Pre-eclampsia affects 3-8% of all pregnancies and is one of the most common causes of death during pregnancy. Pre-eclampsia is a pregnancy related disorder characterized by high blood pressure and protein in the urine. The blood pressure is defined as high when the systolic pressure is greater than 140 mmHg or the diastolic pressure is greater than 90 mmHg and when measured at two separate times. Two forms of pre-eclampsia are currently recognized, the early-onset pre-eclampsia, which occurs after week 20 and before week 34 of gestation, and the late-onset preeclampsia, which occurs after week 34 of gestation. The late-onset pre-eclampsia is the most frequent form, but the early-onset can be considered the more severe form. Women who have had pre-eclampsia are at increased risk to develop cardio-vascular diseases, like heart disease and stroke, later in life.

In the severe disease there might be a combination of impaired liver function, swelling, shortness of breath, visual disturbances, low platelet count and increased red blood cell breakdown, which together result in an increased risk of a poor outcome for mother and child. When left untreated the mother will be confronted with seizures at which point the disease is known as eclampsia.

Pre-eclampsia is a syndrome which means that there are multiple systems (organs) in the body involved in the pathogenesis. There have been many assessments of tests that could give a prognostic value in relation to the risk of developing pre-eclampsia. Due to the nature of the disorder it is likely that no single marker will be sufficient. Currently   ultrasonography of the uterine arteries in combination with one or two angiogenic biomarkers will be likely to give the combination with the highest prognostic value. However the angiogenic biomarkers currently used only seem to have value in the second trimester of gestation. IQ Products is doing research to define markers that already are of value in the first trimester and make it possible to get a risk assessment around week 12 of gestation.

Risk Factors for pre-eclampsia:

• Prior (chronic) hypertension
• Never given birth before
• Prior or family history of pre-eclampsia
• Obesity
• Diabetes mellitus
• Multiple gestation (twins)
• Older age (>35 years)

References:

1. Pauli JM and Repke JT. Preeclampsia: Short-term and Long-term Implications. Obstet Gynecol Clin North Am. 2015 Jun;42(2):299-313 (PMID:26002168)
2. Chaiworapongsa T, et al. Pre-eclampsia part 1: current understanding of its pathophysiology. Nat Rev Nephrol. 2014 Aug;10(8):466-80 (PMID:25003615)