The role of the clinical laboratory in the early diagnosis of preeclampsia.,Il ruolo del laboratorio clinico nella diagnosi precoce di preeclampsia

Hypertensive pregnancy disorders include a large spectrum of conditions, including pre-existing chronic hypertension, gestational hypertension, preeclampsia (PE) and eclampsia. In particular, PE is one of the most important causes of maternal morbidity and mortality and perinatal death, preterm birth, and delayed intrauterine growth. The studies support a pathogenetic model of insufficient placentation which results in a vicious circle clinically dominated by an increase in blood pressure and proteinuria in the first phase, and by the involvement of the central nervous system up to convulsions in the more advanced stages. A crucial aspect of patient management is therefore represented by the identification of biological markers measurable in maternal blood (circulating) useful in the diagnosis, prognostic stratification and monitoring. In particular, in recent years many resources have been used to identify a biophysical and biochemical screening test aimed at identifying women at greater risk of PE, but none of these tools when used alone has demonstrated a significant predictive value. Few biomarkers are currently used in clinical practice. The analysis of the literature suggests that angiogenic and anti-angiogenic molecules, in particular the fms-like-tyrosine-kinase receptor 1 and placental growth factor (sFlt-1/PlGF) ratio, can be considered the biomarkers with the best diagnostic performance in the second trimester of pregnancy. However, doubts remain about their use in clinical practice before the 20th gestational week. © 2021 Biomedia. All rights reserved.