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

Preeclampsia (PE) is a multi-systemic complication of pregnancy often characterised with the
onset of hypertension and proteinuria after 20 weeks of gestation. Today, PE is the leading cause of
maternal and perinatal morbidity and mortality worldwide. An early detection of PE would allow a chance
to plan the appropriate monitoring and for clinical management to be immediately done following early
detection thus making prophylactic strategies much more effective.

This systematic review aims to evaluate the potential of the various serum
biomarkers and diagnostic modalities (uterine artery Doppler, MAP, and maternal history) available for
early prediction of PE with articles included and obtained through MEDLINE Full Text, Pubmed, Science
Direct, ProQuest, SAGE, Taylor and Francis Online, Google Scholar, HighWire and Elsevier ClinicalKey.

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) and
placental protein 13 (PP-13) were the most commonly studied biomarkers. Whereas uterine Doppler
scanning and Mean Arterial Pressure (MAP) were the most commonly studied out of other modalities.

Current evidence shows serum biomarkers such as PIGF, PP-13 and sFlt yielded the best
results for a single biomarker with others having conflicting results. However, a combination model with
other diagnostic modalities performed better than a single biomarker. In the future, new techniques will
hopefully provide sets of multiple markers, which will lead to a screening program with clinically relevant
performance. However further studies are required to improve current methods.