PREDICTING A COMMON PREGNANCY COMPLICATION
Preeclampsia is a sudden and potentially fatal complication that strikes about five percent of pregnant women in America. There's no cure now, but a new study has uncovered some common risk factors you should know about.
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Janel Hemrick loves being a mom to little Clara.
Janel Hemrick
Clara's mom
"She's full of energy ... into everything ... is very active."
Clara is Janel's second child. During her first pregnancy, she developed preeclampsia.
Janel Hemrick
"I remember that my blood pressure was 200 over 100."
At 26 weeks, she gave birth to Myles. He lived just 20 days.
Janel Hemrick
"There's always going to be that time that you wonder, 'What if they could have done something else? What if they would have known sooner? Could I have done something different, and would Myles still be here?'"
Preeclampsia is a dangerous complication of pregnancy. Women develop high blood pressure, swelling and protein in the urine. It can turn into eclampsia, which could lead to seizures.
Baha Sibai, M.D.
OB/GYN
University of Cincinnati Medical Center
Cincinnati, OH
"This has been a frustrating condition for 2000 years now."
Doctor Baha Sibai co-authored a study on risk factors for preeclampsia. High levels of a toxic molecule called "SFLT-1" were found in the blood. That led to reduced levels of two growth factors, which are vital for a healthy pregnancy.
Baha Sibai, M.D.
"They are abnormal way before the patient develops the signs and symptoms."
A urine dip stick test could potentially be used to check for these risk factors.
Baha Sibai, M.D.
"Developing something like this would have great implications because it has to be simple and easy to use."
Now, the only cure for preeclampsia is to deliver the baby early. Preventing it altogether is the new goal.
Doctor Sibai says a number of studies are underway to look for ways to fight preeclampsia -- including using antioxidants like vitamins C and E and calcium.
BACKGROUND: Preeclampsia affects 5 percent of all pregnant women. It can occur suddenly and without warning. It usually happens during a woman's first pregnancy or pregnancies resulting from a first-time partner. Obesity is one of the strongest risk factors for preeclampsia. Usually, a pregnant woman with preeclampsia develops dangerously high blood pressure and begins excreting protein in the urine. She may develop eclampsia, a series of severe seizures. Even if the condition does not escalate to that extent, some women still may experience bleeding in the liver, fluid in the lung, or even kidney failure. The only cure for preeclampsia is to deliver the baby at that time.
SYMPTOMS: Women may start having headaches. They may start seeing spots before their eyes or have blurred vision. They may have nausea and vomiting as well as abdominal pain.
INDICATORS: New research shows indicators of preeclampsia include the sFlt-1 molecule detected in the blood and PlGF (placental growth factor) found in reduced levels in the urine. Baha Sibai, M.D., of the University of Cincinnati Medical Center, co-authored the study. Researchers compared blood samples of women who did not have preeclampsia to those who later developed it. Those developing preeclampsia showed elevated levels of sFlt-1 prior to preeclampsia occurring. Beginning early in their pregnancies, these women had lower levels of PlGF in the blood than women who did not develop preeclampsia. Researchers also found lower levels of vascular endothelial growth factor (VEGF) in the women who developed preeclampsia. VEGF works in combination with PlGF to foster the growth of new blood vessels including those in the placenta that support the developing fetus.
PREDICTING: Predicting the disease has two important implications. If doctors can identify women who are at very high risk, particularly women who are going to develop the disease very early in pregnancy or who are going to have severe disease, they can then give women something to prevent the disease. Dr. Sibai says, "Rather than doing studies on a large number of women and expose every pregnant woman to the medication, we can only select those who will benefit the most and do the study on them. Secondly, if doctors can find women who are going to have severe disease, then they can start testing very early on. Finding a test that could identify women who will develop the disease early would enable researchers to develop a targeted treatment and allow the pregnancy to continue. Dr. Sibai says a urine test -- possibly a dip stick test -- could potentially predict preeclampsia.
OTHER STUDIES: Women who develop preeclampsia have changes in their antioxidant capacity. Doctors believe giving them antioxidants like vitamins C and E and calcium could potentially prevent the disease or delay its onset. They are studying women who are at high risk, most of whom are in their first pregnancy.
David Bracey
University of Cincinnati Medical Center
165 Health Professional Bldg.
3235 Eden Ave.
Cincinnati, OH 45267-0550
(513) 558-4559
david.bracey@uc.edu
Copyright © 2005 Ivanhoe Broadcast News, Inc.
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