Preeclampsia is a condition which affects 5-10% of pregnancies, with first time pregnancy posing a higher risk to subsequent pregnancies. It is characterized by hypertension and excess protein in the urine. Preeclampsia can lead to maternal and fetal morbidity, damage to the maternal endothelium, kidneys and liver and leaving the fetus with insufficient blood flow through the placenta.
Preeclampsia can progress into eclampsia if it is not managed, a severe condition which is often fatal. Eclampsia is more likely to develop if preeclampsia occurs after week 37. Generally, preeclampsia occurs between weeks 26 and 36, when it is referred to as ‘early onset preeclampsia’ but it can also occur up to six weeks following birth.
There is currently no cure for preeclampsia, although it can be managed during pregnancy depending on the severity. However, preeclampsia may result in abortion, caesarean section or induced labour depending on the circumstances.
Preeclampsia can also lead to further complications such as HELLP syndrome, which is a liver and blood clotting disorder. HELLP involves haemolysis, elevated liver enzymes and low platelet count.
Due to preeclampsia being one of the main causes of maternal and fetal mortality, early diagnosis is highly important so the condition can be managed, ensuring the best chance of fetal survival.
Many researchers have proposed that a balance between sVEGF Receptor 1, also known as soluble fms-like tyrosine kinase-1 (sFlt-1), Endoglin (CD105), and Placental Growth Factor (PlGF) may play a role in the pathogenesis of preeclampsia.
Low levels of PlGF in the urine of pregnant women seem to predict the early onset of preeclampsia. In women, urinary PlGF levels increase during the first two trimesters with a rapid increase after weeks 21-24 and peaking at weeks 29-33. However, levels are much lower in women who develop preeclampsia. Therefore it is proposed that PlGF can be used as a marker to rapidly determine early onset preeclampsia.
VEGFR-1 and Endoglin are thought to be unregulated in pregnant women developing preeclampsia, and that the increase in these levels correlates with increased severity of the disease. Therefore, it has been suggested that following and initial test, serum levels of all three markers can also be measured in order to cancel out false positive results.
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