsia is a serious illness associated with pregnancy, which develops after twenty weeks and is associated with defective ingrowing of the placenta within the mother.  The dangerous illness is both the second most frequent cause of death in pregnant women, and the reason for severe complications for mother and child, especially during premature births.  Now scientists from the Vienna University of Medicine have succeeded, as part of an international research group, in identifying biomarkers, which - with one simple blood test - can be a very reliable help in predicting the emergence of pre-eclampsia in pregnant women as a sign of the illness. The results of the PROGNOSIS study were then published in the renowned medical journal 'The New England Journal of Medicine'.

It is not entirely clear what causes pre-eclampsia, a complication in pregnancy which was once known as 'pregnancy poisoning'. However, it is certain that the function of the plasma is disturbed, the baby receives too little oxygen and nutrients, and the mother also suffers as a result.  The illness does not always reveal itself through early signs, but symptoms are severe headaches, weight gain, water in the legs and especially high blood pressure (hypertension) and a high amount of protein in the urine (proteinuria).

Until now, pre-eclampsia - which, in its more severe forms, can lead to brain haemorrhages, oedema of the lungs and kidney failure - could only be clarified by elaborate tests. Now, as part of an international research group, a team from the University Women's Health Clinic at the Vienna University of Medicine, led by Harald Zeisler, have succeeded in showing that a blood test can help to rule out the possibility whether a pregnant woman with suspected pre-eclampsia will develop pre-eclampsia within a week. Among the many prominent mothers who have had and survived pre-eclampsia are starlet Kim Kardashian, pop star Mariah Carey and actress Jane Seymour, as well as the last First Lady of the USA, Laura Bush.

Emotional and therapeutic benefits
The blood test is based around the quotient of two proteins, namely sFLt-1 (soluble fms-like tyrosine kinase 1) and PlGF (placenta growth factor). If the sFlt-1/PlGF quotient on Elecsys is less than or equal to 38, in 99.3% of cases, there is no risk of pre-eclampsia developing within the next few weeks in pregnant women with suspected pre-eclampsia. "If the sFlt-1/PlGF quotient is greater than 38, we are not only dealing with an increased risk of pre-eclampsia within the next four weeks, but also the associated complications for the mother and baby," explains Zeisler. "These risk patients should be referred to a specialist centre where they can receive the necessary medical treatment, including the possibility of care in an intensive care ward. On the other hand, a smaller quotient below 38 takes away the worry for other women of being affected by pre-eclampsia within a week. That is a great emotional advantage." Pregnant women with suspected pre-eclampsia can receive the appropriate treatment, thereby avoiding any unnecessary stays in hospital.

The innovative blood test from Roche Diagnostics is already in use at Vienna General Hospital, and at the Vienna University of Medicine at the University Women's Health Clinic.

New England Journal of Medicine
Harald Zeisler, Elisa Llurba, Frederic Chantraine, Manu Vatish, Anne Cathrine Staff, Maria Sennström, Matts Olovsson, Shaun P. Brennecke, Holger Stepan, Deirdre Allegranza, Peter Dilba, Maria Schoedl, Martin Hund and Stefan Verlohren. „Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia.“ N Engl J Med 2016; 374:13-22.DOI: 10.1056/NEJMoa1414838.  The PROGNOSIS-Study was sponsored by Roche.

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