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Preeclampsia and pregnancy

 

To date, unfortunately, no drug or effective method has been found to treat preeclampsia. But there are effective methods for predicting and preventing the occurrence of this threatening condition for the life of the mother and fetus.

Let's analyze all the details.

What is preeclampsia?

Preeclampsia is a condition that occurs only in pregnant women. Disorders occur in the kidneys, liver, nervous system, hematopoietic system, and may cause multiple organ failure. At the same time, a pregnant woman's blood pressure rises and protein appears in her urine. There are about 30 theories of the development of this condition. But in recent years, the main theories are circulatory disorders in the system "uterus - placenta - fetus" due to comorbidities, autoimmune or genetic factors.

Preeclampsia is a major cause of death and disability. Every year, more than 50,000 maternal losses due to this pathology are registered in the world. In the structure of childhood losses, preeclampsia accounts for up to 25% of cases. The prevalence of preeclampsia among pregnant women is 2 to 5% and most of it depends on the mother's comorbidities, but the absence of these conditions does not give confidence, because preeclampsia can occur in a completely healthy woman.

If preeclampsia has occurred and cannot be treated, or eclampsia develops (convulsions, coma) - for the life of the mother and child is delivered by cesarean section. The birth of a child, the end of pregnancy for the mother - the only option for salvation in this case.

What factors affect the occurrence of preeclampsia?

High risk factors:

  • Arterial hypertension
  • Preeclampsia during previous pregnancy
  • Chronic kidney disease
  • Autoimmune diseases (systemic lupus erythematosus, antiphospholipid syndrome)
  • Diabetes mellitus type I and II
  • Multiple pregnancy due to assisted reproductive technologies

 

Moderate risk factors:

  • First pregnancy
  • The age of the pregnant woman is over 35 years
  • The interval between births is more than 10 years
  • Obesity: Body mass index over 30 - before pregnancy, or in the first trimester
  • Preeclampsia in a pregnant mother
  • Spontaneous multiple pregnancy

How to prevent preeclampsia?

At each visit to the doctor, where you observe pregnancy - it is mandatory to monitor blood pressure and urine protein analysis.

But in addition, there is a screening program that is conducted in 11 - 13 weeks of pregnancy, during the combined screening of the first trimester.

Preeclampsia risk screening:

  1. The anamnesis, average indicators of arterial pressure, dopplerographic indicators of PI of uterine arteries and plcental growth factor PlGF are defined.
  2. The ratio of sFlt-1 / PlGF is an accurate predictor of preeclampsia

 

Indicators in the first trimester are estimated. If these indicators were in the risk zone of preeclampsia - the woman throughout the pregnancy is observed as having a high risk of developing this condition.

Thanks to such a combined screening and timely appointment of preventive therapy, the risk of preeclampsia can be reduced by more than 60%!

This combined screening can predict up to 90% of early preeclampsia (occurring before 34 weeks of gestation), 75% of preeclampsia from 34 to 37 weeks of gestation, and 45% of preeclampsia from 37 weeks of gestation and older.

Later, in the second and third trimesters of pregnancy, it is possible to re-assess the risk of preeclampsia regardless of the risk in the first trimester. To do this, use the same PI in the uterine arteries and the ratio of sFlt-1 / PlGF - if necessary.

If you have moderate or high risk factors - a reason to discuss this with an obstetrician-gynecologist who monitors your pregnancy, because you may have a potential risk of preeclampsia.

At our medical center, we use this latest screening program to calculate the risk of preeclampsia.

Individually, it is possible for each pregnant woman to calculate and predict the risk of this serious condition.

This gives many women the opportunity to enjoy a normal pregnancy and give birth to healthy babies on time!

Prevention is better than cure.