Welcome to Preeclampsia Markers Study


WHO Multicentre Collaborative Study (WHO/RHP Project A55036)
Screening for Preeclampsia: evaluation of the predictive ability of angiogenic factors for pre-eclampsia

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Beth Israel

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Study Protocol

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The Medical Advisory Board of the University of Illinois College of Medicine Rockford cordially invites you to celebrate

The Lifetime of Service Award
presented to
Adrian I. Katz, MD & Marshall Lindheimer, MD

Project Summary

Preeclampsia, a multisystem disorder that complicates ~5% to 7% of all pregnancies, is associated with substantial and significant morbidity and mortality for the mother and the baby. There are many theories about the cause of preeclampsia, the most plausible hypothesis is that the placenta plays a central role in its pathogenesis.

Placental ischemia early in gestation (or some other aspect of placental pathophysiology) up-regulates the soluble fms-like tyrosine kinase-1 (sFlt-1), an antiangiogenic protein that enters the maternal circulation and inactivates two important circulating growth factors (vascular endothelial and placental called VEGF and PlGF, respectively). Another soluble anti-angiogenic factor of placental origin whose levels are elevated in women with preeclampsia is soluble endoglin (sEng). Thus, measurement of their levels may permit prediction of the disease appearance, and/or confirmation of the diagnosis when hypertension complicates a pregnancy. These observations are exciting as early prediction will help save lives especially in developing nations where tertiary care is limited and may be distant. However, as exciting as they are, these initial observations must be rigorously evaluated in an adequately sized prospective study.

We propose to prospectively and serially monitor urinary PlGF as well as serum sFlt1 and PlGF before or at 20 weeks, at 23-27, and 32-35 weeks of gestation in 12,400 women at risk for preeclampsia (nulliparous, chronic hypertensives, diabetics, previous preeclamptics, underlying renal disease) at 6 medical centres in developing nations within Africa, Asia, Europe and South America. The obstetric populations at these centres should permit completion of the study within 2.5 years, with the collection of sufficient data to evaluate the reliability of these proteins as predictive tests, and the feasibility of such testing in developing nations.

Finally, if as we hypothesize,  this large prospective study convincingly demonstrates that urinary PlGF and serum sFlt1/PlGF and/or sEng bio-markers predict preeclampsia,  with a  high degree of sensitivity and specificity, and weeks prior to overt disease, we will focus on the best way to implement the use of these easily performed and affordable tests in developing nations.

Study News

-Systematic review

  -Steering Committes's Meeting

  • Minutes Geneva 30th Nov to 2nd Dec 2005
  • Minutes Lisbon 30th Jun to 1st Jul 2006
  • Minutes Geneva 17th Apr to 18st Apr 2007
  • Minutes Geneva 18th Apr to 19st Apr 2007

We are in the Press

2nd Investigators' meeting - Lisbon, 30 June - 1 July 2006                     Zoom +