Predicting Preeclampsia

A dangerous and sometimes deadly condition, preeclampsia is a condition of high blood pressure during pregnancy, along with excess protein in the urine. It occurs in one in 15 pregnancies each year, generally after the 32nd week but sometimes as early as the 20th. The causes of preeclampsia are unclear, though there are some indications that point to damage to the blood vessels resulting in insufficient blood flow to the uterus. Diet may also play a role.

Patients with preeclampsia often experience swelling; other symptoms, which tend to crop up suddenly after the 20th week, include pain under the ribs on the right side, headaches and dizziness, unusual nausea, and blurred vision. Preeclampsia increases the risk of miscarriage, and can be fatal to the mother; delivery is the only treatment.

Because the condition is so dangerous, it’s important for doctors to be able to diagnose it quickly, and know when it’s likely to strike. A recent study found that one way to predict it is by looking at the capillaries, small blood vessels, under the skin. An unusually low capillary count, researchers found, is an advance warning of preeclampsia. Looking at capillaries allowed doctors to predict which women would develop preeclampsia seven times out of eight, a higher success rate than the standard diagnostic techniques.

In addition to diagnostic predictors, obstetricians pay attention to women who have risk factors for preeclampsia. The first pregnancy with a given partner is high risk, which suggests that there may be an immune-related element to the condition. Similarly, a long gap between pregnancies is a risk factor. Women under 20 or over 40, who have a family history of preeclampsia, or who are obese are also at high risk. Unfortunately, because the causes of the condition are so little understood, prevention is likewise a mystery. However, studies suggest that vitamin D deficiency is linked to both gestational diabetes and preeclampsia, and research on that is ongoing. Fortunately, the fetus itself can play a part in preventing the condition. A hormone called adrenomedullin has been found to protect women from preeclampsia—when released by the fetus itself.

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