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Prospective biomarkers in preterm preeclampsia: a review
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Accepted version
Date
2018-03-23
Authors
McCarthy, Fergus P.
Ryan, Roisin M.
Chappell, Lucy C.
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Published Version
Abstract
Preterm pre-eclampsia (prior to 37 weeks’ gestation) remains a major cause of maternal and fetal morbidity and mortality particularly in low to middle income countries. Much research has focused on first and second trimester predictors of pre-eclampsia with the aim of allowing stratification of antenatal care and trialling of potential preventative and therapeutic agents. However, none have been shown to be of benefit in randomised controlled trials. In this literature review we critically evaluate predictive and diagnostic tests for preterm pre-eclampsia and discuss their clinical use and potential value in the management of preterm pre-eclampsia. We defined preterm pre-eclampsia as pre-eclampsia occurring prior to 37 weeks’ gestation. Substantial progress has been made in the development of predictive screening tests for preterm pre-eclampsia, but further research is needed prior to their introduction and integration into routine clinical practice. The performance of diagnostic tests mainly utilising angiogenic and anti-angiogenic factors for determining time to delivery in later pregnancy currently hold more promise than first trimester predictive tests, possible reflecting the heterogeneity of pre-eclampsia.
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Keywords
Hypertension , Preterm pre-eclampsia , Placental growth factor , Pregnancy , Screening
Citation
McCarthy, F. P., Ryan, R. M. and Chappell, L. C. (2018) 'Prospective biomarkers in preterm preeclampsia: a review', Pregnancy Hypertension, In Press, doi:10.1016/j.preghy.2018.03.010