Serum uric acid, microalbuminuria, urinary calcium or kallikrein, microtransferrinuria, N-acetyl-3-glucosaminidase, cystatin C, podocyturia, podocalyxin
Platelet count and activation, fibronectin, endothelial adhesion molecules, prostaglandins, prostacyclin, MMP-9, thromboxane, C-reactive protein, cytokines, endothelin, neurokinin B, homocysteine, lipids, insulin resistance, resistin, antiphospholipid antibodies, plasminogen activator-inhibitor (PAl), leptin, p-selectin, angiogenic and antiangiogenic factors such as placental growth factor (PIGF), vascular endothelial growth factor (VEGF), fms-like tyrosine kinase receptor-1 (sFlt-1), endoglin
Antithrombin-III(AT-3), atrial natriuretic peptide (ANP), 32-microglobulin, haptoglobin, transferrin, ferritin, 25-hydroxyvitamin 0, genetic markers, cell-free fetal DNA, serum and urine proteomics and metabolomic markers, hepatic aminotransferases
ADAM 12 = ADAM metallopeptidase domain 12; MMP = matrix metalloproteinase. Adapted from Conde-Agudelo, 2015, Duckworth, 2016.
test employs the same principle by squeezing a handball. The angiotensin 11 infusion test is performed by giving incrementally increasing doses intravenously, and the hypertensive response is quantiied. In an updated metaanalysis, sensitivities of all three tests were reported to range from 55 to 70 percent, and specificities approximated 85 percent (CondeAgudelo, 2015).
Uterine artey Doppler velocimety is posited to relect faulty trophoblastic invasion of the spiral arteries. his failure results in diminished placental perfusion and upstream greater uterine artery resistance. Increased uterine artery velocimetry determined by Doppler ultrasound in the first two trimesters might provide indirect evidence of this process and thus serve as a predictive test for preeclampsia (Dar, 2010; Groom, 2009). Elevated low resistance results in an abnormal vessel waveform represented by an exaggerated diastolic notch. hese indings have value for prediction of fetal-growth restriction but not preeclampsia (American College of Obstetricians and Gynecologists, 2015). Several low velocity waveforms have been investigated for preeclampsia prediction, however, none is suitable for clinical use (CondeAgudelo, 2015; Kleinrouweler, 2012; Myatt, 2012a).
Several serum analytes have been proposed to help predict preeclampsia (see Table 40-5). Newer ones are continually added. In general, none of these tests are clinically beneicial for hypertension prediction.
Hyperuricemia likely results from reduced uric acid clearance from diminished glomerular filtration, increased tubular reabsorption, and decreased secretion. Cnossen and coworkers (2006) reported that its sensitivity to detect preeclampsia ranged from 0 to 55 percent, and speciicity was 77 to 95 percent.
Isolated gestational proteinuria is a risk factor for preeclampsia Qayaballa, 2015; Morgan, 2016; Yamada, 2016). As a predictive test for preeclampsia, microalbuminuria has sensitivities that range from 7 to 90 percent and specificities that span 29 to 97 percent (Conde-Agudelo, 2015).