Postpartum Preeclampsia Early Detection and Treatment: Using Biomarkers to Implement Risk-stratified Intervention (Nepal Pilot Randomized Controlled Trial)
Medical College of Wisconsin
Summary
The goal of this study is to address the significant morbidity associated with preeclampsia diagnosed after delivery. All participants will undergo biomarker evaluation with soluble fms-like tyrosine kinase-1 and placental growth factor (sFlt-1/PlGF) ratio testing before delivery to assess the predictive ability of these biomarkers with new-onset postpartum preeclampsia. High-risk participants will be randomized to a bundle of care strategies aimed at early detection and management of postpartum preeclampsia.
Description
This is a pilot randomized controlled trial of 60 normotensive, pregnant patients randomized to early monitoring and management for postpartum preeclampsia after biomarker evaluation with sFlt-1/PlGF ratio. After obtaining informed consent, participants will undergo preeclampsia risk assessment using sFlt-1/PlGF ratio testing prior to delivery. Patients with a low risk ratio will receive routine postpartum care. Patients with a high risk ratio will be randomized 1:1 to the intervention bundle focused on early detection and management of postpartum preeclampsia versus routine postpartum care. T…
Eligibility
- Age range
- 18+ years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * Pregnant patients ≥ 36 weeks gestation without major fetal anomalies * Age ≥ 18 years * Admitted for labor at Dhulikhel Hospital, or intend to deliver at Dhulikhel Hospital * At risk for preeclampsia, using the Clinical Risk Assessment for Preeclampsia according to ACOG and USPSTF * 1 or more high risk factors: * History of preeclampsia * Type 1 or 2 diabetes * Multifetal gestation? * Renal disease * Autoimmune disease * 2 or more moderate risk factors: * Nulliparity * BMI \> 30 * First-degree relative with a history of preeclampsia…
Interventions
- OtherEarly detection and management of postpartum preeclampsia bundle
Remote blood pressure monitoring, education, and dispensing antihypertensive medication (nifedipine ER) for outpatient management of asymptomatic, mild range BP.
Locations (2)
- Medical College of WisconsinMilwaukee, Wisconsin
- Dhulikhel HospitalDhulikhel