Infant Viability in Severe Preeclampsia: Management Strategies and the Potential Role of Calprotectin—A Narrative Review

TL;DR

This review discusses how to manage severe preeclampsia to improve infant survival and explores calprotectin as a potential biomarker for the condition.

Contribution

The paper evaluates calprotectin's potential as a biomarker and proposes multidisciplinary strategies for managing severe preeclampsia.

Findings

Calprotectin levels are elevated in preeclampsia, indicating possible inflammation.

Multidisciplinary care in tertiary units is recommended to improve neonatal outcomes.

Calprotectin's role as a fetal viability marker remains unproven and requires further research.

Abstract

Preeclampsia (PE) is a vascular-related pregnancy disorder characterized by high blood pressure and proteinuria after 20 weeks’ gestation. Defective placentation, together with endothelial dysfunction, has a crucial role in the development of PE. Current evidence suggests that calprotectin is a potential marker for screening, even if it is not yet a standard diagnostic tool. The aim of our study is to the review monitoring methods for severe preeclampsia, which endangers neonatal viability. Starting from here, we look for ways to safely prolong pregnancy and also evaluate calprotectin as a potential biomarker of this pathology. Current issues and future perspectives are analyzed. As a solution, multidisciplinary management should be offered in tertiary-level units by maternal–fetal medicine specialists and neonatology units to increase fetal/neonatal viability. Based on the severity of preeclampsia and intrauterine growth restriction, cardiotocography and Doppler ultrasound monitoring should be scheduled. Delivery is also taken into consideration based on gestational age and maternal condition. Placental histological findings appear to be crucial in understanding this disease. The elevated calprotectin levels in preeclampsia suggest underlying inflammatory processes in the mother, which potentially contribute to the development of the condition; however, more research is needed to clarify calprotectin’s role. Conclusion: Early-stage preeclampsia remains a significant risk to maternal and neonatal health, with significant impacts on neonatal viability. Further elucidation of a role for calprotectin in the development of preeclampsia and its relevance for fetal viability are necessary. Calprotectin could be a potential biomarker in preeclampsia, as an important inflammation marker. But, so far, calprotectin has failed to prove its role as a marker of fetal viability, and thus, more studies are needed.

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