Early warning for pregnant women

A pregnant woman rarely discovers she has preeclampsia until she is stricken by advanced complications—spiking blood pressure, severe headaches, seizures, a stroke, or a ruptured liver. By then, her life is in danger: preeclampsia causes one in five maternal deaths in the United States and 63,000 deaths each year, worldwide. The treatment is delivery of the baby, which is usually premature.

A new, low-cost urine test developed by Yale medical school associate professor Irina Buhimschi could diagnose this poorly understood disorder weeks or even months before severe symptoms show up, according to a preliminary study of 347 pregnant women. The simple dye test detects improperly folded blood proteins, which Buhimschi and colleagues have identified as hallmarks of the disorder.

Buhimschi says the new test, which costs pennies per patient, could save lives: in the developing world, earlier diagnosis could allow rural women to travel to hospitals for life-saving care, including cesarean sections. In industrialized countries, earlier diagnosis could buy time for women who must deliver early, allowing them to take steroids that help preterm infants survive by hastening their lung development. And because the test can distinguish preeclampsia from other disorders, such as chronic hypertension or kidney dysfunction, it could prevent “just-in-case” preterm deliveries resulting from uncertain diagnoses.

Buhimschi’s findings were published in the American Journal of Obstetrics and Gynecology. She says several private companies are negotiating with Yale for rights to manufacture the test.