DISPATCH: Decreasing Intervention Using sFlt-1/PlGF Applied to Chronic Hypertension

Ki vehet részt

• Age 18 and older
• Singleton living pregnancy
• Gestational age between 23+0 and 34+6 weeks gestation, confirmed by a fetal crown-rump length measurement in a first trimester ultrasound or by in vitro fertilization dates
• Chronic hypertension, defined as:; At least 2 blood pressure measurements 140 systolic or 90 diastolic 4 hours apart diagnosed at less than 20 weeks 0 days of gestation and within 12 months of conception; History or current use of anti-hypertensive medications for the indication of lowering blood pressure within 12 months prior to conception or prior to 20 weeks 0 days in the current pregnancy. Use during a prior pregnancy and through 12 weeks postpartum, or use for stage 1 chronic hypertension are not exclusions
• Evaluated in triage for worsening chronic hypertension, rule out preeclampsia due to:; Worsening blood pressures from baseline and/or development of severe range blood pressures; Preeclampsia associated symptoms: headache, vision changes, abdominal pain; New onset proteinuria or worsening proteinuria; Lab abnormalities suspicious for preeclampsia including anemia, signs of hemolysis, thrombocytopenia, increasing serum creatinine, elevated liver function tests; Any other concerning features of preeclampsia according to the evaluating clinician

Ki nem vehet részt

• Hemolysis, elevated liver enzymes, low platelet syndrome (HELLP syndrome), pulmonary edema, eclamptic seizure, stroke, myocardial infarction, placental abruption, or heart failure
• Absent or reversed end-diastolic flow in the umbilical artery Doppler
• Unable to consent
• Major birth defect or chromosomal abnormality that may necessitate preterm birth for other reasons
• Other pregnancy complication that may necessitate preterm birth (e.g., PPROM)
• IV Heparin use within 24 hours of the lab draw
• Exogenous PlGF-2 or PlGF-3 given for therapeutic use at a concentration higher than 100 pg/mL