16. Is there any biomarker(s) for predicting immediate delivery or expectant management in preeclampsia?

Abstract

Introduction Preeclampsia is a pregnancy specific disorder and currently the only effective treatment is delivery of placenta. To control maternal and fetal complications, immediate delivery is well recommended, although studies have suggested that expectant management is possible for both severe and mild preeclampsia. A recent study also suggested that the most trigger for delivery in preeclampsia was difficult to control blood pressure. The indications for delivery within or after 48hours were largely dependent on obstetricians’ experiences. Objectives In this study we investigated whether there is any biomarker(s) or clinical parameter(s) that may affect the decision for either immediate delivery or expectant management. Methods Data from157 women with preeclampsia were collected from a referral university teaching hospital and data included clinical parameters and laboratory biomarkers. A retrospective analysis was performed. Results There were 122 cases (77%) who delivered within 48 hours because of either maternal or fetal conditions. Of 157 cases, 110 cases (70%) were early onset preeclampsia. In early onset preeclampsia, 79 cases (72%) delivered within 48 hours. There was no difference in clinical parameters between cases who delivered within 48 hours and who did not. There were no differences in ALT or ASL or ALP or Uric acid or Blood urea nitogen or creatinine or cystatin C or platelet counts between cases who delivered within 48 hours and who did not. In late onset preeclampsia (n = 47), 43 cases (91%) delivered within 48 hours. There were also no differences in both clinical parameters and liver or renal biomarkers between cases who delivered within 48 hours and who did not. Similar findings were also observed in severe and mild preeclampsia. Conclusions Our study demonstrated that there is currently no biomarker(s) for predicting immediate delivery or expectant management. These results were regardless of the severity or the time of onset of preeclampsia.