Pre-eclampsia is a specific pathology of pregnancy classically associating arterial hypertension with proteinuria. Its prevalence in industrialized countries is 3 to 8% of pregnancies, which makes it a frequent pathology, and it is responsible for 30% of premature deliveries. The consequences of this pathology can be very serious for the mother:renal insufficiency, hepatic cytolysis, retro-capsular hematoma of the liver, convulsions, disseminated intravascular coagulation. Moreover, the consequences on the fetus and the pregnancy are just as serious: intrauterine growth retardation, induced prematurity, retroplacental hematoma, fetal death in utero. Pre-eclampsia therefore remains difficult to diagnose and to prognose. The diagnosis of pre-eclampsia based on blood pressure and proteinuria has a predictive value of 30% for adverse outcomes related to pre-eclampsia. In recent years, new biomarkers have been studied: PlGF, a placental growth factor, and sFlt-1, the free fraction of its membrane receptor.The pathophysiology and specificity of these biomarkers, but especially their ratio, has been widely studied and demonstrated in the diagnosis and prognosis of preeclampsia. Nevertheless, few studies have analyzed the impact of this report on the hospitalization of patients, except mainly a German study which showed a change in the decision to hospitalize in 16.9% of cases. On the other hand, no French study has been carried out on this subject. Finally, no professional recommendation fully integrates or clearly frames the use of the ratio in current practice. Its use therefore remains disparate between countries, but also within the same country, as in France, where few centers use it. The decision to hospitalize a patient with suspected preeclampsia depends on the organization of the health care system. It therefore seems interesting to analyze the precise impact on hospitalizations of the use of a diagnostic and prognostic tool such as the sFlt-1/PlGF ratio with the specificities of the French health system, which favors outpatient management.The study would evaluate the use of this promising tool in the daily management of parturients, paving the way for the development of simple recommendations applicable in the various French maternity hospitals. The hypothesis is that the use of the sFlt-1/PlGF ratio in patients with suspected pre-eclampsia would reduce the rate of hospitalization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
43
Blood test for biomarkers (sFlt-1/PlGF ratio) For patients in the "standard" group, the biomarker results will be masked and then revealed afterwards for statistical analysis. For the "biomarkers" group, the monitoring decision will be made based on the ratio calculation
Blood test for biomarkers (sFlt-1/PlGF ratio) For patients in the "standard" group, the biomarker results will be masked and then revealed afterwards for statistical analysis. For the "biomarkers" group, the monitoring decision will be made based on the ratio calculation.
Nice University Hospital
Nice, France
hospitalization rate
hospitalization rate for each group.
Time frame: up to 4 months
sFlt-1/PlGF ratio at inclusion and length of hospital stay
correlation between sFlt-1/PlGF ratio at inclusion and length of hospital stay
Time frame: up to 4 months
Complications specific to pre-eclampsia
occurrence of complications specific to pre-eclampsia (eclampsia, HELLP-syndrome, fetal death in utero...)
Time frame: up to 4 months
Pregnancy Outcome
Correlation of the sFlt-1/PlGF ratio at inclusion and its kinetics with pregnancy outcome (route of delivery and urgency criteria)
Time frame: up to 4 months
newborn health status at birth
Correlation of the sFlt-1/PlGF ratio at inclusion and its kinetics with newborn health status at birth (Apgar score and need for immediate pediatric management)
Time frame: up to 4 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.