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Infant Viability in Severe Preeclampsia: Management Strategies and the Potential Role of Calprotectin-A Narrative
Oala Ioan Emilian1, Adrian Apostol2, Viviana Mihaela Ivan2
1Doctoral School, Faculty of Medicine, "George Emil Palade" University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania.
Insights
Preeclampsia (PE) monitoring requires multidisciplinary care to improve fetal viability. While elevated calprotectin suggests inflammation in PE, its role as a biomarker for fetal viability needs further research.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Neonatology
Background:
- Preeclampsia (PE) is a serious pregnancy complication characterized by hypertension and proteinuria.
- Defective placentation and endothelial dysfunction are key factors in PE development.
- Calprotectin is being investigated as a potential, though not yet standard, screening marker for PE.
Purpose of the Study:
- To review monitoring strategies for severe preeclampsia to enhance neonatal viability.
- To explore methods for safely prolonging pregnancy in PE cases.
- To evaluate calprotectin as a potential biomarker for preeclampsia and its impact on fetal well-being.
Main Methods:
- Review of current monitoring methods for severe preeclampsia.
- Analysis of multidisciplinary management approaches in tertiary care settings.
- Evaluation of cardiotocography, Doppler ultrasound, and placental histology in PE management.
- Assessment of calprotectin levels in relation to PE and fetal outcomes.
Main Results:
- Multidisciplinary management by maternal-fetal medicine and neonatology specialists is crucial for improving fetal/neonatal viability.
- Cardiotocography and Doppler ultrasound are indicated based on PE severity and intrauterine growth restriction.
- Elevated calprotectin levels in PE suggest an inflammatory component, but its direct role in fetal viability is unproven.
Conclusions:
- Early-stage preeclampsia poses significant risks to maternal and neonatal health, impacting neonatal viability.
- Further research is essential to clarify the role of calprotectin in PE development and its relevance to fetal viability.
- Calprotectin shows potential as an inflammation marker in PE, but requires more studies to confirm its utility as a biomarker for fetal viability.
Abstract:
Preeclampsia (PE) is a vascular-related pregnancy disorder characterized by high blood pressure and proteinuria after 20 weeks' gestation. Defective placentation, together with endothelial dysfunction, has a crucial role in the development of PE. Current evidence suggests that calprotectin is a potential marker for screening, even if it is not yet a standard diagnostic tool. The aim of our study is to the review monitoring methods for severe preeclampsia, which endangers neonatal viability. Starting from here, we look for ways to safely prolong pregnancy and also evaluate calprotectin as a potential biomarker of this pathology. Current issues and future perspectives are analyzed. As a solution, multidisciplinary management should be offered in tertiary-level units by maternal-fetal medicine specialists and neonatology units to increase fetal/neonatal viability. Based on the severity of preeclampsia and intrauterine growth restriction, cardiotocography and Doppler ultrasound monitoring should be scheduled. Delivery is also taken into consideration based on gestational age and maternal condition. Placental histological findings appear to be crucial in understanding this disease. The elevated calprotectin levels in preeclampsia suggest underlying inflammatory processes in the mother, which potentially contribute to the development of the condition; however, more research is needed to clarify calprotectin's role. Conclusion: Early-stage preeclampsia remains a significant risk to maternal and neonatal health, with significant impacts on neonatal viability. Further elucidation of a role for calprotectin in the development of preeclampsia and its relevance for fetal viability are necessary. Calprotectin could be a potential biomarker in preeclampsia, as an important inflammation marker. But, so far, calprotectin has failed to prove its role as a marker of fetal viability, and thus, more studies are needed.
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