Abstract

Preeclampsia (PE) is a serious hypertensive disorder of pregnancy, characterized by new-onset hypertension and proteinuria or evidence of other end-organ damage after 20 weeks of gestation. It is one of the leading causes of maternal and fetal morbidity and mortality worldwide.

Early screening and prediction of PE play a crucial role in improving pregnancy outcomes. Traditionally, screening and diagnosis of preeclampsia have primarily relied on regular blood pressure monitoring and urine protein testing. Although these methods remain mainstream, they have certain limitations, especially in the early prediction of the condition.

We synthesize current research and clinical guidelines on biomarkers and PE screening models. Recent advances in medical research have opened new avenues with the discovery and application of maternal serum biomarkers. These biomarkers, including Placental Growth Factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and the sFlt-1/PlGF ratio, have shown great potential in the early prediction of the risk of developing preeclampsia, even before clinical symptoms appear. These tests help to stratify risk more accurately, aiding clinical decisions regarding the timing of intervention, closer monitoring, or appropriate referral for treatment.

PE screening is most effective when performed early in the first trimester, often combining multiple factors. Combined screening models incorporating maternal risk factors, mean arterial pressure (MAP), PlGF and/or PAPP-A (Pregnancy-Associated Plasma Protein-A), along with uterine artery Doppler ultrasound, demonstrate high detection rates for early-onset PE (before 34 weeks). The sFlt-1/PlGF ratio in the second and third trimesters is also a useful tool for the diagnosis and short-term prognosis of PE, especially in pregnant women with suspected symptoms. The use of low-dose aspirin in high-risk women identified through early screening has been shown to be effective in reducing the incidence of PE. Preeclampsia screening tests, especially first-trimester combined multi-marker models, play a key role in identifying pregnant women at high risk. This allows for the implementation of preventive measures and close monitoring, contributing to minimizing the dangerous complications of PE for both mother and child.