EARLY RISK-ASSESSMENT METHODS FOR PREDICTION OF PREECLAMPSIA DEVELOPMENT AND SAFER PREGNANCY OUTCOMES

Abstract

Preeclampsia is a multi-system obstetrical syndrome which is responsible for up to six percent of pregnancy complications worldwide. The purpose of this thesis is to explore early-risk assessment methods for preeclampsia development utilizing combined scientific evidence about clinical risk factors and biochemical index markers, and to provide evidence-based recommendations for implementation into nursing practice. Preeclampsia and other hypertensive disorders account for 16% of maternal deaths in the United States (ACOG, 2020). There is emerging research which reveals that blood-based biomarkers, early risk-assessment model implementation and early routine blood pressure readings may predict preeclampsia development before the 20th week gestation. The most relevant and statistically significant clinical risk factors are shown to be history of preeclampsia and chronic hypertension. Several biochemical markers, such as Placental Growth Factor, TNF-alpha and Plasma Protein-A are shown to have relevance in predicting and diagnosing preeclampsia development. Patients who are identified as high-risk in early gestation can begin prophylactic Aspirin therapy starting at 11 weeks gestation. This is shown to reduce the incidence of preeclamptic preterm deliveries (Rolnik, et al., 2017). The last chapter includes an implementation proposal for nursing practice, and evaluation of practice recommendations utilizing the Plan-Do-Act-Study model.