Evaluation of Serum Biomarkers and Other Diagnostic Modalities for Early Diagnosis of Preeclampsia

Objective: Preeclampsia (PE) is a multi-systemic complication of pregnancy often characterised with theonset of hypertension and proteinuria after 20 weeks of gestation. Today, PE is the leading cause ofmaternal and perinatal morbidity and mortality worldwide. An early detection of PE would allow a chanceto plan the appropriate monitoring and for clinical management to be immediately done following earlydetection thus making prophylactic strategies much more effective.Materials and methods: This systematic review aims to evaluate the potential of the various serumbiomarkers and diagnostic modalities (uterine artery Doppler, MAP, and maternal history) available forearly prediction of PE with articles included and obtained through MEDLINE Full Text, Pubmed, ScienceDirect, ProQuest, SAGE, Taylor and Francis Online, Google Scholar, HighWire and Elsevier ClinicalKey.Results: Ninety-five articles were found that fulfilled all of our inclusion criteria. Placental growth factor(PlGF), pregnancy associated plasma protein A (PAPP-A), soluble fms-like tyrosine kinase (sFLT) andplacental protein 13 (PP-13) were the most commonly studied biomarkers. Whereas uterine Dopplerscanning and Mean Arterial Pressure (MAP) were the most commonly studied out of other modalities.Conclusion: Current evidence shows serum biomarkers such as PIGF, PP-13 and sFlt yielded the bestresults for a single biomarker with others having conflicting results. However, a combination model withother diagnostic modalities performed better than a single biomarker. In the future, new techniques willhopefully provide sets of multiple markers, which will lead to a screening program with clinically relevantperformance. However further studies are required to improve current methods.