About

Dr. Sarosh Rana is a Research Professor at the University of Chicago, specializing in Obstetrics and Gynecology with a focus on Maternal Fetal Medicine. Her research concentrates on the pathogenesis of preeclampsia, a common hypertensive disorder of pregnancy, with particular interest in elucidating the role of angiogenic biomarkers in predicting adverse maternal and fetal outcomes. She conducts both national and international translational studies to advance understanding and management of hypertensive disorders during pregnancy. Dr. Rana's educational background includes an MBBS and MD from Jawaharlal Nehru Medical College in India, along with residencies in Obstetrics and Gynecology at Mayo Clinic, Brown University, and the University of Chicago, as well as a fellowship in Maternal-Fetal Medicine from Harvard School of Public Health. Her work has contributed significantly to the clinical utility of angiogenic biomarkers such as sFlt-1 and PlGF in the diagnosis, prognosis, and management of preeclampsia, and she has been involved in developing real-world evidence for their use in routine clinical evaluation. Her research also explores the economic impact of biomarker testing, patient perceptions of remote monitoring, and the shared pathophysiology between preeclampsia and other cardiovascular conditions.

Research topics

• Medicine
• Internal medicine
• Intensive care medicine
• Political Science
• Gynecology
• Pathology
• Obstetrics
• Family medicine
• Cardiology
• Genetics

Selected publications

• Internal and external validation of a machine learning algorithm to detect preeclampsia-related adverse outcomes in high-risk pregnancies

  Pregnancy Hypertension · 2026-03-26 · 1 citations

  articleOpen access

  OBJECTIVES: This study aimed to refine an existing machine learning (ML) algorithm for predicting preeclampsia-related adverse outcomes and to assess its generalizability and predictive performance through internal validation in a German cohort and external validation in a North American cohort. STUDY DESIGN: A retrospective analysis was conducted using data from two cohorts: a cohort of 1,634 pregnant women in Germany and a prospective study cohort of 946 in North America, all presenting with clinical suspicion of preeclampsia. MAIN OUTCOME MEASURES: Gradient-boosted trees and logistic regression were used to predict (1) any adverse maternal or fetal outcome, (2) delivery within 14 days before 34 + 0 weeks, and (3) delivery within 7 days after 34 + 0 weeks. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC). RESULTS: Despite notable differences in baseline characteristics between cohorts, the refined model demonstrated strong and consistent predictive performance. For predicting any adverse outcome, AUROCs were 0.92 (95% CI: 0.87-0.96) in the German cohort and 0.87 (95% CI: 0.82-0.91) in the North American cohort. For delivery within 14 days before 34 + 0 weeks, AUROCs were 0.92 and 0.88, respectively. For delivery within 7 days after 34 + 0 weeks, AUROCs were 0.79 and 0.78. CONCLUSIONS: The refined ML model maintained high predictive accuracy across two distinct populations, demonstrating its generalizability and potential for integration into clinical decision-making. These findings support the use of machine learning in enhancing the prediction of preeclampsia-related adverse outcomes and improving maternal and neonatal care.

  PublisherDOI

• Antepartum home blood pressure monitoring in high-risk pregnancies: patients’ knowledge and perceptions

  Pregnancy Hypertension · 2026-02-23

  articleSenior author
  PublisherDOI

• Blood pressure Cuff Kit implementation in the antepartum period: clinical outcomes in high-risk patients

  Pregnancy Hypertension · 2026-02-23

  articleSenior author
  PublisherDOI

• Prediction of preeclampsia using first-trimester maternal serum Activin A levels: a prospective cohort study

  Pregnancy Hypertension · 2026-02-23

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  PublisherDOI

• Postpartum blood pressure monitoring and management: Critical findings from an expert convening

  Pregnancy · 2026-01-01

  articleOpen access

  Abstract Hypertensive disorders of pregnancy (HDP) are significant contributors to maternal morbidity and mortality, impacting an estimated 15.9% of delivery hospitalizations in the United States. More than 50% of hypertension‐related deaths occur postpartum, and it is estimated that 80% of maternal mortality cases are preventable. Given this, the American Medical Association hosted a convening of experts to discuss and identify areas of consensus on postpartum blood pressure (BP) monitoring and management clinical practices, including the use of self‐measured blood pressure (SMBP) and remote patient monitoring (RPM). Key recommendations include initiating antihypertensive therapy for BP ≥140/90 mmHg postdelivery, maintaining inpatient monitoring for at least 12 h after medication adjustment, providing all HDP patients with home BP devices and education at discharge, post‐discharge BP monitoring should be a minimum of once daily for at least 2 weeks postpartum, treatment protocols are recommended prior to implementation of home BP monitoring, and a coordinated transfer of care should be facilitated to a primary care provider for all patients with an HDP. While SMBP or RPM shows promise for improving outcomes, evidence for guidelines remains limited. The authors strongly recommend and support the need for further research to establish evidence for guidelines to support broad‐scale improvement in postpartum BP monitoring and management.

  PublisherOA PDFDOI

• Impact of antepartum remote blood pressure monitoring on hypertensive pregnancies: a comparative analysis of clinical outcomes

  Pregnancy Hypertension · 2026-02-23

  articleSenior author
  PublisherDOI

• Preeclampsia Education of the Nation (India), PEN(I): implementing educational models and global expansion strategies

  Pregnancy Hypertension · 2026-02-23

  articleSenior author
  PublisherDOI

• Serum soluble-fms-like tyrosine kinase 1-to-placental growth factor ratio on Elecsys immunoassay platform predicts preeclampsia with severe features in hospitalized women with hypertensive disorders of pregnancy

  American Journal of Obstetrics and Gynecology · 2025-11-13 · 2 citations

  articleOpen access

  BACKGROUND: Previous single-center studies conducted in the United States in women with suspected preeclampsia indicated that serum soluble fms-like tyrosine kinase 1-to-placental growth factor ratio values of >38 measured on a widely available Elecsys immunoassay platform during the third trimester of pregnancy predicted the development of preeclampsia with severe features and adverse outcomes within 2 weeks of testing. OBJECTIVE: This study aimed to validate the Elecsys soluble fms-like tyrosine kinase 1-to-placental growth factor ratio test for the prediction of preeclampsia with severe features in a United States population using the prospective Preeclampsia Risk Assessment: Evaluation of Cut-offs to Improve Stratification cohort that recruited women with a hypertensive disorder of pregnancy (gestational hypertension, chronic hypertension, de novo and superimposed preeclampsia) across 18 tertiary and community hospitals throughout the United States. STUDY DESIGN: We measured soluble fms-like tyrosine kinase 1-to-placental growth factor ratios using the Elecsys platform in archived serum samples from the Preeclampsia Risk Assessment: Evaluation of Cut-offs to Improve Stratification study that recruited hospitalized women with a hypertensive disorder of pregnancy between 23 0/7 and 34 6/7 weeks of gestation. The primary study outcome was prediction of preeclampsia with severe features within 2 weeks after testing. The secondary outcomes included a composite of adverse maternal and fetal/neonatal outcomes and prediction of delivery within 2 weeks. RESULTS: In the validation cohort of the Preeclampsia Risk Assessment: Evaluation of Cut-offs to Improve Stratification study (556 enrollments), the serum soluble fms-like tyrosine kinase 1-to-placental growth factor ratio at a cutoff value of >38 demonstrated a 67% positive predictive value (95% confidence interval, 61-73) and a 95% negative predictive value (95% confidence interval, 92-97) for the progression to preeclampsia with severe features within 2 weeks. Among women at <30 weeks of gestation (n=188), serum soluble fms-like tyrosine kinase 1-to-placental growth factor ratio at a cutoff value of >38 demonstrated a 78% positive predictive value (95% confidence interval, 68-86) and a 100% negative predictive value (95% confidence interval, 96-100) for the progression to preeclampsia with severe features within 2 weeks. The Elecsys soluble fms-like tyrosine kinase 1-to-placental growth factor ratio test performed better than standard-of-care clinical measures, with an area under the receiver operating characteristic curve of 0.92 (95% confidence interval, 0.89-0.90) for soluble fms-like tyrosine kinase 1-to-placental growth factor ratio vs <0.70 for standard-of-care tests, such as liver enzymes, platelet count, and serum creatinine (P<.001). Compared with women with a ratio of ≤38, those with a ratio of >38 had a higher risk of developing adverse maternal (relative risk, 4.9 [95% confidence interval, 2.6-9.9]; P<.001) and fetal/neonatal (relative risk, 3.2 [95% confidence interval, 2.6-4.0]; P<.001) outcomes and were more likely to deliver within 2 weeks (adjusted hazard ratio, 3.3 [95% confidence interval, 2.7-4.0]; P<.001). CONCLUSION: The soluble fms-like tyrosine kinase 1-to-placental growth factor ratio of >38 measured on the Elecsys platform predicted the development of preeclampsia with severe features, delivery, and adverse maternal and fetal/neonatal outcomes within 2 weeks of testing among preterm pregnant women hospitalized with a hypertensive disorder of pregnancy.

  PublisherDOI

• A-341 Impact of PlGF Assay Imprecision on sFlt-1/PlGF Ratio Interpretation in Preeclampsia Risk Assessment

  Clinical Chemistry · 2025-10-01

  articleOpen access

  Abstract Background Preeclampsia remains a challenge in OB/GYN care, as current management largely relies on symptom monitoring and laboratory tests with limited diagnostic accuracy. Once diagnosed, the only effective treatment is delivery of the infant. The discovery of angiogenic biomarkers imbalance—as reflected by an increased sFlt-1/PlGF ratio—has led to the development of more specific diagnostic tools. While European guidelines have endorsed sFlt-1/PlGF-based testing for many years, adoption in the US has been delayed, partly due to the absence of an FDA-approved assay. In May 2023, the FDA cleared the sFlt-1/PlGF ratio assay on the ThermoFisher B·R·A·H·M·S KRYPTOR platform, yet its clinical uptake remains limited. In this study, we evaluated the analytical precision of the sFlt-1 and PlGF assays, and particularly the impact of PlGF imprecision on sFlt-1/PlGF ratio interpretation and its clinical reliability in preeclampsia risk assessment. This study presents our practical experience with the aim to optimize laboratory practices and facilitate the clinical implementation of the sFlt-1/PlGF testing. Methods sFlt-1 and PlGF were measured on the KRYPTOR instrument using a homogeneous sandwich fluoroimmunoassay. Between-day precision was assessed using three levels of commercial QC materials, and analyzed over a three-month span. Patient-based QC pools were measured for PlGF once perday for 9 non-consecutive days and the results were compared to those of the commercial QC materials. 180 samples obtained from 161 hospitalized pregnant women were analyzed to assess the relationship between PlGF levels and the sFlt-1/PlGF ratio. Results The sFlt-1 assay demonstrated good precision (CV ∼3.0%) across all QC levels, while the PlGF assay exhibited higher imprecision as compared to the manufacturer’s claims, particularly at low QC levels (CV 7.7%-11.3%). Long-term QC monitoring revealed a downward drift in PlGF values, with improved stability after reagent lot changes. Patient-based QC pools showed similar swings and patterns compared to the QC materials during the same 9-day time frame. Importantly, despite higher imprecision at lower PlGF levels (23.1-34.7 pg/mL), the clinical interpretation of the sFlt-1/PlGF ratio remained robust, as low PlGF consistently correlated with ratios well above the critical cut-off of 40. Conclusion Despite the suboptimal precision observed at low QC levels and potential drifts in PlGF results, the sFlt-1/PlGF ratio remains a reliable tool for preeclampsia risk assessment. Our study highlights the need for critical evaluation of analytical performance beyond FDA approval, and the importance of assessing the potential impact of assay imprecision on patient care for individual biomarkers.

  PublisherOA PDFDOI

• Response to the Letter to the Editor: “Signs or symptoms of suspected preeclampsia – A retrospective National database study of prevalence, costs, and outcomes”

  Pregnancy Hypertension · 2025-01-10

  letterSenior authorCorresponding
  PublisherDOI

Recent grants

• NIH Grant K08HD068398

  NIH · $390k · 2015

Frequent coauthors

• S. Ananth Karumanchi

  Cedars-Sinai Medical Center

  488 shared

• Ravi Thadhani

  Emory and Henry College

  241 shared

• Ariel Mueller

  Massachusetts General Hospital

  235 shared

• Saira Salahuddin

  Beth Israel Deaconess Medical Center

  193 shared

• Julia Wenger

  University of Graz

  134 shared

• Jim Thornton

  University of Nottingham

  128 shared

• Sajid Shahul

  University of Chicago

  126 shared

• Avery Tung

  University of Chicago

  115 shared

Labs

• Preeclampsia labPI