Even after thousands of studies, questions still remain about one of the most common conditions unique to pregnancy, pre-eclampsia. The disorder leads to dangerously high blood pressure in about 5% of pregnancies in the United States, and the rate is significantly higher in black women. And it’s becoming more common.
The only known cure is delivery, which poses a serious dilemma. The longer a person with pre-eclampsia is pregnant, the worse the disease is, but the longer the fetus is pregnant, the better the health at birth. It is difficult for doctors to predict a patient’s severity for individual treatment decisions.
research in NEJM record provide a way to predict whether pregnancy-related hypertension will deteriorate to severe pre-eclampsia. This can lead to organ failure, vision loss, and stroke. The new study focuses on the balance between two pregnancy proteins, said lead author Sarah Kilpatrick, chair of obstetrics and gynecology at Cedars-Sinai Medical Center in Los Angeles. High levels of the protein PIGF (placental growth factor) are good to stimulate placental growth. known to rise. However, a high sFlt-1 number alone does not predict progression to severe cases.
To determine how protein levels are associated with disease, Kilpatrick’s team studied 1,014 racially and geographically diverse high-risk patients between 23 and 35 weeks’ gestation. All were already hypertensive and had been admitted to one of 18 urban or suburban hospitals.
The team found that patients were more likely to develop severe pre-eclampsia within two weeks if the “bad” to “good” protein ratio was 40 or higher. , the probability was less than 5%. Kilpatrick says a ratio of say 10 allows doctors to monitor high-risk patients at home, while a ratio of 100 allows patients to be transferred to hospitals where complications of pre-eclampsia and premature babies can be managed. suggests. “For an incredibly complex disease, knowing this risk can actually be of clinical benefit,” he says. “For me, it’s probably the most important thing.”
William Grobman, an expert in maternal-fetal medicine at Ohio State University, says there is currently no rapid, definitive test for pre-eclampsia. The study doesn’t remove all uncertainty, but it does give clinicians a “better understanding of who gets worse with the condition in a given period of time.” looking forward to it. Meanwhile, Kilpatrick sees the study as an important step toward FDA approval for such tests.
