The Food and Drug Administration has approved a blood test that can identify pregnant women at imminent risk of developing severe high blood pressure called pre-eclampsia, a leading cause of disability and death among pregnant women.
The condition particularly affects black women in the United States and may have contributed to the recent death of 2016 Olympic gold medal-winning track and field star Tori Bowie. Two of Bowie’s black teammates, Allyson Felix and Tiana Bartoletta, also developed pre-eclampsia during their pregnancy.
A new test could provide an early warning to identify many pregnant women with suggestive symptoms who could develop a life-threatening illness within the next two weeks.
“It’s groundbreaking. It’s revolutionary,” said Dr. Doug Woolkers, professor of maternal-fetal medicine at the University of California, San Diego, of the test. “This is the first step forward in diagnosing pre-eclampsia since his 1900 when the condition was first defined.”
However, because there is no effective treatment for pre-eclampsia, which usually relieves after birth, it is not clear how much this test improves outcomes and saves lives.
“There is no treatment to reverse or cure pre-eclampsia other than childbirth. This is something of a last resort,” Dr. Walkers said.
Developed by Thermo Fisher Scientific, this new blood test has been available in Europe for several years. Pregnant women hospitalized with blood pressure disorders from 23 to 35 weeks of gestation are eligible.
With up to 96% accuracy, this test can tell you who won’t develop pre-eclampsia in the next two weeks and is safe to leave the hospital. On the other hand, her two-thirds of the women with positive results may progress to severe pre-eclampsia in the meantime and need to deliver babies prematurely.
Distinguishing between these two groups of women is a long-standing problem for physicians.
“The warning signs of pre-eclampsia are not very specific,” says Dr. Sarosh Rana, a professor of obstetrics and gynecology at the University of Chicago who is studying the test. “Many women will suffer from edema and headaches.” (Edema means swelling.)
“But we don’t really know who among those patients are really at higher risk of adverse outcomes,” she says.
Pre-eclampsia affects 1 in 25 pregnancies and its incidence has increased in recent years in the United States. The problem usually begins around the middle of pregnancy, but it can also occur after giving birth. It can cause a condition called eclampsia, which can lead to seizures and death.
Black women in the United States have a much higher pre-eclampsia rate than white women, and the risk of kidney damage and death from pre-eclampsia is three times that of white women. Black women are also more likely to lose babies.
A blood test measures the ratio of two proteins produced by the placenta. A study published in the New England Journal of Medicine in November followed 1,014 pregnant women who were admitted to 18 medical centers in the United States with preeclampsia from 2019 to 2021. Just under a third were black and 16 percent were Hispanic.
researchers It turns out that the balance of the two proteins is greatly disrupted in the blood Number of women who developed severe pre-eclampsia. In the group with the widest percentage, she had a 65% chance of progressing to severe pre-eclampsia and giving birth to a baby within 2 weeks, either spontaneously or induced.
“If your levels are the highest, you will give birth in a few days,” said study author Dr. Ravi Sadani.
Women who have symptoms suggestive of preeclampsia but test negative can go home safely, Dr. Rana said, but they may need to repeat the test every two weeks.
Pre-eclampsia progresses rapidly and without blood tests the warning signs can be vague.
“A woman can go from feeling good, perfectly healthy, with normal kidney and liver function, to failure of these organs within 24 to 48 hours, leading to swelling of the brain and seizures. said Dr. Sadani. “That’s the scary part about this disease.”
