Pre-eclampsia is high blood pressure that develops during pregnancy, usually after 20 weeks, often with protein in the urine or signs of organ stress. It affects about 5-8% of pregnancies in the U.S. and can progress to serious complications. Treatment currently means close monitoring and delivery when the risks of continuing pregnancy outweigh the benefits.
What's actually going on in research
Trials are testing whether aspirin or other drugs started early in pregnancy can prevent pre-eclampsia in high-risk women, ways to predict who will develop it through blood tests or imaging, and treatments that might extend pregnancy safely when pre-eclampsia appears preterm. Researchers are also studying the biology behind why blood vessels in the placenta don't develop normally.
Early prediction tests
Blood tests measuring placental proteins, combined with blood pressure and ultrasound findings in the first trimester, may identify women at high risk months before symptoms appear. This could allow earlier prevention strategies.
Low-dose aspirin timing
Studies are refining when to start aspirin in high-risk pregnancies and whether the time of day matters. Evidence suggests starting before 16 weeks and taking it at bedtime may work better than current standard advice.
Angiogenic factor therapies
Drugs that target the imbalance in blood vessel growth factors are being tested to see if they can treat pre-eclampsia after it develops. The goal is to safely extend pregnancy when delivery would mean extreme prematurity.
What to know before you search
Eligibility typically depends on risk factors like prior pre-eclampsia, chronic hypertension, diabetes, kidney disease, first pregnancy, or carrying multiples, and on how far along the pregnancy is.
What types of trials are currently open
- Prevention trials — Testing aspirin, calcium, or other supplements started early in pregnancy to prevent pre-eclampsia in women at higher risk.
- Prediction studies — Studies developing or validating blood tests, ultrasound measurements, and risk calculators to identify who will develop pre-eclampsia.
- Treatment trials — Testing medications given after pre-eclampsia develops to control blood pressure, reduce seizure risk, or allow safer pregnancy extension.
- Delivery timing studies — Comparing outcomes when delivery happens at different gestational ages after pre-eclampsia is diagnosed.
- Long-term follow-up studies — Tracking women after pre-eclampsia to understand later cardiovascular disease risk and whether interventions reduce it.
Recently added Pre-eclampsia trials
Exercise to Improve Heart and Metabolic Health After Childbirth in Women at High Risk for Preeclampsia
Women who develop hypertensive disorders of pregnancy have an increased risk of cardiovascular disease later in life. Whether exercise during the postpartum period improves cardiometabolic health in this population remains unclear. This pilot randomized controlled trial will recruit 40 women who were identified as being at high risk for preeclampsia during pregnancy and subsequently developed a hypertensive disorder of pregnancy. Participants will be enrolled 6 to 8 weeks after delivery and randomly assigned to a 12-week exercise program or standard postnatal care. The exercise program will consist of three sessions per week combining moderate-intensity aerobic exercise, resistance training, and pelvic floor exercises. Cardiovascular function, blood pressure, blood markers of cardiometabolic health, physical fitness, and body composition will be assessed before and after the 12-week period. Changes in mood, sleep quality, and health-related quality of life will also be evaluated. The study will provide preliminary evidence on the effects of postpartum exercise in this population and inform the design of a larger trial.
Retinal and Choroidal Microcirculation in Preeclampsia: An OCTA Study
Preeclampsia is a multisystemic and multifactorial disorder that complicates pregnancy and is characterized by new-onset hypertension after the 20th week of gestation accompanied by proteinuria or systemic findings such as renal dysfunction, hepatic dysfunction, pulmonary edema, thrombocytopenia, or neurological symptoms including headache and visual disturbances. It represents a significant risk factor for maternal and fetal morbidity and mortality. In normal pregnancy, trophoblasts invade and dilate the maternal spiral arteries, thereby increasing uteroplacental blood flow. In preeclampsia, however, inadequate trophoblastic invasion leads to defective placentation, resulting in uteroplacental hypoperfusion and ischemia. The hypoxic and ischemic placenta releases anti-angiogenic mediators into the maternal circulation, which disrupt maternal endothelial function. This endothelial dysfunction results in vasoconstriction, microthrombosis, and increased vascular permeability. Consequently, hypertension, renal and hepatic dysfunction, pulmonary edema, and neurological symptoms may develop in maternal organ systems. The endothelial dysfunction observed in preeclampsia can also affect the microvascular structures of the eye, leading to circulatory disturbances at the level of the retina and choroid. Disruption of endothelial integrity, together with vasospasm and microthrombus formation, may cause reduced perfusion in the retinal and choroidal microcirculation, forming the basis of the ophthalmic manifestations of preeclampsia. Clinically, this condition may present with visual disturbances, blurred vision, scotomas, retinal edema, and choroidal thickening. These microvascular changes can be evaluated noninvasively in outpatient settings using Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA). OCT and OCTA allow high-resolution imaging of retinal and choroidal structures and enable quantitative assessment of vascular parameters such as vessel density, the size of the foveal avascular zone (FAZ), and choriocapillaris flow voids. Through these techniques, microvascular hypoperfusion, loss of vascular integrity, and ischemic areas caused by endothelial damage associated with preeclampsia can be objectively identified. The aim of this study is to evaluate ocular vascular changes associated with preeclampsia using OCT and OCTA
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