How are women screened for preeclampsia?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Answer

Preeclampsia is an appropriate disease to screen, as it is common, important, and increases maternal and perinatal mortality. However, although numerous screening tests for preeclampsia have been proposed over the past few decades, no test has so far been shown to appropriately screen for the disease. [90] (Measurement of urinary kallikrein was shown to have a high predictive value, but it was not reproducible. [91, 92] )

 A prospective study demonstrated that an sFlt-1:PlGF ratio of 38 or lower had a negative predictive value of 99.3% (95% confidence interval [CI], 97.9 to 99.9), suggesting an extremely unlikely development of preeclampsia or HELLP (hemolysis, elevated liver enzyme, low platelets) syndrome within 1 week, in women with a clinical suspicion of preeclampsia or HELLP syndrome. [58] Therefore, an sFlt-1:PlGF ratio of 38 or lower may have a potential role in predicting the short-term absence of preeclampsia in women in whom the syndrome is suspected clinically. [58] A randomized trial is necessary to determine the interval of such testing in women suspected on having preeclampsia or HELLP syndrome, as well as the effect of this screening test on maternal and fetal outcomes.

Intensive monitoring in women who are at increased risk for developing preeclampsia, when identified by a predictive test, may lower the incidence of adverse outcome for the mother and the neonate. 

The USPSTF recommends screening pregnant women for preeclampsia with blood pressure measurements throughout pregnancy. [93]


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