Vivantes Network of Health, Clinicum Neukoelln, Clinic of Obstetric Medicine, Berlin, Germany.
Roche Diagnostics International, Rotkreuz, Switzerland.
Pregnancy Hypertens. 2019 Jul;17:28-35. doi: 10.1016/j.preghy.2019.03.002. Epub 2019 Mar 11.
Preeclampsia is a major cause of morbidity and mortality, can be difficult to diagnose, and is associated with significant healthcare costs. The prediction, diagnosis and prognosis of preeclampsia have depended on repeated assessment of women with known risk factors, including intensive monitoring and hospitalization. Many of these women may never go on to develop preeclampsia. Recent developments in the pathogenesis of preeclampsia have shown that maternal serum biomarkers can be used to predict preeclampsia. When the ratio of the anti-angiogenic soluble fms-like tyrosine kinase-1 (sFlt-1) and the pro-angiogenic placental growth factor from the placenta is altered, preeclampsia becomes more likely, providing a diagnostic measurement for risk. The use of angiogenic biomarkers in addition to standard clinical tests can more accurately predict which women are at risk of developing preeclampsia and which are at low or moderate risk, which is likely to streamline the management of pregnant women and target resources in a more efficient way. The studies reviewed here all demonstrate cost savings from use of angiogenic biomarker tests as an addition to standard care.
子痫前期是发病率和死亡率的主要原因，难以诊断，且与高额的医疗保健费用有关。子痫前期的预测、诊断和预后取决于对具有已知危险因素的女性进行反复评估，包括强化监测和住院治疗。其中许多女性可能永远不会发展为子痫前期。子痫前期发病机制的最新进展表明，母体血清生物标志物可用于预测子痫前期。当胎盘产生的抗血管生成可溶性 fms 样酪氨酸激酶-1（sFlt-1）与促血管生成胎盘生长因子的比例发生改变时，子痫前期的可能性更大，为风险提供了诊断测量。除了标准的临床检测之外，使用血管生成生物标志物可以更准确地预测哪些女性有发展为子痫前期的风险，哪些处于低风险或中风险，这可能会更有效地简化孕妇管理并更有效地利用资源。这里综述的研究都表明，将血管生成生物标志物检测作为标准护理的补充，可以节省成本。
