Placental growth factor in suspected preterm pre‐eclampsia: a review of the evidence and practicalities of implementation

Hurrell, Alice; Beardmore-Gray, Alice; Duhig, Kate; Webster, Louise; Chappell, Lucy C; Shennan, Andrew

doi:10.1111/1471-0528.16425

Cited by 20 publications

(16 citation statements)

References 44 publications

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“…Regarding the biochemical marker that is most relevant to many predictive models, there are commercially available assays to measure PlGF which have been reviewed by Hurrell et al [ 90 ]. The Triage PlGF test is a single-use fluorescence immunoassay and can be used at the point-of-care with a low-cost analyzer.…”

Section: Low-cost Technologies To Improve Access To Pre-eclampsia Scr...mentioning

confidence: 99%

Pre-eclampsia: a Scoping Review of Risk Factors and Suggestions for Future Research Direction

Lee

Brayboy

Tripathi

2022

Regen. Eng. Transl. Med.

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Most of maternal deaths are preventable, and one-quarter of maternal deaths are due to pre-eclampsia and eclampsia. Prenatal screening is essential for detecting and managing pre-eclampsia. However, pre-eclampsia screening is solely based on maternal risk factors and has low (< 5% in the USA) detection rates. This review looks at pre-eclampsia from engineering, public health, and medical points of view. First, pre-eclampsia is defined clinically, and the biological basis of established risk factors is described. The multiple theories behind pre-eclampsia etiology should serve as the scientific basis behind established risk factors for pre-eclampsia; however, African American race does not have sufficient evidence as a risk factor. We then briefly describe predictive statistical models that have been created to improve screening detection rates, which use a combination of biophysical and biochemical biomarkers, as well as aspects of patient medical history as inputs. Lastly, technologies that aid in advancing pre-eclampsia screening worldwide are explored. The review concludes with suggestions for more robust pre-eclampsia research, which includes diversifying study sites, improving biomarker analytical tools, and for researchers to consider studying patients before they become pregnant to improve pre-eclampsia detection rates. Additionally, researchers must acknowledge the systemic racism involved in using race as a risk factor and include qualitative measures in study designs to capture the effects of racism on patients. Lay Summary Pre-eclampsia is a pregnancy-specific hypertensive disorder that can affect almost every organ system and complicates 2–8% of pregnancies globally. Here, we focus on the biological basis of the risk factors that have been identified for the condition. African American race currently does not have sufficient evidence as a risk factor and has been poorly studied. Current clinical methods poorly predict a patient’s likelihood of developing pre-eclampsia; thus, researchers have made statistical models that are briefly described in this review. Then, low-cost technologies that aid in advancing pre-eclampsia screening are discussed. The review ends with suggestions for research direction to improve pre-eclampsia screening in all settings. Overall, we suggest that the future of pre-eclampsia screening should aim to identify those at risk before they become pregnant. We also suggest that the clinical standard of assessing patient risk solely on patient characteristics needs to be reevaluated, that study locations of pre-eclampsia research need to be expanded beyond a few high-income countries, and that low-cost technologies should be developed to increase access to prenatal screening.

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Section: Low-cost Technologies To Improve Access To Pre-eclampsia Scr...mentioning

confidence: 99%

Pre-eclampsia: a Scoping Review of Risk Factors and Suggestions for Future Research Direction

Lee

Brayboy

Tripathi

2022

Regen. Eng. Transl. Med.

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“…Apart from symptom-based diagnosis, the measurement of circulating angiogenic biomarkers of preeclampsia further facilitates the diagnosis. Of specific value is the determination of circulating levels of sFlt1 and PIGF [8,9,44,45]. In preeclampsia, circulating levels of sFlt1 tend to be increased while circulating PIGF levels are reduced [8,9].…”

Section: Diagnosis Of Preeclampsiamentioning

confidence: 99%

Pathological AT1R-B2R Protein Aggregation and Preeclampsia

Quitterer

AbdAlla

2021

Cells

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Preeclampsia is one of the most frequent and severe complications of pregnancy. Symptoms of preeclampsia usually occur after 20 weeks of pregnancy and include hypertension and kidney dysfunction with proteinuria. Up to now, delivery of the infant has been the most effective and life-saving treatment to alleviate symptoms of preeclampsia because a causative treatment does not exist, which could prolong a pregnancy complicated with preeclampsia. Preeclampsia is a complex medical condition, which is attributed to a variety of different risk factors and causes. Risk factors account for insufficient placentation and impaired vasculogenesis and finally culminate in this life-threatening condition of pregnancy. Despite progress, many pathomechanisms and causes of preeclampsia are still incompletely understood. In recent years, it was found that excessive protein complex formation between G-protein-coupled receptors is a common sign of preeclampsia. Specifically, the aberrant heteromerization of two vasoactive G-protein-coupled receptors (GPCRs), the angiotensin II AT1 receptor and the bradykinin B2 receptor, is a causative factor of preeclampsia symptoms. Based on this knowledge, inhibition of abnormal GPCR protein complex formation is an experimental treatment approach of preeclampsia. This review summarizes the impact of pathological GPCR protein aggregation on symptoms of preeclampsia and delineates potential new therapeutic targets.

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“…PE impacts 2–8% of all pregnancies and is a major cause of both maternal and perinatal morbidity and mortality [ 2 ]. The underlying mechanisms contributing to the pathophysiology of PE are still to be determined [ 2 ] and the condition's involvement of various organs makes diagnosis a challenge [ 3 , 4 ]. Edema in several organs, such as the heart, lung, coelomic cavities, and subcutaneous tissue, which is primarily induced by increased vascular permeability and cardiac dysfunction, should trigger suspicion of PE [ 2 , [5] , [6] , [7] ].…”

Section: Introductionmentioning

confidence: 99%

Gallbladder wall thickening in a woman with postpartum preeclampsia: A case report

Murata

Yoshimoto

Shibano

et al. 2022

Case Reports in Women's Health

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Background Preeclampsia (PE) is hallmarked by dysfunction of various organs; therefore, its diagnosis can be challenging, especially when patients present with right upper abdominal pain. Herein, we present a case of postpartum gallbladder wall thickening (GBWT) that led to a diagnosis of PE, rather than hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome or gallbladder and biliary disease. Case Presentation A 31-year-old postpartum woman presented with a fever, hypertension, headache, and right upper abdominal pain. HELLP syndrome and intracranial hemorrhage were initially suspected, due to the combination of symptoms and elevated levels of aspartate transaminase, alanine transaminase, and lactate dehydrogenase. However, hemolysis and thrombocytopenia were absent, and a computed tomography (CT) scan of the head did not indicate the presence of intracranial hemorrhage. Further, transabdominal ultrasound and CT revealed GBWT (edematous gallbladder); CT also revealed an enlarged heart, lung edema, pleural effusion, and ascites. Thus, PE, rather than HELLP syndrome or gallbladder or biliary disease, was diagnosed based on gestational hypertension and proteinuria, new-onset headache, liver dysfunction, and edema in several organs, including the lung. Nicardipine treatment quickly improved hypertension and headache, and, over time, the patient's urination increased, and edema subsided throughout the body. Furthermore, laboratory results improved, and the patient was discharged on postpartum day 11. Conclusion Postpartum gallbladder wall thickening can be a diagnostic sign of PE.

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Placental growth factor in suspected preterm pre‐eclampsia: a review of the evidence and practicalities of implementation

Cited by 20 publications

References 44 publications

Pre-eclampsia: a Scoping Review of Risk Factors and Suggestions for Future Research Direction

Pre-eclampsia: a Scoping Review of Risk Factors and Suggestions for Future Research Direction

Pathological AT1R-B2R Protein Aggregation and Preeclampsia

Gallbladder wall thickening in a woman with postpartum preeclampsia: A case report

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