Decidual vasculopathy in preeclampsia 3: Prediction and early detection

Preeclampsia (PE) is a hypertensive disease of pregnancy of unknown etiology,
defined by (the onset of) high blood pressure and proteinuria after 20 weeks of
gestation, causing serious maternal and fetal morbidity. Decidual vasculopathy
(DV) is a pathological finding of spiral arteries seen in PE. We previously
showed an association of DV with disease severity and fetal outcome in PE. We
concluded that PE with DV could represent a subclass of severe, early disease,
with possibly a unique underlying disease process. The prediction of PE would
enable closer monitoring and preventive interventions for high risk patients.
Various biomarkers have been found to be associated with the development of PE,
however, so far no single biomarker has been found to have a sufficient
predictive power. We hypothesize that PE can be optimally predicted using a
specific combination of biomakers. The prediction of PE with DV has not been
studied. We hypothesize that DV will be associated with a specific set of
biomarkers for the prediction of PE.

Storage of blood samples, placental material and ultrasonic measurements to be
used in a future study the prediction of PE and DV.

Blood samples will be drawn and stored. Additionally, uterine artery blood flow
will be measured ultrasonically. Measurements will take place in first and
second trimester; peripartum and after onset of clinical disease in cases that
develop preeclampsia. After delivery, placental material will be sampled and
stored.

Pregnant women at 11-13 weeks GA, at 18-22 weeks GA, at time of development of
PE (if applicable) and before delivery (for a maximum total of 5 times) will
undergo blood sampling and ultrasonic examination of the uterine artery flow.
30-40 ml of blood will be drawn per sampling. After delivery, placental
material will be sampled for histological analysis.