Detection and Management of Preeclampsia: Current Laboratory Testing and Emerging Biomarkers
Continuing Education Credits
Preeclampsia (PE) is a multisystem, transient disorder of pregnancy that affects 5-10% of pregnant patients, usually during their first pregnancy. This course defines preeclampsia (PE) and discusses its prevalence, characteristics, signs, and symptoms. Pathophysiology, causes, treatment, and prevention are presented in this course along with the laboratory tests used in the diagnosis of preeclampsia.
Objectives
- Define preeclampsia (PE) and discuss its prevalence, characteristics, signs, and symptoms.
- Identify the characteristics of mild and severe PE as well as the relationship to the HELLP Syndrome.
- State the risk factors for PE and differentiate between eclampsia and the HELLP Syndrome.
- Describe the pathophysiology of PE, its cause, treatment, and prevention.
- List the main triggers used to diagnose PE.
- Identify laboratory tests used to assist in the diagnosis of PE.
- Define and describe angiogenesis relative to its possible role in PE and associated pro-angiogenic and anti-angiogenic factors.
- Describe the various potential biomarkers for identifying pregnant patients at risk for PE.
- Describe the various potential biomarkers for identifying pregnant patients at risk for PE.
- Describe the various potential biomarkers for identifying pregnant patients at risk for PE.
Course Outline
- Background and Overview of Preeclampsia
- Background and Overview
- Which of the following statements is not true in describing preeclampsia (PE)?
- True or False: Preeclampsia (PE) affects 5–10% of pregnant patients and typically occurs after 20 weeks' gestation.
- Classification and Characteristics of Preeclampsia
- Classification and Characteristics of Preeclampsia
- HELLP Syndrome
- Which of the following can be defined as the presence of hypertension (blood pressure ≥140/90 mm Hg) on two occasions at least six hours apart without evidence of any organ damage in the pregnant patient?
- What condition not attributable to any other disorder is associated with eclampsia?
- Which statement is true regarding the HELLP syndrome?
- Risk Factors for Preeclampsia
- Risk Factors for Preeclampsia
- Which of the following are considered risk factors for PE?
- Pathophysiology of Preeclampsia
- Pathophysiology of Preeclampsia
- Pathophysiology of Preeclampsia, continued
- Doppler Ultrasonography of Uterine Arteries
- Treatment and Prevention
- Treatment and Management of Preeclampsia
- Treatment and Management of Preeclampsia, continued
- Treatment and Prevention Using Aspirin
- Postpartum Preeclampsia
- True or False: The only cure for PE is the delivery of the baby.
- Which statements are true regarding the use of aspirin to prevent PE?
- Current Laboratory Testing for Preeclampsia Workup
- Laboratory Tests for Preeclampsia Workup: Urine and Serum Chemistry
- Laboratory Tests for Preeclampsia Workup: Hematology and Coagulation
- Which laboratory tests listed below are typically performed to assist in the diagnosis of PE, to establish baseline levels early in the disorder, and to monitor for progression to HELLP or severe preeclampsia?
- Emerging Biomarkers for Preeclampsia
- Emerging Biomarkers to Identify Risk for Preeclampsia
- Angiogenesis and Angiogenic Biomarkers
- Table 1: Circulating Levels of Angiogenic Biomarkers in Preeclampsia
- Table 2: Circulating Levels of Other Potential Biomarkers in Preeclampsia
- Laboratory Methods for Quantitation of Biomarkers Used for Determining Risk of PE
- Thermo Scientific PlGF and sFlt-1 Biomarker Test System
- True or False: Angiogenesis is the physiological process through which new blood vessels form from pre-existing vessels.
- What statement is inaccurate concerning angiogenesis and angiogenic biomarkers?
- True or False: Placental Growth Factor (PIGF) acts as a vasodilator, increasing the diameter of existing arteries, and its serum levels have been found to be significantly lower in mild and severe PE.
- Choose the correct answer regarding the circulating levels of sFlt-1, sEng, and the sFlt-1/PIGF ratio in pregnant patients with preeclampsia (PE).
- Which potential preeclampsia (PE) biomarker that is decreased in PE can be described as a glycoprotein, which is derived from the trophoblast cells and released by the placenta and lining of the uterus?
- Which potential PE biomarker is a cell surface molecule expressed by platelets and endothelial cells, and circulating levels are increased in PE?
- Which statement is not true regarding the Thermo Fisher Scientific Test System used to aid in the prognosis of PE with severe features in pregnant patients?
- Summary and Conclusions
- Current Guidelines for Identifying Preeclampsia
- Summary and Conclusions
- What conclusions can be made regarding the clinical use of biomarkers to identify and diagnose PE?
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical
laboratory technicians, laboratory supervisors, and laboratory managers. This
course is also appropriate for MLS and MLT students and pathology residents.
Author Information: David Moffa, PhD, has over 30 years of experience in the health care industry as an executive manager, clinical laboratory director, and medical laboratory scientist. He is currently a technical consultant for Kentmere Healthcare, Wilmington, DE, and until his retirement, was the Regional Director for LabCorp, Inc. He holds a PhD in medical biochemistry from the School of Medicine, West Virginia University.
The author has no
conflict of interest to disclose.
Reviewer Information:
Laurie Bjerklie, MA, MLS(ASCP)CM, is
a Lead Education Developer. She earned a B.S. in Medical Laboratory Science
from the University of North Dakota and an M.A. in Curriculum and Instruction
from Saint Xavier University. She has over 15 years of experience in higher
education and has held program director and faculty positions in both MLT and
MLS programs.
Prior to her retirement in 2012, Jenny Camele was employed by Laboratory Corporation of America as the manager of customer service operations for the Fairmont West Virginia Region and a Quality Assurance committee member. She holds a Bachelor of Science degree in Medical Technology from West Virginia University.