Preeclampsia (PE) is a multisystem, transient disorder of pregnancy that affects 5-10% of pregnant women (usually during their first pregnancy). It is also referred to as toxemia or pregnancy-induced hypertension. PE typically occurs after 20 weeks gestation and can present as late as 4-6 weeks postpartum. The condition is clinically characterized by hypertension and proteinuria, with or without pathologic edema. Although PE is often accompanied by new-onset proteinuria, hypertension and other signs or symptoms of preeclampsia may present in some women in the absence of proteinuria. Therefore, PE should be considered in any pregnancy complicated by elevated blood pressure, even if proteinuria is not present.
Worldwide, PE is considered one of the major causes of maternal morbidity and mortality, resulting in greater than 50,000 maternal deaths and over 500,000 fetal deaths.
PE is primarily a disorder of healthy young women who were not previously known to be hypertensive. The condition can affect both the mother and the unborn child. In severe cases, the condition may present with seizures, liver and kidney dysfunction, as well as clotting abnormalities.
PE can mimic and be confused with many other diseases, including chronic hypertension, chronic renal disease, primary seizure disorders, gallbladder disease, pancreatic disease, immune or coagulation-related diseases, and hemolytic-uremic conditions. Moreover, it is especially difficult to diagnose in pregnant women who have a preexisting condition such as hypertension. Despite considerable research over the years, the precise cause of PE is unknown. The only cure at this time is the delivery of the fetus.
Recent efforts have been underway to improve upon the early and accurate diagnosis of PE and to improve upon the risk assessment for the condition. Since PE is a complex disorder, early screening tests for the disorder could serve to decrease the incidence of maternal and fetal complications. Several new promising biomarkers are now available to aid in the early prediction of PE in high-risk pregnancies and may offer the clinician earlier treatment options with improved outcomes for the mother and fetus. The future laboratory may well serve a key role in the early and accurate diagnosis of PE.