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Late pregnancy screening for preeclampsia with a urinary point-of-care test for misfolded proteins.

用错误折叠蛋白的尿点护理试验对先兆子痫进行晚期妊娠筛查。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0233214
  • 作者列表:"Li XM","Liu XM","Xu J","Du J","Cuckle H
  • 发表时间:2020-05-20
Abstract

:The aim was to describe and assess a new late pregnancy point-of-care urinary preeclampsia screening test. Urine samples were collected from a consecutive series of 1,532 pregnant women hospitalized at 20-41 weeks gestation in a Chinese single obstetric unit. A simple disposable Congo red based device was newly developed and employed to prospectively test misfolded proteins in pregnant women's urine. A total of 140 preeclampsia cases were clinically diagnosed, 101 severe and 87 pre-term. Detection and false positive rates were similar in the training and validation subsets with combined 74% and 3.0%. The detection rate was 83% in severe, 86% in pre-term, 49% and 50% in mild and term cases (P<0.0001) respectively. In conclusion, a simple point-of-care urinary test for misfolded proteins can be used to screen for preeclampsia in late pregnancy with very high screening performance. To the best of our knowledge, this is the first study to screen for preeclampsia using Congo red based device in Chinese pregnant population.

摘要

: 目的是描述和评估一种新的晚期妊娠定点尿先兆子痫筛查测试。在中国单一产科单位,连续收集1,532名妊娠20-41周住院的孕妇的尿液样本。新开发了一种简单的一次性刚果红装置,用于前瞻性地测试孕妇尿液中错误折叠的蛋白质。临床诊断子痫前期140例,重度101例,早产87例。检测和假阳性率在训练和验证子集中是相似的,组合为74% 和3.0%。重度检出率为83%,早产检出率为86%,轻度和足月检出率分别为49% 和50% (P<0.0001)。总之,一种简单的针对错误折叠蛋白的即时尿液检测可用于筛查妊娠晚期的先兆子痫,具有非常高的筛查性能。据我们所知,这是第一项在中国孕妇人群中使用刚果红装置筛查先兆子痫的研究。

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METHODS::Background: The exact cause of preeclampsia remains unknown. The past decade has seen an ongoing debate on the relative importance of primipaternity versus prolonged birth/pregnancy interval.Aims: The aim of the current study was to analyze these two major potential risk factors in a high risk population in the Northern suburbs of Adelaide; a socioeconomically disadvantaged area characterized by instable relationships and overall poor health and lifestyle.Methods: A retrospective cohort study was performed on all multigravid women birthing at the Lyell McEwin Hospital, Adelaide, from July 2011 to August 2012; 2003 patients were included in this analysis. Basic demographic data, previous pregnancy outcomes, paternity, and birth and pregnancy intervals were recorded.Results: Women with a previously normal pregnancy had a significantly increased risk of developing preeclampsia in subsequent pregnancy with a new paternity (OR: 2.27 [p = .015]). Increasing birth and pregnancy intervals were associated with a significantly increased risk of developing preeclampsia in later pregnancies, with OR 1.39 at 3 years (p = .042) and OR 2.05 at 4 years (p = .002).Conclusions: The results of this study indicate that both prolonged birth interval and primipaternity are independent risk factors for preeclampsia in multigravidae.

翻译标题与摘要 下载文献
影响因子:1.44
发表时间:2020-01-01
DOI:10.1080/14767058.2018.1484097
作者列表:["Lapoirie J","Contis A","Guy A","Lifermann F","Viallard JF","Sentilhes L","James C","Duffau P"]

METHODS::Introduction: Philadelphia-negative myeloproliferative neoplasms (MPNs) greatly increase the risk of maternal and fetal complications during pregnancy. Currently, international agreements regarding the management of these women are lacking.Patients and methods: Our study aimed to assess the current management and outcomes of MPN pregnancies in a French cohort. We retrospectively analyzed 27 pregnancies in women with MPNs that were associated with a specific mutation. Nineteen pregnancies in nine women with essential thrombocythemia and eight pregnancies in five women with polycythemia vera were identified.Results: Our study showed 70% live births, but only 30% uneventful pregnancies. Fetal complications were mainly early spontaneous abortions (22%), fetal growth restriction (15%), and premature delivery (15%). Maternal issues were divided between thrombosis (15%) and hemorrhages (11%). High rates of preeclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome (15%) were reported. Uterine artery Doppler was performed in 70% pregnancies. Abnormal Doppler results were found in 43% pregnancies. Pregnancies with high platelet counts and packed cell volume remaining static or increasing ended with fetal death and utero-placental dysfunction. According to expert consensus, most of the pregnancies (67%) could be stratified in the high risk group and had a bad obstetrical outcome, with 50% standard-risk pregnancies versus 22% high-risk pregnancies that were uneventful. Higher risk pregnancies were prescribed heparin and/or interferon α in 72%.Conclusions: The prognosis of these pregnancies remains very bad and may be improved by a more effective collaboration between specialists as well as a therapeutic intensification including heparin and interferon α.

影响因子:1.44
发表时间:2020-02-01
DOI:10.1080/14767058.2018.1495191
作者列表:["Capriglione S","Plotti F","Terranova C","Gulino FA","Di Guardo F","Lopez S","Scaletta G","Angioli R"]

METHODS::Purpose: The challenge to obtain improved predictive tools, able to identify women destined to develop preeclampsia (PE), is raising the interest of researchers for the attractive chance to allow for timely initiation of prophylactic therapy, appropriate antenatal surveillance, and better-targeted research into preventive interventions. We aimed to gather all the evidence reported up to now in scientific literature relating to all prediction tests for PE.Materials and methods: We searched articles on conventional literature platforms from January 1952 to August 2016, using the terms "preeclampsia," "gestational preeclampsia," and "gestational hypertensive disorders" combined with "predictive test" and "risk assessment." Abstracts/titles identified by the search were screened by three investigators.Results: The search identified 203 citations, of which 154 potentially relevant after the initial evaluation. Among these studies, 20 full articles were excluded, therefore, 134 primary studies met the criteria for inclusion and were analyzed.Conclusions: Current evidence suggests that a combination of several features may provide the best predictive accuracy for the identification of PE. Large-scale, multicenter, multiethnic, prospective trials are required to propose an ideal combination of markers for routine screening.

翻译标题与摘要 下载文献
妊娠高血压方向

妊娠高血压是妊娠期妇女所特有而又常见的疾病,以高血压、水肿、蛋白尿、抽搐、昏迷、心肾功能衰竭,甚至发生母子死亡为临床特点。妊娠高血压综合征按严重程度分为轻度、中度和重度,重度妊娠高血压综合征又称先兆子痫和子痫,子痫即在高血压基础上有抽搐。

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