Research May Help Predict Preeclampsia

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"If we had a better way -- an easy test -- for physicians to do that would help confirm the diagnosis, that'd be great, because it really is defined as hypertension and proteinuria, so if you don't have those two together, it's hard to make the diagnosis sometimes," Raynor explained.

Recent research is igniting hope for such a test. Scientists now have identified two proteins that appear to be involved in the development of preeclampsia.

One of these proteins, known as soluble endoglin, rises earlier and more steeply in women who develop preeclampsia, researchers have reported. Levels of another protein, called sFlt1, also increase. It's believed that these two proteins interfere with the growth and function of blood vessels, signaling a spike in the woman's blood pressure.

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"We believe they cause the disease by preventing proangiogenic factors from operating, such as vascular endothelial growth factor and TGF beta1, and that leads to damage and dysfunction of the endothelial cells," said Dr. Richard J. Levine, a senior investigator with the epidemiology branch of the U.S. National Institute of Child Health and Human Development. "These are the cells that line the interior of the vascular system and lead to all the clinical conditions that are perturbed in preeclampsia."

These findings raise the possibility of developing a blood test to screen women at risk for preeclampsia. But more studies will be needed before researchers know whether it's worth the trouble and expense of performing such tests, said Levine, lead author of a pivotal study in the New England Journal of Medicine associating the two proteins with preeclampsia.

At the moment, the value of a predictive tool is uncertain, because there's no way to prevent preeclampsia, and treatment options are limited. If a pregnancy isn't very far along, and the woman's symptoms aren't too severe, the doctor may try to buy time by putting her on bed rest and medications. The only way to stop preeclampsia is to deliver the baby. Magnesium sulfate, an anticonvulsant medication, is typically administered intravenously to prevent the woman from having seizures.

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