Vice President, Women’s Health, Roche Diagnostics
Preeclampsia — a potentially serious condition that affects women in pregnancy — is difficult to diagnose. Thankfully, a new test is better able to predict who might develop it.
We live in a world where women outnumber men, yet statistics show that women’s medical needs are continually underestimated and often go unmet.
Perhaps this is because many women are too busy focusing on the health and happiness of others — sometimes at the expense of themselves — to notice the scale of the problem.
Take the tragedy of maternal deaths. Many of these are preventable because the healthcare solutions to prevent or manage complications in pregnancy are well-known.
Even so, there are approximately 830 deaths every day from preventable causes related to pregnancy and childbirth1, with 80% including complications from severe bleeding, infections (mostly after childbirth), unsafe abortions and high blood pressure during pregnancy2.
Why early detection of preeclampsia is crucial
Preeclampsia is a condition that usually affects women in the second half of their pregnancy. This, along with other hypertensive disorders of pregnancy, is one of the leading causes of fetal and maternal morbidity and mortality, accounting for 10–15% of all maternal deaths3.
Naturally, early detection and effective care can vastly reduce the number of preeclampsia-related fatalities. The problem is that preeclampsia symptoms — such as high blood pressure and swollen feet, ankles and hands — can be mistaken for the normal effects of pregnancy, making it difficult to diagnose.
There are approximately 830 deaths every day from preventable causes related to pregnancy and childbirth.
To further complicate matters, standard preeclampsia diagnosis is limited and involves detecting high blood pressure after 20 weeks and protein in the urine.
Unfortunately, these two indicators are poor predictors of who will develop adverse outcomes and who will go on to have normal pregnancies. This is an issue because 80% of pregnant women with signs of preeclampsia won’t develop the condition4 — but are unnecessarily hospitalised in case they do.
Clearly, when it comes to preeclampsia diagnostics, there’s a need for a more innovative solution.
The benefits of an innovative new preeclampsia testing using biomarkers sFlt-1 and PlGF
Thankfully, one test has been found. A novel preeclampsia testing has been developed that measures two proteins found in the mother’s blood, making it possible to predict with greater certainty which women with suspected preeclampsia will and will not develop the condition.
In fact, a recent study published in the New England Journal of Medicine, shows the test predicts which women will not develop preeclampsia in the next week with more than 99% confidence5.
This is good news for patients, because women who are unlikely to develop preeclampsia are saved the stress of close monitoring and the disruption of a hospital stay. Sophia Chao notes: “This innovation in preeclampsia testing using biomarker tests ultimately ensured that those who needed a high level of care received it, while others would be able to return home safely.”
It’s also good for clinicians, because doctors can send healthy women home safely and focus patient management on women who are more likely to need it.
And, ultimately, there’s a cost-saving for the healthcare system. By using the new biomarker testing in clinical practice, the hospitalisation of women suspected of having preeclampsia could be reduced by 50%, leading to cost savings of £344 per patient6. Annual UK savings are projected to be £24 million.
It’s just one example of how an increase in medical knowledge, coupled with advances in science, data, analytics and digital technology, promise a transformational shift in the approach to diagnostics and healthcare, making it more evidence-based and personalised.
1 WHO 2016 Maternal mortality fact sheet2 WHO 2016 Maternal mortality fact sheet3 Berg, C. J., Mackay, A. P., Qin, C., and Callaghan, W. M. (2009).Overview of maternal morbidity during hospitalization for labor and delivery in the United States: 1993-1997 and 2001-2005. Obstet.Gynecol. 113, 1075-1081.4 Klein, E., Schlembach, D., Ramoni, A., et al. (2016). Influence of the sFlt-1/PIGF ratio on clinical decision-making in women with suspected preeclampsia. Plos ONE 11(5): e0156013. doi:10.1371/journal.pone.0156013.5 Zeisler, H., Llurba, E., Chantraine, F. et al. (2016). Predictive Value of the sFlt-1: PlGF Ratio in Women with Suspected Preeclampsia. N Engl J Med. 374, 13-22.6 Vatish, M., Strunz-McKendry, T., Hund, M., Allegranaz, D., Wolf, C., Smare, C. (2016). sFIt/PIGF ratio test for pre-eclampsia: an economic assessment for the UK. Ultrasound in Obstet Gynecol. 48(6):765-771