While some pregnancies are generally smooth and the baby is delivered without complications, there are many pregnancies that are not. This makes pregnancy a complex and stressful period, where not only the woman’s life is in danger, but also the infant’s. One of the most common, yet dangerous, complications of a pregnancy is preeclampsia. There are a number of factors that increase a mother to-be’s risk of developing preeclampsia, but determining whether someone will have this complication has always been a little hit or miss.
That is until recently, when a new blood test was developed and studied that seemed to show which patients were likely to develop preeclampsia with the highest accuracy rate of any other test to date. With this new test, pregnant women can better predict the complications they will face, and be better prepared. What this could lead to is more mothers and infants surviving pregnancy, labor, and delivery with fewer injuries and long-term effects.
The Cedars-Sinai blood test
The new blood test, developed by researchers at the Cedars-Sinai health-science center, can accurately determine whether a pregnant woman will develop preeclampsia by determining whether there is an imbalance of two placental proteins.
The blinded, prospective study was conducted across 18 hospitals in the United States, and included 1,014 women who were hospitalized for preterm hypertension. Through a blood test, the two proteins measured were tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF). The senior co-author of the study, S. Ananth Karumanchi, MD, stated “An sFlt-1 to PIGF ratio of 40 or greater predicted the development of serious preeclampsia, adverse outcomes and early delivery within two weeks, two-thirds of the time.”
Based on the data, this test could accurately determine which pregnant women were going to develop preeclampsia 90% of the time, which beat out the usual standard-of-care markers that were accurate less than 75% of the time. Ultimately, this study and its findings will likely lead to potential drug therapies for those women who are at risk of developing the condition.
What is preeclampsia?
Per Cedars-Sinai, preeclampsia is “the most common of hypertensive disorders associated with pregnancy. The severe form of the disease can lead to dangerously high blood pressure, organ failure, vision loss or even stroke. It affects approximately 5% of pregnant women and is a leading cause of maternal and fetal death and serious illness.”
The Centers for Disease Control and Prevention (CDC) reports that while there are pre-existing risk factors that increase the likelihood of developing preeclampsia (diabetes, chronic hypertension, kidney disease, obesity, or being older than 40 years of age), preeclampsia can also develop in women who have no history of risk factors. This is known as gestational hypertension, and makes preeclampsia much harder to predict. That is another reason why the new blood test from Cedars-Sinai is so important. The test is able to predict whether that woman with no history of hypertension will develop preeclampsia anyway.
What makes preeclampsia so dangerous?
While high blood pressure (hypertension) in a non-pregnant person is common, it can usually be treated and managed without necessarily leading to life-threatening situations or outcomes. For mothers-to-be, hypertension can be a symptom of preeclampsia, which can lead to the death of the mother and the infant during delivery.
The Mayo Clinic lists several reasons why preeclampsia is so dangerous, including:
- Preterm birth. The only cure or treatment for preeclampsia is delivery. A preterm birth –which is a delivery of the baby before 37 weeks– increases the risks for several developmental problems for the baby, including breathing and eating difficulties, mental developmental delays, cerebral palsy, and vision and hearing issues.
- Placental abruption. Placental abruption is when the placenta dislocates from the wall of the uterus, leading to severe bleeding. This can threaten both the life of the mother and the child.
- HELLP syndrome. HELLP stands for “hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count.” It is a severe form of preeclampsia, and can threaten the life of the mother and infant. It may even cause lifelong health problems for the mother after the delivery.
- Eclampsia. Eclampsia is a condition that develops with signs and symptoms that include preeclampsia. Eclampsia presents with seizures or a coma, and is hard to predict and “can happen without any previously observed signs or symptoms of preeclampsia.”
Why is failure to diagnose preeclampsia considered medical malpractice?
While preeclampsia is caused by medical conditions, pre-existing or not, an obstetrician taking the right steps to identify and treat risk factors that can lead to the complication is a key part of avoiding preeclampsia altogether. It can also help the mother-to-be and her care-provider plan out what to do in the case that she does develop the complication, so that she can be cared for in an efficient and safe manner.
Throughout the pregnancy, obstetricians and other OBGYN medical professionals are responsible for assessing the health of the pregnant woman through various tests and physical examination to ensure that the pregnancy is progressing in a healthy manner. Such factors as weight and blood pressure are recorded, and urine tests are performed to study the proteins in the pregnant woman. Through these tests, conditions and complications can be caught before it’s too late. These tests should be done regularly throughout the entirety of the pregnancy. If the obstetrician neglects to have these tests performed, and a woman suffers such complications as preeclampsia without any possible warnings, then the woman and infant who very well may sustain injuries and conditions due to this will have grounds to file a medical malpractice claim. Failure to diagnose a condition that could have been caught through regular check-ups is a dereliction of duty by the medical professional.