A simple urine test enables fast preeclampsia diagnosis

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preeclampsia diagnosis

Preeclampsia can be life-threatening for both mothers and babies. Researchers at Ohio State University have discovered that a simple urine test could be used for fast preeclampsia diagnosis.

Preeclampsia is one of the deadliest pregnancy-related conditions. Symptoms of preeclampsia can include high blood pressure, excess protein in urine (proteinuria) or signs of liver or kidney problems. It affects up to 8% of pregnancies in the United States and is responsible for 13% of maternal deaths globally. Preeclampsia is also the number one reason a baby is delivered prematurely. Preeclampsia diagnosis currently relies on identifying high blood pressure and particular proteins in the urine.

Preeclampsia can develop without symptoms  

Often described as mysterious, preeclampsia can be hard to diagnose as it can develop without any symptoms. It usually begins after 20 weeks of pregnancy and if left untreated, it can lead to serious complications for the mother and baby.

Undetected, preeclampsia can lead to eclampsia which includes seizures and coma and can be fatal. Even if there is just a suspicion of preeclampsia, pregnant women are typically induced, and the majority of babies are delivered prematurely. The concern with premature birth is it increases a newborn baby’s risk of chronic health issues such as learning disabilities, blindness and cerebral palsy.

The biggest challenges are some symptoms mimic normal pregnancy such as headaches and swelling. Also, the disease is progressive and not everyone progresses at the same time. For example, some women may have preeclampsia for weeks before any symptoms appear, while other women can progress to dangerous levels in just days.

Scientists design fast, non-invasive, and inexpensive diagnostic test

In a bid to reduce the number of deaths, preeclampsia diagnosis has been the focus for researchers at The Ohio State University College of Medicine, along with The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital. They designed a rapid, non-invasive and inexpensive diagnostic test. The test is a paper-based point-of-care Congo Red Dot (CRD) paper test. The premises behind the test is proteins in the urine of women with preeclampsia bind to Congo red dye, resulting in red dye appearing on the test paper. They recently piloted a clinical study using this diagnostic test to establish or rule out preeclampsia diagnosis. The results of the study were published in Lancet’s E-Clinical Medicine.

The clinical study included 346 pregnant women who were undergoing assessment for high blood pressure and possible preeclampsia. The CRD test, a urine test which provides bedside results within three minutes, was carried out on each participant. The results were analysed by trained clinical research nurses and then the patient’s physician made a final diagnosis. It was hypothesized pregnant women with preeclampsia would display a positive CRD test.

Test accuracy rate of 86% is superior compared to current diagnostic tests

Of the 346 patients enrolled in the study, 89 were diagnosed with preeclampsia. Due to the preeclampsia diagnosis, 79% of these women were then induced, with delivery on average occurring at 33 weeks of gestation. The accuracy rate of the CRD test for diagnosing preeclampsia was 86%. This is far superior to the other biochemical diagnostics tests currently used.

These findings show the CRD test is a simple point-of-care diagnostic test which enables accurate and rapid preeclampsia diagnosis. This easy and non-invasive test has the potential to help maintain the health of pregnant women and their babies, not only in first world countries, but also in underdeveloped countries where there is a lack of resources available to pregnant women. Hence, this simple urine test could have a significant impact on global health of women and children.

Written by Lacey Hizartzidis, PhD

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References:

  1. Research finds simple urine test allows for rapid diagnosis of preeclampsia. EurekAlert website https://www.eurekalert.org/pub_releases/2019-03/m-rfs031319.php. Accessed March 24, 2019.
  2. Kara M. Rood, Catalin S. Buhimschi, Theresa Dible, Shaylyn Webster, Guomao Zhao, Philip Samuels, Irina A. Buhimschi. Congo Red Dot Paper Test for Antenatal Triage and Rapid Identification of Preeclampsia. EClinicalMedicine, 2019; DOI: 1016/j.eclinm.2019.02.004.

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