Recent advances in the diagnosis and management of pre-eclampsia.
Alice HurrellKate DuhigBrooke VandermolenAndrew H ShennanPublished in: Faculty reviews (2020)
Pre-eclampsia is an elusive condition to diagnose and a complex disease to manage. There have been recent developments in prediction, prevention, diagnosis, and management. Risk modelling has been used to identify women at highest risk of developing pre-eclampsia as well as predicting maternal adverse outcomes in confirmed disease. New evidence has shown that aspirin prophylaxis significantly reduces early onset pre-eclampsia as well as preterm birth. The criteria for the diagnosis of pre-eclampsia are evolving, and proteinuria is no longer a pre-requisite to make a diagnosis. Angiogenic biomarker testing accelerates diagnosis as well as minimises adverse maternal outcomes and has been incorporated into national guidelines. Emerging evidence demonstrates that expedited delivery in late preterm pre-eclampsia may be protective against maternal adverse outcomes but increase the risk of neonatal unit admission. Both women and their offspring are at increased risk of long-term health complications following pre-eclampsia, and it is important that postnatal health is optimised. This article summarises recent developments in the field of pre-eclampsia research, evaluating the impact on clinical care for women at risk of, or with suspected or confirmed, pre-eclampsia.
Keyphrases
- pregnancy outcomes
- preterm birth
- early onset
- polycystic ovary syndrome
- healthcare
- birth weight
- gestational age
- public health
- pregnant women
- low birth weight
- mental health
- late onset
- quality improvement
- breast cancer risk
- emergency department
- cervical cancer screening
- health information
- palliative care
- type diabetes
- high fat diet
- metabolic syndrome
- pulmonary embolism
- risk assessment
- human health
- health promotion
- body mass index
- cardiovascular disease
- health insurance
- insulin resistance
- social media
- pain management
- chronic pain
- percutaneous coronary intervention
- adipose tissue
- drug induced