Screening
One systematic review of 27 observational studies concluded that patients with an abnormal uterine artery Doppler waveform in the second trimester have a 4 to 6 times higher risk of pre-eclampsia compared with those with normal Doppler evaluations.[68] In spite of these results, the value of uterine artery Doppler evaluation as a screening test for pre-eclampsia was found to be limited. No data are available specifically for HELLP syndrome.
Although the US Food and Drug Administration (US FDA) has approved the soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) test to aid risk assessment for the progression to pre-eclampsia with severe features in women hospitalised for hypertensive disorders of pregnancy (gestational hypertension, pre-eclampsia, or chronic hypertension with or without superimposed pre-eclampsia), the American College of Obstetricians and Gynecologists (ACOG) does not recommend any single biomarker test (e.g., PlGF testing or the sFlt-1/PlGF ratio) for the prediction of pre-eclampsia, diagnosis or exclusion of pre-eclampsia with severe features, or determination of the management approach after a positive or negative test result.[8][69]
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