To diagnose preeclampsia, healthcare providers rely on measurable signs: a woman’s blood pressure, the amount of protein in her urine, and tests for how well her organs are working (specifically, lungs, kidneys, liver, brain, and platelets in her blood). These diagnostic criteria can sometimes be less than ideal for a few reasons:
An accurate preeclampsia diagnosis is important: women with suspected preeclampsia who may not actually have preeclampsia could be unnecessarily admitted to the hospital for monitoring or even delivered prematurely.
Researchers in this recent study asked if a new blood test could rule out a diagnosis of preeclampsia in at-risk pregnant women presenting with signs and symptoms of preeclampsia.
The test is novel because it measures eight different markers that link to the mechanisms likely causing preeclampsia. The test measures three blood vessel growth factors, two placenta function factors, one hypoxia (lack of oxygen) factor, and one inflammation factor. To answer this research question, 1,036 pregnant women between 28-36 weeks of pregnancy with suspected preeclampsia (new or worsening high blood pressure, new or worsening protein in urine, and other signs or symptoms that needed evaluation to rule out preeclampsia) completed this study across 20 different sites in the United States. The patients were followed after the test to see if they went on to be diagnosed with preeclampsia. Researchers found that the test had a high negative predictive value, meaning 95% of those who tested negative for preeclampsia with this new test would actually not have preeclampsia for the 7 days after testing.
Take home message: This is a large, well-designed, multi-site study showing promising results for a new test to rule out preeclampsia among women with suspected preeclampsia. This could be a useful test to use in clinical settings to avoid unnecessary admissions to the hospital for monitoring or even premature delivery.
Citation: Costantine MM, Sibai B, Bombard AT, Sarno M, West H, Haas DM, Tita AT, Paidas MJ, Clark EAS, Boggess K, Grotegut C, Grobman W, Su EJ, Burd I, Saade G, Chavez MR, Paglia MJ, Merriam A, Torres C, Habli M, Macones G, Wen T, Bofill J, Palatnik A, Edwards RK, Haeri S, Oberoi P, Mazloom A, Cooper M, Lockton S, Hankins GD. Performance of a Multianalyte 'Rule-Out' Assay in Pregnant Individuals With Suspected Preeclampsia. Hypertension. 2022 May 12:101161HYPERTENSIONAHA12219038. doi: 10.1161/HYPERTENSIONAHA.122.19038. Epub ahead of print. PMID: 35545947.
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