Hypertension is the most common medical problem encountered in pregnancy and remains an important cause of maternal and fetal morbidity and mortality. It complicates up to 15% of pregnancies. assessment of arterial stiffness, PWV and some biomarkers may help in prediction and stratification of pregnancy induced hypertension/Pre-eclampsia.
Not accurately yet. However, recent work on combination of early ultrasound (uterine artery Doppler), maternal characteristics (e.g. BP, weight, age, parity), and biochemical markers (PAPPA, PlGF etc) ore looking more promising. see the following as a starting point: Audibert, F, Boucoiran, I et al (2010). 'Screening for preeclampsia using first‐ trimester serum markers and uterine artery Doppler in nulliparous women'. Am J Obstet Gynecol, 203 (4), 383 e1‐8; Di Lorenzo, G, Ceccarello, M et al (2012). 'First trimester maternal serum PIGF, free beta‐hCG, PAPP‐A, PP‐13, uterine artery Doppler and maternal history for the prediction of preeclampsia'. Placenta, 33 (6), 495‐501.
Promising data on mesuring the sFlt/PIGF ration will be presented at a congress in Paris- COGI dec 2014 to predict and also rule out PE.
The identification of biomarkers of pregnancy induced hypertension/Pre-eclampsia apeares to be promised, but no significant evidences around clinical settings. There are data about soluble fms-like tyrosine kinase-1 s(Flt1), placenta growth factor, bone-related proteins (osteoprotegerine), soluble endoglin, as well as their ratios as predictors of preeclampsia. My opinion is follow: no ideal one biomarker, risk prediction score based on clinical data, objective findings, biomarker is required.
To referr:
Leaños-Miranda A1, Campos-Galicia I, Ramírez-Valenzuela KL, Chinolla-Arellano ZL, Isordia-Salas I. Circulating angiogenic factors and urinary prolactin as predictors of adverse outcomes in women with preeclampsia. Hypertension. 2013 May;61(5):1118-25. doi: 10.1161/HYPERTENSIONAHA.111.00754. Epub 2013 Mar 4.
Bastek JA, Elovitz MA. The role and challenges of biomarkers in spontaneous preterm birth and preeclampsia. Fertil Steril. 2013 Mar 15;99(4):1117-23. doi: 10.1016/j.fertnstert.2013.01.104. Epub 2013 Feb 5.
Early ultrasound, maternal characteristics in the screening tools used by health workers (based on pervious studies) and biomarkers of PIH are the most suggestive indicators I know
PAPP-A, s-Flt-1/PlGF, soluble -Endoglin, PP13, cystatin-C, HbF, and α₁-microglobulin (A1M). PAPP-A and HbF both show potential as predictive biochemical markers in the first trimester with 70% sensitivity at 95% specificity for preealampsia. However, PAPP-A is not PE-specific and needs to be combined with Doppler ultrasound to obtain the same sensitivity as HbF/A1M. Soluble Flt -1 and PlGF are promising biochemical markers that together show high sensitivity from the mid-second trimester.Placental Protein 13 (PP13) A member of the Galectin family ,galectin 1 can also measure.
Four papers from the international SCOPE Study Consortium are useful when considering this question.
North RA, McCowan LME , Dekker GA, Baker P Poston L Walker J, Taylor RS, Black M, Kenny L. Clinical risk prediction for pre-eclampsia in nulliparous women: development of model in international prospective cohort. BMJ 2011;342:d1875. doi:10.1136/bmj.d1875.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072235/pdf/bmj.d1875.pdf
Kenny LC, Black MA, Poston L, R Taylor, Myers JE, Baker PN, McCowan LM, Simpson NAB, Dekker GA, Roberts CT, Rodems K, Noland B, Raymundo M, Walker JJ, North RA.Early pregnancy prediction of preeclampsia in nulliparous women, combining clinical risk and biomarkers; the SCOPE International cohort study. Hypertension 2014;64:644-652.
http://hyper.ahajournals.org/content/64/3/644.full.pdf+html
Myers JE, Kenny LC, McCowan LME, Chan EHY, Dekker GA, et al. (2013) Angiogenic factors combined with clinical risk factors to predict preterm pre-eclampsia in nulliparous women: a predictive test accuracy study. BJOG: An International Journal of Obstetrics & Gynaecology 2013;120(10):1215-23. DOI: 10.1111/1471-0528.12195
http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12195/pdf
Myers JE, TuyttenR, Thomas G, Wouter L, Kas K, Vanpoucke G, Roberts CT, Kenny LC, Simpson NAB, Baker PN, North RA. Integrated Proteomics pipeline yields novel biomarkers for predicting preeclampsia. Hypertension Jun;61(6):1281-8. doi: 10.1161/HYPERTENSIONAHA.113.01168.
http://hyper.ahajournals.org/content/61/6/1281.full.pdf+html
hi:
yes, we can partially predict PIH or preeclampsia whit some biomarkers and Roll over test in 26 -28 week of pregnancy.
Please have a look on:
Hypertension. Oct 2011; 58(4): 548–549.
Published online Aug 29, 2011. doi: 10.1161/HYPERTENSIONAHA.111.178921
Uric acid: A Clinically Useful Marker to Distinguish Preeclampsia from Gestational Hypertension; Richard J Johnson, Mehmet Kanbay, Duk-Hee Kang, Laura Gabriela-Sánchez Lozada, and Daniel Feig