Reducing the risk of pre-eclampsia

Early screening for effective treatment

Global health burden affecting millions of mothers and infants

Pre-eclampsia is a complication of pregnancy marked by high blood pressure and protein in the urine. Left untreated, pre-eclampsia can lead to eclampsia, a serious condition that can, in some cases, lead to death. Pre-eclampsia also affects blood flow to the placenta, often leading to growth-restricted or prematurely born babies. Avoiding this condition would bring substantial improvements to maternal and fetal health.

Mothers at risk

  • Over 10 million women around the world develop pre-eclampsia annually
  • 76 000 pregnant women die each year from pre-eclampsia and related hypertensive disorders globally
  • Every 7 minutes one woman loses her life due to these often preventable conditions
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Infants at risk

  • The impact of hypertension disorders on global infant mortality is enormous. 500 000 babies die from pre-eclampsia and other hypertension disorders annually
  • Over 2.5 million preterm births are caused by pre-eclampsia each year

Early screening for effective treatment

The consensus among caregivers and researchers is that timing matters more than ever in pre-eclampsia treatment. The earlier you identify women at high risk for pre-eclampsia, the better the outcome for mother and child.

PerkinElmer’s PlGF 1-2-3 assay is the most sensitive first trimester screening assay for pre-eclampsia to date and therefore the choice for the ground-breaking ASPRE study (Rolnik et al, 2017).

When the PlGF 1-2-3 assay is used in combination with a comprehensive first trimester screening program including maternal medical history, mean arterial blood pressure and if available, uterine artery Doppler ultrasound, women at high risk for pre-eclampsia can be identified long before symptoms appear. 

PlGF 1-2-3™ – the 2nd generation PlGF assay

  • Measures free PlGF (isoform 1)
  • Options for 48 and 96 well kits
  • Sensitivity 1.9 pg/ml
  • 20 min incubation time with DELFIA® Xpress
  • CE-IVD native pregnancy serum controls
  • Clinical validity demonstrated in the ASPRE study
  • Same CE-IVD PlGF assay is applicable in 1st, 2nd and 3rd trimesters
  • Proven DELFIA® technology

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Read more about ASPRE

New screening protocol for a new era

The combined screening program for pre-eclampsia is the most effective way to identify women at high risk of pre-eclampsia in the early stages of pregnancy. The program consists of the PlGF 1-2-3™ blood test, maternal medical history assessment, mean arterial blood pressure measurement and, if available, uterine artery Doppler ultrasound.

Record medical history
  • First pregnancy?
  • Previous or family history with pre-eclampsia?
  • Ethnicity?
  • Chronic hypertension?
  • Smoking?
  • Weight and height?
PlGF 1-2-3™ serum test
The high sensitivity PlGF 1-2-3 ™ assay can be performed as early as the first trimester, at 11-13+6 weeks. The serum sample is analysed using the same PerkinElmer instrument that is used for aneuploidy screening. No additional sample is required as the sample can be used both to screen for pre-eclampsia and for aneuploidy screening. Women with an elevated risk for pre-eclampsia show a lower maternal serum level of placental growth factor (PlGF).
Measure blood pressure
Take 2 measurements from both arms simultaneously using two automated blood pressure monitors. The woman should be properly seated with her arms supported at the level of the heart.
Measure uterine artery doppler pulsatility index ultrasound
The pulsatility index can be measured between 11-13+6 weeks via transvaginal or transabdominal ultrasound. Combined pre-eclampsia screening without doppler is a good option if access to ultrasound is limited.
ASPRE results, 82% drop in the rate of early pre-eclampsia and 62% drop in the rate of preterm pre-eclampsia

Low dose aspirin in the reduction of pre-eclampsia rate

The ASPRE trial results showed that the rate of developing early onset pre-eclampsia dropped by 82% and preterm pre-eclampsia by 62% among those women who received 150 mg aspirin treatment per night and were at high risk of developing the disease (see Effective treatment protocol). A secondary analysis proves that if we exclude the patients suffering with known chronic blood pressure, the therapy with aspirin allows to almost eradicate preterm pre-eclampsia for patients that are compliant with the aspirin treatment in 90% of the cases.

This is compelling evidence that a combined screening program, coupled with low-dose aspirin treatment, can help reduce the rate of preterm pre-eclampsia and delay or prevent pre-eclampsia. While aspirin treatment is not a cure for pre-eclampsia, fewer women need to suffer from this serious disease if low- dose aspirin is administered early in the pregnancy. (Rolnik et al. 2017)

Aspirin treatment according to ASPRE study design

Dose 150 mg

A dose response effect of aspirin is demonstrated. A high proportion (1/3) of population is non responsive to aspirin if given at lower doses.

Start 12 weeks

Aspirin is effective if given to high risk women before 16 weeks of gestation.

Finish 36 weeks

Avoid potential hemorrhage for neonate.

Time Bed time -

Lower incidence of PE when aspirin taken at bedtime compared to morning or afternoon.

Products may not be licensed in accordance with their laws in all countries, such as the United States and Canada. Please check with your local representative for availability.

PerkinElmer does not endorse or make recommendations with respect to research, medication, or treatments. All information presented is for informational purposes only and is not intended as medical advice. For country specific recommendations please consult your local health care professionals.

1. Daniel L. Rolnik et al. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. DOI: 10.1056/NEJMoa1704559, New England J Med June 2017
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