By Rebecca SmithPre-eclampsia affects up to one in ten pregnant women, causing high blood pressure and protein in the urine.
Only a minority of women with the condition will go on to develop life threatening complications but all must be monitored closely.
The only cure is to deliver the baby early but doctors have a fine balancing act to consider which women need to be induced early because they are at risk of complications and which can safely carry their baby to term.
Now researchers at University of British Columbia, in Canada, have found a collection of measures and tests which can predict the one in 100 women with pre-eclampsia that will develop full blown eclampsia, where the mother may suffer seizures, fall into a coma and die.
The findings are published in The Lancet medical journal.
The researchers formulated a calculation using data on the mother’s characteristics, past medical history present symptoms; cardiovascular signs; results of kidney, blood, and liver tests; and fetal assessment tests such as fetal heart rate and estimated weight.
They tested the calculation on more than 2,000 women with pre-eclampsia of whom 13 per cent went on to develop complications. None died.
The calculation called fullPIERS, identified more than three quarters of women who subsequently had events as being at high risk, whereas only 16 per cent of the population was incorrectly identified as being at high risk.
Older tests could be abandoned in light of these findings and replaced with simpler ones, saving money on laboratory costs, the researchers said.
Co-author Dr Peter von Dadelszen, from the Child & Family Research Institute, University of British Columbia, write in the journal: "The fullPIERS model identifies women at increased risk of adverse outcomes up to 7 days before complications arise and can thereby modify direct patient care (eg, timing of delivery, place of care), improve the design of clinical trials, and inform biomedical investigations related to pre-eclampsia.
"Although the model-making process is not finished, we hope that the planned external validation (through prospective data collection and use of extant international databases) and implementation of fullPIERS will help to reduce the risk of the life-ending, life-altering (eg, stroke), and life-threatening (eg, eclampsia) complications that make pre-eclampsia so important."
In an accompanying comment article, Dr Gary Darmstadt, from the Bill and Melinda Gates Foundation, Family Health Division, in Seattle, said: "Hypertension in pregnancy and pre-eclampsia challenge the public-health community because of the need to simultaneously protect the mother and baby and to balance sometimes competing needs to accelerate or delay the end of the pregnancy.
"This study focuses primarily on maternal outcomes but also has implications for neonatal health. Hypertension in pregnancy and pre-eclampsia are conditions that call for further collaboration between maternal and neonatal health experts.
"We hope that this new knowledge will be translated into effective and immediate action and further adapted and validated for use in low-income and middle-income countries, and thus used to its greatest advantage to save the lives of mothers and babies."
© The Telegraph Group London 2010
