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Am J Perinatol 2021; 38(09): 976-982
DOI: 10.1055/s-0039-1701023
Commentary

Preeclampsia: The Need for a Biological Definition and Diagnosis

Alex C. Vidaeff
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
,
George R. Saade
2   Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas
,
Baha M. Sibai
3   Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, UT Health, Houston, Texas
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Abstract

The centuries-old approach to the prevention of eclampsia and its associated maternal morbidity and mortality is based on the recognition of the presence of premonitory signs and symptoms such as hypertension and proteinuria. The spectrum of preceding signs and symptoms came to be known as preeclampsia, which is debatably considered to be an early stage on a clinical continuum possibly leading to eclampsia. The premonitory signs and symptoms were then construed as diagnostic criteria for the poorly understood syndrome of preeclampsia, and this led to a perpetual debate that remains subject to wide disagreement and periodic updates. In this commentary, we will draw attention to the fact that the criteria for preeclampsia should be viewed from the prism of a screening test rather than as diagnostic of a condition in itself. Focusing research on developing better diagnostic and screening methods for what is clinically important, namely maternal and perinatal morbidity and mortality from hypertensive disorders of pregnancy, a long overdue upgrade from what was possible centuries ago, will ultimately lead to better management approaches to what really matters.

Keywords

preeclampsia - definition - diagnosis - biomarkers


Publication History

Received: 29 August 2019

Accepted: 13 December 2019

Article published online:
27 January 2020

© 2020. Thieme. All rights reserved.

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