Detection and Identification of Preeclampsia Via Volatile Biomarkers

Preeclampsia is a form of hypertension that is unique to human pregnancy. The clinical findings of preeclampsia can manifest as either a maternal syndrome (hypertension and proteinuria with or without other multisystem abnormalities) or as a fetal syndrome (fetal growth restriction, reduced amniotic fluid, and abnormal oxygenation).

The incidence of preeclampsia ranges between 2 and 7 percent in healthy nulliparous women. In these women, preeclampsia is generally mild, with the onset near term or intrapartum (75 percent of cases), and the condition conveys only a minimally increased risk for adverse pregnancy outcome. In contrast, the incidence and severity of preeclampsia are substantially higher in women with multifetal gestation, chronic hypertension, previous preeclampsia, pregestational diabetes mellitus, and in those with preexisting thrombophilias.

The etiology of preeclampsia is unknown. Many theories have been suggested, but most of them have not withstood the test of time. Some of these theories: Abnormal trophoblast invasion, coagulation abnormalities, vascular endothelial damage, cardiovascular maladaptation, immunologic phenomena, genetic predisposition and dietary deficiencies or excesses.

Preeclampsia is a clinical syndrome that embraces a wide spectrum of signs and symptoms that have been clinically observed to develop alone or in combination. The classic triad of preeclampsia includes: hypertension, proteinuria, and edema. However, there is now universal agreement that edema should not be considered as part of the diagnosis of preeclampsia. The diagnosis of preeclampsia requires the presence of an elevated blood pressure (BP) with proteinuria,3 usually starting after the 20th week of the pregnancy, but the severity of the disease process is generally based on the maternal BP which is considered as the traditional hallmark for diagnosis of the disease.

Women with preeclampsia may exhibit a symptom complex ranging from minimal BP elevation to derangements of multiple organ systems. The renal, hematologic, and hepatic systems are most likely to be involved.