When a pregnant patient presents with signs that could indicate preeclampsia, obstetric clinicians often face a difficult question: What happens next?
Should the patient be admitted to the hospital? Is delivery necessary? Or can she safely return home with close monitoring?
For clinicians like Dr. Jennifer Risinger, Ob Hospitalist Group (OBHG) Market Medical Director in Columbia, South Carolina, those decisions are part of daily practice. That’s why, during Preeclampsia Awareness Month, she was eager to participate in a May 28 webinar hosted by the Preeclampsia Foundation, “Preeclampsia Tests: Real-world Impact of Preeclampsia Biomarker Tools.”
The webinar brought together experts to discuss a rapidly evolving area of obstetric medicine: biomarker-based testing that can help clinicians better predict, diagnose, and manage preeclampsia and related hypertensive disorders of pregnancy (HDP).
Predictive, not reactive
Preeclampsia affects an estimated 5 to 8% of pregnancies and remains one of the leading causes of maternal and neonatal morbidity worldwide. Despite decades of research, clinicians have had relatively few tools to help determine which patients are truly at risk for severe disease and which can be safely managed without hospitalization or early delivery.
Recent advances in biomarker testing may help change that.
“Is she at risk? Can I safely send her home? Does she need to be here? Do I need to deliver her?” Dr. Risinger said during the webinar. “If a test can be added to our arsenal to really help us be not reactive, but predictive as to who we really need to pay attention to, this is a game changer.”
One of the most promising developments is testing based on the ratio between two biomarkers found in maternal blood: soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF). The balance between these proteins provides important information about placental function and the likelihood that a patient will develop severe preeclampsia.
The clinical value of the test lies particularly in its ability to rule out imminent disease. Research has shown that an sFlt-1/PlGF ratio below established thresholds carries a negative predictive value of approximately 96 to 99% for the development of preeclampsia over the following one to four weeks.
For clinicians working in busy labor and delivery units, that level of confidence can be transformative.
“As an OB hospitalist and someone who specializes in that OB emergency department workup, I love this idea,” Dr. Risinger said. “That negative predictive value is so important that I can safely say, ‘OK, I think for the next two weeks we’re going to be OK.’”
The implications extend beyond clinical decision-making. Better risk stratification can help avoid unnecessary admissions, reduce anxiety for patients and families, and potentially prevent premature deliveries that can lead to neonatal intensive care unit stays.
‘Amazing work’ and improved outcomes
The Preeclampsia Foundation has advocated for biomarker development and adoption for more than a decade, helping bring together researchers, clinicians, regulators, industry leaders, and patient advocates to accelerate progress. Those efforts contributed to the development and eventual FDA approval of the first biomarker-based preeclampsia test in 2023, followed by additional approved testing options in 2025.
These advances are particularly meaningful in communities where patients may face geographic or logistical challenges accessing care.
Dr. Risinger noted that many of the patients she serves travel significant distances for obstetric care.
“Our patients are very open to it and very excited,” she said. “I’ve got a lot of rural patients who are away from their family. If I can provide a test and give reassurance that it’s negative and that I think the next two weeks are OK, I can say, ‘Let’s let you go home with a monitor and be with your family.’”
That combination of advanced clinical tools and patient-centered decision-making reflects the type of care OBHG clinicians strive to provide every day.
As a national leader in obstetric hospitalist medicine, OBHG clinicians routinely manage some of the most complex and time-sensitive situations in obstetrics. The organization’s focus on evidence-based practice and continuous clinical innovation allows hospitalists to stay at the forefront of emerging developments that can improve outcomes for mothers and babies.
For Dr. Risinger, biomarker testing represents an exciting example of how new technology can support—not replace—clinical expertise. The next challenge, she said, is continuing to build the evidence base and increase awareness among clinicians throughout the United States.
“I hope everyone finds this as exciting as I do,” Dr. Risinger said. “If we can keep our moms at home versus in the hospital and keep babies out of the NICU unless they need to be there, this is amazing work.”