Pre-eclampsia (PE) is a pregnancy disorder characterized by a new onset of hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg), and proteinuria (≥300 mg/24 h urine), or hypertension and organ dysfunction with or without proteinuria (thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema), after 20 weeks of gestation1. PE can progress into eclampsia (seizures) or HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) and death2. The disorder is caused by placental and maternal vascular dysfunction and always resolves after delivery.
Worldwide, PE concerns 2–8% of pregnancies with wide variation between countries. Eclampsia occurs in 1-2% and HELLP syndrome in 10-20% of severe PE. PE remains a leading cause of maternal and perinatal mortality and morbidity. Hypertensive disorders of pregnancy represent about 18% and 16% of maternal deaths worldwide and in developped countries respectively2,3,4.
The pathogenesis of PE is not completely known, but the imbalance between angiogenic factors has been shown to play a role in the onset of clinical manifestations of the disease5. The ischemic placenta secretes antiangiogenic factors into the maternal bloodstream that alter maternal endothelial cell function and lead to the symptoms of PE. Abnormalities in the uteroplacental circulation and angiogenic factors blood levels occur long before clinical manifestations of PE6.
Several pro-angiogenic (VEGF, PlGF) and anti-angiogenic (sFlt-1, sEndoglin) factors produced by the developing placenta, have been extensively studied for their potential clinical utility in PE5,7. During the first trimester of pregnancy, the combination of PlGF with clinical, biophysical and biological factors has been shown to improve the detection rate of PE8. During the 2nd and 3rd trimesters, these biomarkers have proved to be helpful for short-term prediction, diagnosis and prognosis of PE9.
OVVI Diagnostics is developing a point-of-care solution for PE biomarker testing, giving precise quantitative results within minutes from a simple fingerprick.
- Obstetrics & Gynecology: January 2019 - Volume 133 - Issue 1 - p e1-e25
- Eur J Obstet Gynecol Reprod Biol 2013; 170:1
- Lancet 2010; 376: 631–44
- Lancet 2006; 367: 1066–74
- N Engl J Med.2004;350(7):672–83
- J Clin Invest 2003; 111:649
- Seminars in Nephrology 2011, Vol 31, No 1, pp 33-46
- Int J Gynecol Obstet 2019; 145 (Suppl. 1): 1–33
- Int J Reprod Bio Med 2019;17: 1–10