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 preeclampsia 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 preeclampsia was found to be limited. No data are available specifically for HELLP syndrome.
Although the Food and Drug Administration (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 preeclampsia with severe features in women hospitalized for hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, or chronic hypertension with or without superimposed preeclampsia), 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 preeclampsia, diagnosis or exclusion of preeclampsia with severe features, or determination of the management approach after a positive or negative test result.[8][69]
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