ACOG release new practice update on biomarker testing for hypertensive disorders in pregnancy

ACOG release new practice update on biomarker testing for hypertensive disorders in pregnancy: © makibestphotoi - stock.adobe.com

Contemporary OB/GYN®: Can you give some of the top takeaways from the new clinical practice update from the American College of Obstetricians and Gynecologists (ACOG)?

Padmashree Woodham, MD: The sFIt-1:PIGF ratio can be used for patients who meet inclusion criteria as described in the PRAECIS trial (e.g., avoid testing in asymptomatic, nonhospitalized individuals at less than 23 weeks or more than 35 weeks of gestation and in postpartum individuals).

I am very encouraged by ACOG issuing new guidance around using the test in conjunction with standard clinical practices for stratifying the risk of preeclampsia with severe features. Many ob-gyns are still unaware of this test, and ACOG making a statement helps to further spread the word about how this biomarker test can help caregivers make more informed decisions, improving outcomes for hundreds of thousands of women diagnosed with preeclampsia every year in the United States

The Thermo Fisher Scientific tests are designed to be used together with other laboratory tests and clinical assessments to assess pregnant women who have been hospitalized for hypertensive disorders of pregnancy to determine if they are at risk of progressing to preeclampsia with severe features within the next two weeks.

Contemporary OB/GYN®: Can What does this mean for physicians? And how can they implement this testing into their practice?

Woodham: In the United States, maternal mortality rates exceed most other developed countries, and preeclampsia is one of the main contributors. Black women are at a particularly high risk. Preeclampsia threatens the health of mothers and their newborns during pregnancy. It also increases the risk of cardiovascular disease for affected women later in life. For years, clinicians have sought to improve the risk stratification and clinical management of preeclampsia.

Preeclampsia, which affects roughly 2% to 8% of pregnant women worldwide, causes high blood pressure and often prompts doctors to keep the patient in the hospital for close monitoring.¹ At this time, the only treatment for severe preeclampsia is delivery of the baby. The FDA-cleared biomarker test can assess whether a patient is at high or low risk of developing severe preeclampsia based on the risk-stratification ratio. When used alongside other diagnostic measures, the test can tell who will develop preeclampsia with severe features within the next two weeks–allowing doctors to make more informed treatment decisions including safely prolonging pregnancy.

Contemporary OB/GYN®: Can What are some of the benefits and detriments of using biomarker testing for risk assessment of hypertensive disorders in pregnancy?

Woodham: There are several benefits of using biomarker testing for risk assessment of hypertensive disorders in pregnancy, including:

• Women who test positive (have an elevated ratio) could receive enhanced surveillance and accelerated care before severe features develop.
• These tests enable caregivers to provide more informed decisions and improve outcomes for thousands of women at risk for preeclampsia every year in the United States.
• There are no detriments of biomarker testing that come to mind, unless clinicians use it as diagnostic rather than prognostic.

Contemporary OB/GYN®: Can What is a common misconception about biomarker testing?

Woodham: A common misconception about biomarker testing is that it is diagnostic when in fact it is prognostic and an adjunct to standard clinical practice.

Reference:

1. Karrar SA, Martingano DJ, Hong PL. Preeclampsia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 25, 2024.