Contemporary prediction of preeclampsia

Abstract

To provide a concise review of advances in prediction of preeclampsia, highlighting the most important and interesting articles among the many published within the past months, making a clear distinction between early and late clinical forms of the condition. The performance of maternal levels of angiogenic factors to predict preeclampsia, especially early-onset preeclampsia, could be further improved by combining several markers and by evaluating the longitudinal changes between the first and second trimester. Combining first trimester angiogenic factors with maternal history, mean blood pressure and uterine artery Doppler achieves a detection rate of approximately 90% for an approximately 10% of false positives for early preeclampsia. The incorporation of parameters reflecting maternal vascular stiffness into multiparametric models in contingent strategies might result in fewer tests than concurrent screening, with similar prediction performance. Combining several tests into multiparametric models results in the early identification of the vast majority of cases bound to develop early preeclampsia, which is the clinical form that most contributes to adverse maternal and perinatal outcome. This may allow more efficient allocation of resources according to the individual risk and the evaluation of prophylactic strategies in a selected subgroup of women.