New test predicts life-threatening pregnancy disorder

(SCIENTIFIC AMERICAN) – Even after thousands of studies, questions still linger about one of the most common diseases unique to pregnancy: preeclampsia. This disorder leads to dangerously high blood pressure in about 5 percent of U.S. pregnancies, with significantly higher rates in Black women. And it is becoming more common.

The only known cure is delivery, which creates a serious dilemma: the longer that people with preeclampsia remain pregnant, the sicker they get—but the longer a fetus gestates, the healthier it will be at birth. It is challenging for doctors to predict how intense a case will be in order to make individual treatment decisions.

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A study in NEJM Evidence offers a way to predict whether pregnancy-related high blood pressure will deteriorate into severe preeclampsia, which can cause organ failure, vision loss and stroke. The new research focused on the balance between two pregnancy proteins, says lead author Sarah Kilpatrick, chair of obstetrics and gynecology at Cedars-Sinai Medical Center in Los Angeles. A high level of the protein PIGF (placental growth factor), which stimulates placental growth, is good. A high level of the protein sFlt-1 (soluble fms-like tyrosine kinase) is bad—and is known to rise well before a patient shows signs of preeclampsia. But high sFlt-1 numbers alone don't predict progression to a serious case.

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