Clinical and Biochemical Markers for Prediction of Preeclampsia

Abstract

Submit Manuscript | http://medcraveonline.com disturbed liver function, renal failure and cerebral ischemia. PE is characterized by vasospasm, increased peripheral vascular resistance, and thus reduced organ perfusion [8].Pregnancy per se is a state of oxidative stress arising from the increased metabolic activity in placenta mitochondria and the reduced scavenging power of antioxidants [9]. The aetiology of PE is still not completely understood, although many facts of the disease have been illuminated. Endothelial cell dysfunction would seem to be the common denominator in the various stages of PE and appears to be present from the first trimester of pregnancy [10,11].Prediction and prevention of PE is a very important contribution for maternal health. The only guaranteed primary prevention of PE is avoidance of pregnancy; there are identified risk factors (maternal age, interval between pregnancies and maternal weight). Prevention of PE demands knowledge of the pathophysiological mechanism. Availability of techniques for early detection and intervention in the pathophysiological process are necessary. Finally, prevention of PE is a proper antenatal care which provides screening for hypertension and proteinuria, making intervention, such as timely delivers possible. With an organised antenatal care, such as found in most high in-come countries, the maternal mortality and serious morbidity have decreased.First step in prediction and prevention of PE is detection of women's level of risk for PE, based on factors in her history. Major risk factors for PE are: nuliparity, maternal age >40, prior PE, anti phospholipid antibody syndrome, family history of pe in first-degree relative, renal disease, chronic hypertension, diabetes mellitus, multiple gestations, strong family history of cv disease (heart disease or stroke in ≥2 first-degree relatives), obesity etc [1,3,12]. The maternal demographic characteristics, including medical and obstetric history, are potentially useful in screening for PE, but only when the various factors are incorporated into a combined algorithm derived by multivariate analysis [3].Blood pressure measurement is a screening test routinely used in antenatal care to detect or predict a hypertensive disease. Studies investigating the predictive accuracy of blood pressure measurement report conflicting results. In the period within 20 week of gestation the values of MAP over 85-90 mmHg and values of DBP over 75mmHg are an important predictive indicator for determination of the risk of hypertensive disorders in pregnancy, especially PE [13]. Regarding these conflicting reports, it is uncertain whether blood pressure measurement should be used routinely as a predictive test or should only be used to diagnose hypertensive disorders in pregnancy once they are suspected [14,15].Normal placentation is a process that starts in the first trimester and is more or less completed at the end of the second trimester. In PE, defective invasion of the spiral arteries by cytotrophoblast cells is associated with ...