Get ahead of preeclampsia with a simple blood test
Insights on preeclampsia management
Preeclampsia is a severe complication related to hypertension affecting pregnant women.
This life-threatening disease can only be cured by the delivery of the baby and contributes largely to maternal and neonatal mortality and morbidity. Preeclampsia can start from week 20 and happens up to 6 weeks after delivery.1
The incidence of preeclampsia has nearly doubled in the US from 2007 to 2019 with an acceleration since 20142
Close to 16% of the pregnant women in the US are suffering from hypertensive disorders of pregnancy3 with half of them developing preeclampsia4
Preeclampsia is the cause of 17% of maternal deaths5 and 15% of premature birth in the US
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The incidence of preeclampsia has nearly doubled in the US from 2007 to 2019 with an acceleration since 20142 |
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Close to 16% of the pregnant women in the US are suffering from hypertensive disorders of pregnancy3 with half of them developing preeclampsia4 |
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Preeclampsia is the cause of 17% of maternal deaths5 and 15% of premature birth in the US |
Contents
Goal of the PRAECIS study6
PRAECIS (Preeclampsia Risk Assessment: Evaluation of cut-offs to Improve Stratification) study was intended to identify and validate a sFlt-1/PlGF ratio to stratify the short-term risk of developing preeclampsia with severe features (sPE) in women with hypertension hospitalized in late pregnancy.
Key results
• At a cut-off of 40, the clinical performance of the sFlt-1/PlGF ratio is:
• 65% PPV (95% CI, 59 to 71)
• 96% NPV (95% CI, 93 to 98)
• 94% Sensitivity (95% CI, 89 to 96)
• 75% Specificity (95% CI, 70 to 79)
• The ratio performed better than standard clinical measures (area under the ROC, 0.92 versus 0.75)
• Women with a ratio >=40 were at higher risk for adverse maternal outcomes (16.1% versus 2.8%; relative risk, 5.8; 95% CI, 2.8 to 12.2)
Conclusion
PRAECIS is the largest prospective U.S. study to date and included 30% Black and 16% Hispanic women. The PRAECIS study clearly demonstrated that in women with a hypertensive disorder of pregnancy presenting between 23 and 35 weeks of gestation, measurement of serum sFlt-1/PlGF provided stratification of the risk of progressing to sPE within the coming fortnight as well as a strong association with adverse outcomes.
Implications for the clinical practice
The measurement of serum sFlt-1/PlGF can be used to determine if patients require stepped up care or to follow expectant management per ACOG guidelines.
Read the full article at the New England Journal of Medicine Evidence.
In the news
- AJOG: Real-world evidence for the utility of serum soluble fms-like tyrosine kinase 1/placental growth factor test for routine clinical evaluation of hospitalized women with hypertensive disorders of pregnancy
- ACOG Clinical Practice Update: Biomarker Prediction of Preeclampsia With Severe Features
- Clinical Lab Products: Making the Case for New Biomarker-based Assays
- 360Dx: Three-Year FNIH-Led Study Could Clear a Path for Earlier Preeclampsia Tests in the US
- Labcorp: Labcorp Launches New Test for Risk Assessment and Prognosis of Severe Preeclampsia in Pregnant Women
- Today's Clinical Lab: Battle against Preeclampsia: Where Do We Stand Today?
- The American Journal of Managed Care: More Informed Management of Preeclampsia Is Necessary
- Time Best Inventions 2023: Thermo Fisher Scientific Preeclampsia Blood Tests
- Wall Street Journal: All Pregnant Women Should Be Screened for Blood-Pressure Disorders, U.S. Advisers Say
- The Pathologist: The Golden Age of Medicine
- Health: FDA Approves First Blood Test to Predict Preeclampsia in Pregnant Women
- CBS News: Blood test to help identify risk of preeclampsia during pregnancy approved by FDA
- New York Times: A Blood Test Predicts Pre-eclampsia in Pregnant Women
- Wall Street Journal: Preeclampsia Blood Test Wins FDA Clearance
PIGF and sFlt-1 assays
B•R•A•H•M•S PIGF plus KRYPTOR and B•R•A•H•M•S sFlt-1 KRYPTOR
The Thermo Scientific™ B•R•A•H•M•S™ PIGF plus KRYPTOR™ is to be used in conjunction with the Thermo Scientific™ B•R•A•H•M•S™ sFlt-1 KRYPTOR™ along with other laboratory test and clinical assessments to aid in the risk assessment of pregnant women (singleton pregnancies between gestational age 23+0 to 34+6/7 weeks) hospitalized for hypertensive disorders of pregnancy (preeclampsia, chronic hypertension with or without superimposed preeclampsia, or gestational hypertension) for progression to preeclampsia with severe features (as defined by The American College of Obstetricians and Gynecologists guidelines) within 2 weeks of presentation.
Ease of handling7,8
B•R•A•H•M•S KRYPTOR Analyzers
Exceptionally precise, fast and easy
The Thermo Scientific™ B•R•A•H•M•S™ KRYPTOR™ compact PLUS automated random access immunoanalyzer is an user-friendly bench-top instrument that can easily be integrated into any laboratory.
- Easy and staightforward laboratory routine with less operator intervention
- Intelligent dilution and separate calibration significantly reduce the need of sample re-run
- Cost reduction due to efficient sample processing
Speak to a clinical specialist to address your questions:
Helpful Resources
- ACOG practice bulletin 222 (2020)
- Cameron et al (2022). J Am Heart Assoc. 11:e023791
- Ford et al (2022). MMWR CDC. 71(17)
- Wen et al (2021). BJOG; 00:1-11.
- Joseph et al (2021). Obstst Gynecol; 137:763-71
- Thadhani et al (2022). NEJM; https://doi.org/10.1056/EVIDoa2200161
- US IFU B·R·A·H·M·S sFlt-1 plus KRYPTOR
- US IFU B·R·A·H·M·S PlGF plus KRYPTOR
