Preecclampsia

preeclampsia

When pregnancy is accompanied by high blood pressure after 20 weeks and excessive protein in the urine, that is called preeclampsia, and it can be fatal. One in 15 pregnant women experience preeclampsia, usually in the third trimester but sometimes toward the end of the second. There are a number of factors that lead to preeclampsia, although the exact causes are not well understood. Abnormal placental development is thought to be a contributing factor, as well as insufficient blood blow to the uterus.

Because the condition is so sudden and so dangerous, clinicians pay close attention to risk factors for preeclampsia. It is more likely in the woman’s first pregnancy, her first pregnancy by a particular partner, or her first pregnancy after a long gap—all of which also suggests an immune component to the condition. Women who are under 20, who are over 40, who are obese during pregnancy, or who have a family history of preeclampsia are at heightened risk. Other risk factors are having had preeclampsia in a previous pregnancy, a multiple pregnancy, or a woman having diabetes or high blood pressure when she became pregnant.

In a new report, doctors recommend that women at risk for preeclampsia take a low-dose aspirin regimen, similar to that used to reduce stroke risk, after the first trimester. Once preeclampsia has developed, the only treatment is delivery, regardless of the stage of pregnancy, so early detection and prevention are very important. The aspirin regimen was shown to reduce preeclampsia incidence by 24 percent. Premature birth rates were reduced 14 percent, and fetal growth rates also improved in the study. Aspirin was not found to increase the risk of bleeding after delivery, or of harm to the fetus or newborn.

Beyond that, early detection is absolutely necessary to management and prevention. Norwegian researchers recently discovered a group of biological indicators of preeclampsia that can be found in blood or urine tests. This is an important finding for two reasons. First, in the long term, it can help provide insight into what is going on in the bodies of women with preeclampsia, helping us to understand and possibly prevent it. In the short term, it provides a test that can predict the condition well before symptoms—pain under the ribs on the right side, unusual nausea, headaches and dizziness, and blurred vision—develop, so that it can be better managed or even avoided.

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