Pre-Eclampsia (The Hypertension of Pregnancy)
Hypertension (high blood pressure) complicates 10% of all pregnancies, 15% of first time moms. 1-2% of these is severe and results in ICU admissions. This remains the leading cause of maternal deaths worldwide.
The placental circulation develops rapidly up to the 16th week of pregnancy. In those who later develop preeclampsia this development is not normal at this early stage. A reaction develops and builds up.
Later in pregnancy it shows as hypertension and protein in the urine.
Hypertension is only one of the manifestation. Preeclampsia actually affects all the organs - brain, heart, kidney and liver. The only treatment is to deliver the baby. Once the placenta is out the situation gradually reverts to normal
First time moms are at highest risk.
We can now detect those who are at highest risk of developing severe preeclampsia.
Combining the First Trimester Scan measurements and protein levels in the blood, the risk can be calculated and treatment commenced to prevent/reduce the severity of the preeclampsia. This test is done between 11th to the 13th week of pregnancy.
The risk of a repeat preeclampsia is 25-30% once a previous pregnancy is complicated by this condition. Certain causes should be investigated. Preventive treatment should be commenced in all subsequent pregnancies.
Preeclampsia is preventable.
Uterine Artery Doppler Study