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Chapter 20 - Candidate Biomarkers for Prediction of Pregnancy Location and Viability

Published online by Cambridge University Press:  16 April 2025

Roy G. Farquharson
Affiliation:
Liverpool Women’s Hospital
Mary D. Stephenson
Affiliation:
University of Illinois, Chicago
Mariëtte Goddijn
Affiliation:
Amsterdam University Medical Centers
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Summary

Accurate discrimination between normal and abnormal early pregnancies remains a clinical challenge. The successful identification and application of novel biomarkers produced during early pregnancy could change the diagnostic standard and improve patient outcomes. The approach to biomarker discovery can involve either putative or agnostic strategies, and for successful clinical implementation, all biomarkers must proceed through five phases of development. Biomarkers for discrimination of early pregnancy include those related to trophoblast function, corpus luteal function, angiogenesis, endometrial function, inflammation and muscle damage, and unknown mechanisms. To date, no single biomarker (other than serial beta human chorionic gonadotropin) is used in clinical practice, reflecting the significant heterogeneity among available studies and unique considerations in specific subgroups with early pregnancy. Panels consisting of multiple biomarkers are likely the most promising approach for successful implementation.

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