Early Detection and Treatment of Postpartum Preeclampsia Using Biomarkers and Risk-based Care in Nepal

What this Trial Is About

Researchers are studying postpartum preeclampsia, a condition causing significant health issues after delivery. This trial aims to evaluate the use of biomarkers, specifically the soluble fms-like tyrosine kinase-1 and placental growth factor sFlt-1PlGF ratio, to predict new onset postpartum preeclampsia in patients who were normotensive during pregnancy. The study is a pilot randomized controlled trial focused on early detection and management of postpartum preeclampsia in high-risk individuals. Participants will have their sFlt-1PlGF ratio tested before delivery to assess preeclampsia risk. Those with low-risk ratios will receive routine postpartum care, while high-risk participants will be randomly assigned to either an intervention group receiving a bundle of care that includes remote blood pressure monitoring, education, and antihypertensive medication nifedipine ER for managing mild blood pressure elevations, or to standard postpartum care. The study will measure feasibility, effects on hypertension-related healthcare needs, and the predictive ability of the biomarker ratio. Participants will be monitored through remote blood pressure checks and clinical assessments postpartum. Data on recruitment, retention, adherence, and acceptability will be collected over one year to assess study feasibility. Secondary outcomes include hypertension-related complications within four weeks after delivery, and the predictive accuracy of the biomarker ratio two weeks postpartum. Participants remain enrolled in the study for ongoing evaluation, with the study completing in June 2027.

Postpartum Preeclampsia Early Detection and Treatment: Nepal Pilot Study