Diagnosis Of Preeclampsia Research Articles

Artificial Intelligence in Early Diagnosis of Preeclampsia.

Every day, 810 women die of preventable causes related to pregnancy and childbirth worldwide, and preeclampsia is among the top three causes of maternal deaths. To develop a diagnostic system with artificial intelligence for the early diagnosis of preeclampsia. This retrospective study included pregnant women who were screened for the inclusion criteria on the hospital's database, and the sample consisted of the data of 1158 pregnant women diagnosed with preeclampsia and 9194 pregnant women who were not diagnosed with preeclampsia at Kahramanmaras Necip Fazıl City Hospital Gynecology and Pediatrics Additional Service Building, Kahramanmaras/Turkey. The statistical analysis was performed using the Statistical Package for social sciences (SPSS) version 22 for windows. Artificial intelligence models were created using Python, scikit-learn, and TensorFlow. The model achieved 73.7% sensitivity (95% confidence interval (CI): 70.2%-77.1%) and 92.7% specificity (95% CI: 91.7%-93.6%) on the test set. Furthermore, the model had 90.6% accuracy (95% CI: 90.1% - 91.1%) and an area under the curve (AUC) value of 0.832 (95% CI: 0.818-0.846). The significant parameters in predicting preeclampsia in the model were hemoglobin (HGB), age, aspartate transaminase level (AST), alanine transferase level (ALT), and the blood group. Artificial intelligence is effective in the prediction and diagnosis of preeclampsia.

Validation of a new kit for preeclampsia screening: A comprehensive analysis

ObjectivesPreeclampsia is a common pregnancy complication that significantly contributes to maternal mortality, perinatal mortality, and preterm delivery. The sFlt-1/PlGF (fms-like tyrosine kinase-1/placental growth factor) ratio has demonstrated robust diagnostic value for preeclampsia. This study assessed the analytical performance and diagnostic accuracy of a novel quantitative determination kit for sFlt-1 and PlGF for the diagnosis of preeclampsia. MethodsThe detection performance of the test kit was validated using the Center for Medical Device Evaluation (CMDE) and Clinical and Laboratory Standards Institute (CLSI) documents. The test results were compared to those of the Elecsys immunoassay (Roche Diagnostics). Independent discovery and validation sets were used to analyze the diagnostic efficacy of the preeclampsia kit. The area under the curve (AUC) for preeclampsia at different gestational ages was calculated. ResultsCorrelation analysis between the test and Roche kits revealed a strong concordance (sFlt-1: r = 0.9966, P < 0.0001; PlGF: r = 0.9935, P < 0.0001). The AUCs for sFlt-1, PlGF, and the sFlt-1/PlGF ratio in diagnosing preeclampsia were 0.749, 0.795, and 0.834, respectively, in the discovery set and 0.729, 0.811, and 0.831, respectively, in the validation set. The corresponding results from the Roche kit were 0.741, 0.795, and 0.829, respectively, and 0.761, 0.864, and 0.844, respectively. ConclusionsQuantitative sFlt-1 and PlGF kits exhibited high levels of consistency with the Roche kits in terms of quantitative outcomes and diagnostic performance for preeclampsia.

Factors associated with early readmission for postpartum hypertension

BackgroundHypertensive disorders of pregnancy are increasing in prevalence and a leading cause of early post-partum readmissions. Stricter blood pressure (BP) target goals for treatment of hypertension during pregnancy have recently been proposed, however, the treatment goals for management of post-partum hypertension are less well established. ObjectiveWe sought to evaluate the clinical factors associated with early postpartum readmissions for hypertensive disease as well as to evaluate blood pressure thresholds associated with these readmissions. Study designWe conducted a retrospective cohort study of women delivering at a tertiary care center between January 2018 and May 2022 who experienced a hospital readmission for postpartum hypertension or new onset postpartum preeclampsia. Charts were reviewed for clinical and sociodemographic data. Patients with early readmission (<72 hours after discharge) were compared with patients readmitted after three days of initial discharge. Data were analyzed using Chi-square, Student's t-test, Mann-Whitney U test, and logistic regression where appropriate. The p-value <0.05 was significant. ResultsDuring the study period, 23,372 deliveries occurred. Postpartum readmission due to worsening of a known diagnosis of hypertension or new onset postpartum preeclampsia occurred in 1.1% and 0.49% respectively. Patients with early readmission were more likely to have hypertensive disorders of pregnancy (HDP) as the indication for delivery. Among patients readmitted, 93% had two or more systolic BP ≥ 140 or diastolic BP ≥ 90, and 73% had blood pressure of either systolic between 130-139 or diastolic between 80-89 within 24 hours prior to initial discharge. Only 27 patients met criteria (BP ≥ 160/110 on more than one vitals check during their hospitalization) to be started on antihypertensives prior to initial delivery discharge; of those 25 (93%) were discharged with a new prescription for an antihypertensive. After controlling for confounding variables, predischarge blood pressure between 130-140/80-90 mmHg [aOR 2.4(1.5-4.0] was associated with an increased likelihood of early readmission. ConclusionsPatients with delivery for HDP and predischarge BP ≥140/90 mmHg were less likely to have an early readmission within 3 days of initial discharge, however, patients with predischarge BP 130-139/80-89 were more likely to have an early readmission for HDP and postpartum preeclampsia. Further research is indicated to evaluate interventions to prevent postpartum readmission in patients at high risk for persistent hypertension or new onset postpartum preeclampsia.

Urinary concentration of Cathepsin D as a relievable marker of preeclampsia

BackgroundThe early and accurate diagnosis of preeclampsia is crucial to avoid serious complications for both the mother and baby. However, the current diagnostic methods are limited, and there is a need for new diagnostic biomarkers. Previous studies have shown that cathepsin D (CTD) participates in the pathophysiology of preeclampsia and is present in urine samples, making it a potential biomarker for the disease. This study aimed to compare urinary and serum levels of CTD in preeclamptic and normotensive women and analyze its potential role as a diagnostic biomarker in preeclampsia. MethodsThe study included thirty-nine patients with preeclampsia and twelve normotensive pregnant women as controls. Biomarkers were determined using Multiplex Assay kit, and serum prolactin (Prl) and urinary TNF-α levels were also evaluated. Statistical analysis was conducted using the Mann-Whitney U test. ResultsWe found that urinary and serum CTD levels were significantly higher in the preeclampsia group than in the normotensive group, suggesting that CTD could be a diagnostic biomarker for preeclampsia. No significant differences were found in the levels of serum prolactin or urinary TNF-α between the two groups. ConclusionsThe study provides evidence that non-invasive biological samples such as urine can be used to improve new therapeutic strategies for the early management of preeclampsia.

Differences in Cardiometabolic Proteins in Pregnancy Prioritize Relevant Targets of Preeclampsia.

Preeclampsia is a hypertensive disorder of pregnancy characterized by widespread vascular inflammation. It occurs frequently in pregnancy, often without known risk factors, and has high rates of maternal and fetal morbidity and mortality. Identification of biomarkers that predict preeclampsia and its cardiovascular sequelae before clinical onset, or even before pregnancy, is a critical unmet need for the prevention of adverse pregnancy outcomes. We explored differences in cardiovascular proteomics (Olink Explore 384) in 256 diverse pregnant persons across 2 centers (26% Hispanic, 21% Black). We identified significant differences in plasma abundance of markers associated with angiogenesis, blood pressure, cell adhesion, inflammation, and metabolism between individuals delivering with preeclampsia and controls, some of which have not been widely described previously and are not represented in the preeclampsia placental transcriptome. While we observed a broadly similar pattern in early (<34 weeks) versus late (≥34 weeks) preeclampsia, several proteins related to hemodynamic stress, hemostasis, and immune response appeared to be more highly dysregulated in early preeclampsia relative to late preeclampsia. These results demonstrate the value of performing targeted proteomics using a panel of cardiovascular biomarkers to identify biomarkers relevant to preeclampsia pathophysiology and highlight the need for larger multiomic studies to define modifiable pathways of surveillance and intervention upstream to preeclampsia diagnosis.

Índice proteinuria/creatinuria relacionado con preeclampsia con signos de gravedad en pacientes.

Introduction: Preeclampsia is a common hypertensive disorder in pregnant women, whose impact varies depending on its severity and can affect target organs such as the kidneys. The proteinuria/creatinuria index is a test that can be performed in pregnant patients to corroborate the existence of significant proteinuria, which could be found within the diagnosis of preeclampsia. The objective of the study was to determine the association between the proteinuria/creatinuria index and women with signs of severity in preeclampsia. Methods: observational, analytical, retrospective study. The data were taken from the José Carrasco Arteaga Specialty Hospital database in Cuenca-Ecuador between January 2017 and December 2021. The statistical analysis used the SPSS 25 program and Microsoft Excel 2018. The association between variables was evaluated with the chi-square test and calculation of odds ratios. Results: 149 cases were included, the mean age was 31.9 ± 5.5 years, 49% were married, and 64.4% were from the urban area. 35.7% were nulliparous, with the average gestational age being 34.6 ± 4.2 weeks. The universe consisted of 149 preeclamptic patients, of which 86.6% (n=129) presented signs of severity. The median proteinuria/creatinuria ratio was 0.58 (0.26-1.66) mg/dL. The proteinuria/creatinuria index was not associated with preeclampsia with signs of severity (X2=2.161; OR=2.547; 95% CI=0.706- 9.186; P=0.153). Conclusion: This study's proteinuria/creatinuria index was not associated with preeclampsia with signs of severity.

Prediction of pregnancy-related complications in women undergoing assisted reproduction, using machine learning methods

To use machine learning methods to develop prediction models of pregnancy complications in women who conceived with assisted reproductive techniques (ART). A nation-wide register-based cohort study with prospectively collected data. Swedish national registers and nationwide quality IVF register. all nulliparous women who achieved birth within the first 3 ART treatment cycles between 2008 and 2016 in Sweden. Characteristics before the use of ART, such as demographics and medical history, were considered potential predictors in the development of before treatment prediction models. ART treatment details were further included in after treatment prediction models. Potential diagnoses of preeclampsia, placental complications (previa, accreta, and abruption), and postpartum hemorrhage were identified using the International Classification of Diseases recorded in the Swedish Medical Birth and Patient registers, respectively. Multiple prediction model algorithms were performed and compared for each outcome and treatment cycle, including logistic regression, decision tree model, naïve Bayes classification, support vector machine, random forest, and gradient boosting. The performance of each model was assessed with C statistic, and nested cross-validation was used to aid model selection and hyperparameter tuning. A total of 14,732 women gave birth after the first (N = 7,302), second (N = 4,688), or third (N = 2,742) ART cycle, representing birth rates of 24.1%, 23.8%, and 22.0%. Overall prediction performance did not vary much across the different methods used. In the first cycle, the before treatment prediction performance was at best 66%, 66%, and 60% for preeclampsia, placental complications, and postpartum hemorrhage, respectively. Inclusion of after treatment characteristics conferred slight improvement (approximately 1%-5%), as did prediction in later cycles (approximately 1%-5%). The top influential and consistent predictors included age, region of residence, infertility diagnosis, and type of embryo transfer (fresh or frozen) in the later (2nd and 3rd) cycles. Body mass index was a top predictor of preeclampsia and was also influential for placental complications but not for postpartum hemorrhage. The combined use of demographics, medical history, and ART treatment information was not enough to confidently predict serious pregnancy complications in women who conceived with ART. Future studies are needed to assess if additional longitudinal follow-up during pregnancy can improve the prediction to allow clinical protocol development.

CercaTest Red, a novel urine-based point-of-care test for the detection of preeclampsia

Objectives Preeclampsia (PE) poses a serious threat to the health of the pregnant woman and her developing fetus due to the difficulty in diagnosing the condition. The disease can develop and worsen suddenly without noticeable signs and symptoms. Thus, there is an urgent need for a simple Point of Care Test (POCT) that improves accessibility to testing and can be used as an aid in the diagnosis of PE. CercaTest Red is a noninvasive detection kit for impending preeclampsia using urine from pregnant women. This is especially pertinent for women who have limited access to secondary/tertiary healthcare as those in remote settings, low-income countries or simply lack of out of hours laboratory services. Methods The kit employs an absorptive column that separates Congo red dye bound to urinary misfolded protein from pregnant women and unbound dye. When a solution of Congo red dye pre-mixed with urine is loaded onto the absorptive matrix in a detection cuvette, the presence (positive) or absence (negative) of misfolded proteins can be determined based on the color of eluate collected in the lower section of the cuvette. 190 and 937 pregnant women who were >18 years old at the gestational age of ≥20 weeks were enrolled for the feasibility and validation cohort, respectively. The consistency between CercaTest Red and clinical diagnosis of PE according to the American College of Obstetricians and Gynecologist (ACOG) Guidelines was analyzed using the kappa statistic. Results The POCT has a limit of detection (LoD) of human urinary misfolded proteins equivalent to 0.45 μM of denatured human serum albumin, with high reproducibility and stability. An accuracy of 96.84% for diagnosis of preeclampsia with a Kappa statistic of 0.746 (p < 0.001) was validated in a cohort of 937 subjects. Conclusion This test is easy to use, cost-effective and portable with short turnaround time and no laboratory instrument requirement. In the future, the test may have the potential to become quantitative using spectroscopy (Chinese Clinical Trial Registry No. ChiCTR1800017692).

Proteinuria en rango nefrótico en gestantes.

Introduction: Physiological changes in pregnant women can be altered by the appearance of pathological phenomena such as proteinuria in the nephrotic range, relevant in the diagnosis of preeclampsia and glomerular disease. The objective of the present study was to describe the clinical characteristics and results of pregnant women with nephrotic proteinuria in a reference center in Cuba. Methods: The present observational, prospective, longitudinal follow-up study, which lasted 12 weeks, was conducted at the Vladimir Ilich Lenin General Hospital in Holguín, Cuba, between October 2020 and September 2022. All pregnant women with proteinuria in the nephrotic range were registered. The variables were age, body mass index at pregnancy detection, gestational age, African descent, number of pregnancies, serum creatinine, proteinuria in 24 hours at the onset of symptoms, and clinical history. Descriptive statistics are presented. Results: 48 patients entered the study. White, primigravida pregnant women predominated; the average age was 24.8 years. The average gestational time was 31.8 weeks, and serum creatinine was 94.8 µmol/L. The main personal medical history was arterial hypertension and systemic lupus erythematosus. There was no statistical association between the age groups and the persistence of proteinuria. Pregnant women with proteinuria before 20 weeks maintained it after 12 weeks postpartum, defining it as kidney disease. Pregnant women with previous high blood pressure had a 2.2 times higher risk of preeclampsia. Conclusion: In both causal groups (preeclampsia and kidney disease), there were maternal-fetal complications, highlighting induced abortion, preterm birth, intrauterine growth retardation, and low birth weight.

Maternal, obstetrical, and neonatal outcomes in celiac disease

Objectives Some studies have suggested a link between celiac disease (CD) and adverse maternal, obstetrical, and neonatal outcomes. Using a large database, we evaluated the effect of CD on pregnancy outcomes. Methods We conducted a retrospective cohort study using the National Inpatient Sample (NIS) of all deliveries from 2015 to 2019 in the United States. Using ICD-10 codes, we identified pregnant patients who had CD and those who did not. A multivariate logistic regression was used to generate odds ratios (ORs) with 95% confidence intervals (CIs) for maternal, obstetrical, and neonatal outcomes. Results Of 12,039,222 deliveries between 2015 and 2019, there were 10,555 births in women with CD. Pregnant women with CD were more likely to be white and older compared to those without CD. Pregnant women with CD were significantly more likely to carry a diagnosis of gestational hypertension (OR 1.26; 95% CI 1.04–1.52), preeclampsia (1.28; 1.08–1.53), and severe preeclampsia (1.62; 1.25–2.09). They were less likely to have a full-term uncomplicated delivery (OR 0.11; 95% CI, 0.05–0.20), while being more likely to require device-assisted delivery (1.25; 1.04–1.50) and sustain 3rd or 4th degree vaginal lacerations (1.56; 1.21–2.02). Babies of pregnant women with CD were more likely to be small for gestational age (SGA) (OR 1.29; 95% CI 1.03–1.61). Conclusions CD in pregnancy appears to be associated with increased adverse maternal, obstetrical, and neonatal outcomes. Clinicians should discuss these increased risks with CD patients who are planning to conceive.

SFlT-1/PlGF ratio as a predictor of preeclampsia in COVID-19 pregnant patients

The association between SARS-CoV-2 infection in pregnancy and preeclampsia is widely debated in numerous studies. The aim of our study was to investigate whether an increased sFlt-1/PlGF ratio is a good marker of preeclampsia in pregnant patients with COVID-19 infection. This single centre prospective study was conducted in the Department of Obstetrics and Gynaecology, at the Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw. The study group consisted of 68 COVID-19 pregnant patients and 57 SARS-CoV-2 negative pregnant controls. Serum sFlt-1/PlGF ratio was assessed. The two groups did not differ in terms of the frequency of IVF, nulliparity, history of hypertension, pre-gestational diabetes and chronic kidney disease. The primary outcome was the diagnosis of preeclampsia. Preeclampsia was diagnosed in 10 patients in both groups. The sFlt-1/PlGF ratio higher than 38, considered highly suggestive of developing preeclampsia, was found in 20 patients in the COVID-19 group and 15 patients in the control group. The odds of developing preeclampsia in patients with sFlt-1/PlGF ratio > 38 was approximately 4-fold higher in COVID-19 group and 11-fold higher in controls. Sflt-1/PlGF ratio does not differ significantly between the SARS-CoV-2-positive and SARS-COV-2-negative pregnant patients. The sFlt-1/PlGF ratio > 38 is associated with higher odds of the diagnosis of preeclampsia in both of these groups, and therefore may serve as its marker regardless of COVID-19 infection status.

PERINATAL AND MATERNAL OUTCOME OF PREECLAMPSIA WITH SEVERITY FEATURE MANAGED EXPECTANTLY AT ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE (SPHMMC), 2021, ADDIS ABABA, ETHIOPIA. A CROSS SECTIONAL STUDY

ABSTRACT Background Preeclampsia refers to the new onset of hypertension and proteinuria after 20 weeks of gestation in a previously normotensive woman. It is labeled as Preeclampsia with severe features when one of the severity signs occurs. Worldwide, Preeclampsia occurs in up to 7.5 percent of pregnancies and 10 - 15 % of direct maternal deaths are associated with preeclampsia and eclampsia. Majority of adverse maternal and perinatal outcome occur in Preeclampsia with severe features and when Preeclampsia occurs remote from term ( ). Objective The main objective of this study was to determine the maternal and perinatal outcome of Preeclampsia with severe features managed expectantly at SPHMMC in one year period. Materials and Methods: Facility based cross-sectional study was conducted. The study participants were selected consecutively by including all mothers admitted during the study period (January 2021 to December 2021 G.C.) with the diagnosis of Preeclampsia with severe features to SPHMMC that fulfill the inclusion criteria. Data taken was, the patients chart and a direct patient interview using pre-tested &amp; structured questionnaire. Collected data was entered in to Epi info version 7 &amp; analysis was made through SPSS version 25. Descriptive statistics, tables &amp; figures was used to describe the study finding. Result –the mean days of prolongation of pregnancy was 11.5 days with slight increment of maternal complication from expected proportion that completely resolved postpartum. The most common maternal complications were HELLP syndrome (15.1%) and abruptio placenta (7.2%). There were 21 perinatal deaths (08 still births and 13 neonatal deaths) that give perinatal mortality rates of 276 per 1000 live births. The rate of NICU admission was 66.7% and the neonatal survival to seventh day was 71.7%. Only 66(90.4%) of the women were a good candidate for expectant management. Magnesium sulphate and steroid (dexamethasone) at admission was given 100% but 8.2% of the mothers didn’t get magnesium sulphate during intra partum and post partum period. Conclusion / Recommendation - Proper selection of pregnant mothers with pre-eclampsia with severity feature and Close and frequent maternal and fetal surveillance during expectant management is associated with a good perinatal outcome without significant difference in maternal complication. Key Words: pre-eclampsia ,Perinatal outcome, maternal complication.

Evaluation of Therapy in Preeclampsia Patients in Several Public and Private Hospitals

Objective: To determine the rationality and effectiveness of therapy in preeclampsia patients at the Inpatient Installation of several public and private hospital in Banyumas area from January-December 2021.&#x0D; Methods: This study is retrospective, employing purposive sampling for data collection. The data were extracted from the medical records of patients diagnosed with pre-eclampsia at the Inpatient Installation. The sample consisted of 212 patients with a confirmed diagnosis of pre-eclampsia.&#x0D; Results: From this study, it was found that antihypertensive medications given were methyldopa (52.8%), nifedipine (45.2%), and amlodipine (2%). It was found that the results of the five appropriate analyses were the suitable indication, right patient, proper medication, right dose, and correct route (100%). The antihypertensive medications used were effective in reducing the blood pressure of preeclampsia patients (100%), with an average decrease in systolic pressure by 37 mmHg, an average decrease in diastolic pressure by 22 mmHg, and an average decrease in MAP by 28 mmHg.&#x0D; Conclusion: Antihypertensives given to preeclampsia patients in several public and private hospitals in Banyumas were rational and effective in reducing the patient's blood pressure.&#x0D; Keywords: antihypertensives, effectiveness, preeclampsia, rationality.

Circulating miRNAs and Preeclampsia: From Implantation to Epigenetics.

In this review, we comprehensively present the literature on circulating microRNAs (miRNAs) associated with preeclampsia, a pregnancy-specific disease considered the primary reason for maternal and fetal mortality and morbidity. miRNAs are single-stranded non-coding RNAs, 20-24 nt long, which control mRNA expression. Changes in miRNA expression can induce a variation in the relative mRNA level and influence cellular homeostasis, and the strong presence of miRNAs in all body fluids has made them useful biomarkers of several diseases. Preeclampsia is a multifactorial disease, but the etiopathogenesis remains unclear. The functions of trophoblasts, including differentiation, proliferation, migration, invasion and apoptosis, are essential for a successful pregnancy. During the early stages of placental development, trophoblasts are strictly regulated by several molecular pathways; however, an imbalance in these molecular pathways can lead to severe placental lesions and pregnancy complications. We then discuss the role of miRNAs in trophoblast invasion and in the pathogenesis, diagnosis and prediction of preeclampsia. We also discuss the potential role of miRNAs from an epigenetic perspective with possible future therapeutic implications.

UNLOCKING THE FUTURE OF MATERNAL HEALTH: PLATELET INDICES AS PREDICTORS OF PREECLAMPSIA

Objective: Preeclampsia is a dangerous pregnancy condition that puts the health of the mother and fetus at great risk. Early diagnosis and treatment of this illness depend on predictive signs. Because of their correlation with coagulation problems, platelet indices, such as platelet count (PC), platelet distribution width (PDW), mean platelet volume (MPV), and platelet crit (PCT), may be useful as biomarkers for preeclampsia. The purpose of this study is to find out how well platelet indices can predict preeclampsia.&#x0D; Methods: From Mar 1, 2021, to Feb 28, 2022, the study was carried out at the Kamla Nehru State Hospital for Mother and Child in Shimla, Himachal Pradesh. Pregnant women without pre-existing illnesses were removed, and those with normotension who had singleton pregnancies after 20 w of gestation were included. Patients were classified according to the degree and course of preeclampsia, and platelet indices were monitored during pregnancy. To ascertain the significance of fluctuations in the platelet index, statistical tests were conducted and data were analyzed using SPSS-PC-25.&#x0D; Results: According to the study, patients with preeclampsia (PE) and normotensive individuals had significantly different platelet indices. Compared to people with normotension, PE patients showed higher platelet distribution width (PDW), a lower platelet count, and an elevated mean platelet volume (MPV). Interestingly, MPV increased noticeably in PE before blood pressure rose. In severe PE patients, the platelet count drastically reduced. The potential of MPV and platelet count as predictors of PE was shown by Receiver Operating Characteristic (ROC) curve analysis. These results demonstrate the importance of platelet indices in the diagnosis of PE and the potential use of these indices as early indicators of this hypertensive condition in pregnancy.&#x0D; Conclusion: Platelet indices show potential as early indicators for identifying and tracking preeclampsia, especially platelet count, MPV, and PDW. Monitoring platelet indices in addition to blood pressure may help determine the extent and course of the illness, which might lead to better results for both the mother and the fetus. To improve clinical usefulness and improve prediction models, more research in this area is necessary.

Point-of-care diagnosis of pre-eclampsia based on microfiber Bragg grating biosensor

Pre-eclampsia is a serious multi-organ complication that severely threatens the safety of pregnant women and infants. To accurate and timely diagnose pre-eclampsia, point-of-care (POC) biosensing of the specific biomarkers is urgently required. However, one of the key biomarkers of pre-eclampsia, placental growth factor (PlGF), has a reduced level of expression in patients, which challenges the quantification capability and Limit-of-detection (LOD) of biosensors. Herein, we reported a microfiber Bragg grating biosensor for the quantification of PlGF in clinical serum samples. The Bragg grating was inscribed in a unilateral tapered fiber to generate the segmented Fabry-Perot spectrum for improving the capability of detection. Furthermore, a temperature-calibrated Bragg grating was added to enable dual parametric detection of PlGF and temperature simultaneously for removing the crosstalk. Finally, the biosensor was envisaged to be perfectly compatible with microfluidic chips, and thus dramatically reducing the sample consumption to as small as 10 μL. The proposed biosensor can respond to PlGF with concentrations ranging from 5 to 120 pg mL−1, attaining a LOD of 5 pg mL−1 of clinical relevance. More importantly, the biosensor achieved micro volume detection of clinical serum samples from patients, and the ROC curve with an AUC of 0.977 confirmed the viability of the device. Our study paves the way to a new idea for cost-effective and high-precision screening of patients with pre-eclampsia, and hence envisages a promising prospect for point-of-care (POC) diagnosis of patients with pre-eclampsia.

Urine Congo red test for the detection of preeclampsia in pregnant women presenting with suspected preeclampsia

Objectives To determine the predictive performance of the urine Congo red point-of-care test for the identification of preeclampsia in women presenting with suspected preeclampsia. Methods A prospective multi-center cohort study was conducted to include women with suspected preeclampsia (n = 244). The urine Congo red test was determined (score range 1–8). The diagnosis of preeclampsia was based on criteria proposed by The American College of Obstetricians and Gynecologists. The primary outcome was the predictive performance (sensitivity, specificity, negative and positive predictive values, as well as likelihood ratios) of the Congo red kit test for the diagnosis of preeclampsia. Results Fifty-four percent (131/244) of women with suspected preeclampsia subsequently developed preeclampsia. The sensitivity and specificity of the urine Congo red test were 49.6% and 94.7%, respectively, when using a cutoff for Congo red ≥4. The test had a significant positive correlation with the level of urine protein (Pearson correlation 0.61, p-value <.01). Intra- and inter-observer reliabilities were good (intra-class correlation coefficient and Cohen’s kappa coefficient of 0.88 and 0.75, respectively; p < .01). Conclusion The urine Congo red kit test has a high positive predictive performance for the identification of preeclampsia with high reproducibility. This test may be used as a bed side test to rule-in the diagnosis of preeclampsia in women presenting with suspected preeclampsia.

Evaluation of serum levels of soluble vascular endothelial (sVE)-Cadherin in early- and late-onset preeclampsia serum sVE-Cadherin levels in preeclampsia

Objective Endothelial dysfunction is a major feature of preeclampsia. sVE-cadherin plays a role in the preservation and regulation of the endothelial barrier. For that reason, to evaluation of sVE-cadherin may help elucidate the disease pathophysiology of preeclampsia. Methods The sample size was calculated as a minimum of 46 pregnant women for each group based on serum sVE-Cadherin levels in a pilot study of 10 preeclamptic and 10 control groups. Hundred-twenty pregnancies complicated with early-onset (n = 60) and late-onset (n = 60) preeclampsia were compared with 120 gestational-age (GA)-matched (±1 week) uncomplicated pregnancies. The venous blood sampling was performed upon preeclampsia diagnosis prior to the onset of the labor in the preeclampsia group and the matching (±1 week) pregnancy week in the control group. Demographic and biochemical parameters were evaluated. Results Mean serum sVE-Cadherin was significantly higher in women with EOPE compared to that of the GA-matched control group (5.86 ± 1.57 ng/mL vs. 2.28 ± 0.80 ng/mL, p < 0.001), in women with LOPE compared to that of the GA-matched control group (3.11 ± 0.97 ng/mL vs. 1.69 ± 0.87 ng/mL, p < 0.001), and in women with EOPE compared to that of LOPE group (5.86 ± 1.57 ng/mL vs. 3.11 ± 0.97 ng/mL, p < 0.001) after correction for GA. Serum sVE-Cadherin positively correlated with systolic and diastolic blood pressure and a negative correlation with gestational age at sampling. Conclusion The serum level of sVE-Cadherin was higher in women with preeclampsia than that of GA-matched healthy pregnant women, in women with EOPE compared to that of LOPE. sVE-Cadherin is an important marker in early-onset pre-eclampsia with severe clinical findings.

The early predictive value of maternal serum PAPP-A concentration at 11-14 weeks of pregnancy for preeclampsia.

To determine the expression and clinical significance of maternal serum pregnancy-associated plasma protein A (PAPP-A) in pregnant women with different degrees of preeclampsia at 11-14 weeks of gestation. The clinical data of 65 pregnant women with preeclampsia admitted to our hospital from January 2020 to October 2022 were retrospectively analysed. Another 45 normal pregnant women who came to our hospital for prenatal examination and delivery during the same period were selected as the healthy control group. The serum contents of PAPP-A, a-fetoprotein (AFP) and free estriol (uE3) in each group were compared. The correlation between PAPP-A and AFP as well as uE3 was analysed by Pearson analysis. The clinical value of serological indexes in diagnosing preeclampsia was analysed using ROC curve. The levels of PAPP-A and uE3 in pregnant women in the preeclampsia group were lower, while the contents of AFP were higher than these in the healthy control group ( p < 0.01). The pregnant women with severe preeclampsia had lower levels of PAPP-A and uE3 with higher levels of AFP compared to these with mild preeclampsia ( p < 0.001). Pearson correlation analysis showed that serum PAPP-A was negatively correlated with AFP ( r = -0.246, p < 0.05) and positively correlated with uE3 ( r = 0.398, p < 0.01) in preeclampsia patients. ROC curve analysis demonstrated that the area under the curve (AUC) of PAPP-A, AFP and uE3 to assist in the diagnosis of preeclampsia was 0.740, 0.738 and 0.806, respectively. The AUC of the combination of PAPP-A, AFP and uE3 to assist in the diagnosis was 0.912, with a sensitivity of 90.38% and a specificity of 80.33%. The clinical assisted diagnostic value of combined detection was high. The serum level of PAPP-A in pregnant women with preeclampsia in the early pregnancy was significantly lower and related to the severity of the disease. The combination of routine detection for AFP and uE3 had a good predictive value for preeclampsia, which was helpful to take relevant interventions to reduce the incidence of preeclampsia as early as possible, and had a positive impact on protecting maternal and infant health.

437 Differences in Gestational Age at Preeclampsia Diagnosis and Delivery Across BMI Categories

437 Differences in Gestational Age at Preeclampsia Diagnosis and Delivery Across BMI Categories