With rates of preeclampsia on the rise, clinicians are looking at ways to reduce severe outcomes in pregnant patients and their babies. In the future, a blood test that can help predict the risk of severe preeclampsia two weeks before it develops, may be one of the tools they can use.
Preeclampsia is a condition that can happen during or after pregnancy characterized by high blood pressure. Preeclampsia, when severe, can increase the risk of eclampsia (a seizure), organ and blood vessel damage. Left unrecognized or untreated, it can lead to severe health complications and even death. Currently, the main treatment for preeclampsia is delivery and patients with preeclampsia need close monitoring during the pregnancy, delivery and into the postpartum period.
Risk factors for preeclampsia
Patients with certain comorbidities such as chronic hypertension, obesity and diabetes are at an increased risk of developing preeclampsia. However, some people without any risk factors can develop it and it’s unclear why some patients get it and others do not.
New research shows a blood test may predict who is at increased risk of severe preeclampsia by measuring two proteins produced by the placenta. It is important to recognize that the test is not considered 100% accurate and some patients may have a false positive or false negative test result.
Katherine Campbell, MD, MPH, medical director of Inpatient Obstetrics at Yale New Haven Hospital and associate professor of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine says more research is needed, but any time preeclampsia can be caught early is a good thing.
“I do think knowledge is power and understanding what might be increasing the risk or driving development of severe preeclampsia like this is important,” said Dr. Campbell.
One way a test like this is beneficial is by identifying at-risk patients who live far from the necessary obstetrical care. If for example a patient is at increased risk, it would be helpful for them to know in advance if they need to be closer to a hospital that can monitor their baby and intervene if an early delivery is necessary. Those who may end up having a preterm delivery may need specialized care for their baby as well.
In addition, increased monitoring should not end once the baby is born. Some patients can develop postpartum preeclampsia and those who had preeclampsia during a previous pregnancy are at increased risk of developing preeclampsia again in subsequent pregnancies.
“We recommend a patient have what we call a preconception consultation with a maternal-fetal medicine specialist where they talk about their history of preeclampsia and the prior pregnancy. Then, the plan of care for the anticipated pregnancy is discussed and established so that when they become pregnant, they know the steps we’re going to take for risk reduction,” said Dr. Campbell.
Measures such as increased fetal and maternal monitoring can identify preeclampsia when it first presents. Taking a baby aspirin starting at the end of the first trimester can help reduce the risk of developing preeclampsia.
“Preeclampsia is common, but can be a serious condition,” said Dr. Campbell. “We know that if we can recognize and diagnose preeclampsia in a timely fashion, we can lower the risk of complications for both the parent and the baby.”
Learn more about care for high-risk pregnancies at Yale New Haven Health.
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