I'm just so psyched about the possibility of a screening test for those women who are not known to be at risk. Yeah, treatment is still in development, but if you take the long range view this disease has been described in the literature since what, Hippocrates? without any idea of what caused it, and with the only possible treatment being delivery of the placenta. Pubmed has publishing dates back to the 1800s and the first thing that looks like it might actually be a real solid hit in pre-eclampsia research came out in 2003 -- what a tough target this is!

If sFlt-1 really is the unknown toxemia factor, if this continues to pan out, then finally we'll have a screening test. And with a screening test women will be monitored closely, some currently uneducated practitioners might learn to take the disease seriously because they'll be able to tell PE symptoms from regular pregnancy symptoms, and maybe fewer women will die -- especially in third world countries.

I suspect that, cosmically speaking, we'll have a treatment Real Soon Now. It may not be soon enough for any of us, it may come in 40 years, but still -- how cool is that?

Caryn
DS Oscar born 10/20/02 at 34 weeks, rapid-onset severe PE

Not to be a downer, since the study is great and it hopefully will keep women from experiencing what so many of us did, but when I asked my peri about it, he said they're always coming up with some new test that they hope will predict but as far as he understood the information, for those of us who have already had a pre-e pregnancy we already know we're at risk for the disease again. The test is mainly designed to be used as a general screen for those who haven't had a previous pre-e pregnancy. It ultimately could lead to a change in treatment but that would be several years off. I think one of the great side benefits is the amount of press it's received so that more and more women and health care people watch closer for the early warning signs that we do know.

Andrea
Tara and Rowan (May, 2001, 29-weekers, HELLP)
jr (due April 2005, all looking good so far)

That is a great article!! It's nice to see things published about preeclampsia. Now if only HELLP Syndrome could get some notice as well, I'd be very happy!![:D]

Deanna Smith-Powers (30)

Mommy to Thomas James, b.2/10/04 @ 34 weeks due to severe pre-e and HELLP syndrome
Diagnosed with prothrombin genetic mutations-12/28/04

The notion that it may give you the heads-up is interesting - as Jessica says. For those of us embarking on subsequent pregnancies, it would be good knowlege to have. I, like most of us who have been through pe, can't get hold of enough information. I just had a good AFP test, which the peri suggested may indicate less risk this time and am waiting to see if the uterine artery scan will shed any further light. I think it's pretty amazing that this is all new since I had my son 6 years ago - and that finally so much research is being done into pe. If only they would find a darn cure!

Fiona
dh Tom
ds Nate 12/8/97 - 14/8/97 26 weeks severe pre-e IUGR 1lb
ds Jay 4/11/98 30 weeks pre-e 3lbs 11 oz
no 3 due 15/6/05

My biggest question (followed by who gets the test, when, and how much it costs when it does finally become available) is: Does it work to detect other related diseases like pregnancy induced hypertension or superimposed preeclampsia?

It seems like one report I read said it did not. So, while it is great news and we are all happy for the advance and what it will do for others, it may not directly apply to all of us here...Maybe it will eventually lead there? One could hope.

Catherine (23), Moderator
DH Britton (28)
Emma Margaret (03/02/03) 37 wks PIH & Oligo
Lara Julianne (07/31/04) 38 wks Borderline PIH

quote:Originally posted by LisaC



It seems like a test like this would be a great way to determine risk, but I believe that the JAMA study found that some women with low levels never got pre-e. So it seems that this would be an excellent way to assess risk for first time pregnant moms. I think it of like the AFP triple screen where its only an indicator of possibility/probability.

I think its great that such a test would be available. It can help first time moms be more vigilant...(and those women who get pre-e for the first time in a subsequent pg). For women like us...well....we already know we have a risk. That's my uneducated theory which may be very off base!

Hi Lisa- I just wanted to say I think it's a great comparision between the AFP and the possible Urine test for PE. While still boasting a rather high number of false positives, the AFP is still a routinely recommended test. High possibility/probablility is more information than we had before, right? (That's how I looked at the AFP, anyway).

But I do want to interject my humble (and also non-medical) opinion about 2nd time Moms- Yes, you are right, we know we have a risk- but I for one would be VERY interested in a test for PE, should one become available. As a future 2nd time Mom (maybe, we'll see) I would be curious to know the results of testing would be. If there is a higher probablitly, this gives me (and my providers) a good sense of what's brewing in my body. If the test were to come back "normal" than that could ease some 2nd/3rd trimester anxiety. While I'm sure a "normal" test wouldn't change anything regarding seeing a High risk doctor or Perinatologist, it would be at very least mildly reassuring (the same way,say, uric acid levels can be reassuring to 2nd time pregnancies).

Is there going to be a study on second pregnancy, same father mothers?

It's nice to know the PF is keeping us up to date on further studies we can be a part of. If it won't make a difference for women here in the U.S. at least it could be a life saver for a woman across the globe.


Jessica- Colorado Co-Coordinator
dd Katherine Grace born
10-13-2003
34weeks,6days,39minutes PIH/ Pre-E www.coreyandjess.info

All I have to say is I am glad that it got some reconition in the USA it didn't up here in Canada. I didnt' know anything about it before I got pe I read pregnacy books and there was a little about it but I thought the signs were really clear about getting it I had no clue I had it till it was to late. I hope that something come out of this I dont want when I have a child that reachs child bareing age to go through this

It seems like a test like this would be a great way to determine risk, but I believe that the JAMA study found that some women with low levels never got pre-e. So it seems that this would be an excellent way to assess risk for first time pregnant moms. I think it of like the AFP triple screen where its only an indicator of possibility/probability.

I think its great that such a test would be available. It can help first time moms be more vigilant...(and those women who get pre-e for the first time in a subsequent pg). For women like us...well....we already know we have a risk. That's my uneducated theory which may be very off base!

Lisa

Lisa (35)

Jacqueline (stillborn 24 wks) severe pre-e

#2 EDD 6/11/05

To be clear, this was a retrospective study -- they looked at urine samples stored 10 years ago. In the preeclampsia community this is somewhat "old" news, but getting a lot of attention now because the paper was published in JAMA, arguably one of the top 3 medical journals. Publication in a medical journal of this credibility is what gives mainstream media the green light to consider a piece of research "signficant." Researchers now that these results need to be corroborated in further studies, particularly in clinical studies, and those studies are being developed now. It is far too soon for any women to "ask" for this test in the course of their OB care. As an organization, we will publicize research study recruitment when that becomes available. The best thing anybody can do to involve herself in PE studies is to REGISTER on our site as a preeclampsia survivor. For instance, we are colloborating with the NIH on another study that will be commencing very, very soon. Participants are chosen randomly from those who are registered with the PF. If you aren't registered, register. If you know of other PE survivors, get them to register. Those member numbers are our currency in this industry!

The number of women in the study isn't as important as how they are selected. If it's truly a random sample, then it's valid. Plus, the smaller the sample, the stronger the effect has to be to be statistically significant...

WRT the test working at 25 weeks -- that's the urine test they're developing primarily for third world countries IIRC. It's cheap and easy to administer and will allow them to closely monitor women who would otherwise go untreated. They measured the same protein in bloodwork at 13-16 weeks and found that it was lower in women who went on to develop PE as well, and I suspect that test is the one they'll be administering in countries that can support standardized blood tests as a part of their prenatal care.

This is all tied in to the research on sFlt-1, the VEGF and PlGF antagonist the kidney doctors turned up in a cancer study. I've got the link to the original study somewhere if anyone wants it, and I'm pretty sure it's posted several places on the preeclampsia.org site as well.

Caryn
DS Oscar born 10/20/02 at 34 weeks, rapid-onset severe PE