Download Chronic Diseases in Pregnancy: Example Pre-eclampsia

Chronic Diseases in Pregnancy: Example Pre-eclampsia
Pre-eclampsia (Greek=before convulsions) is one of the most dangerous diseases for mother and
child with sometimes life-threatening complications. Its consequences are immense, long term and
short term. Both, child and mother can suffer from serious chronic diseases.
Key facts
 Preeclampsia is one of the most dangerous conditions for mothers and their children
 In extreme cases it can lead to convulsions, deadly for both
 Its short and long term consequences are tremendous for the individual and for society
 New screening tests can identify at-risk patients early before its break-out
What is pre-eclampsia?
Pre-eclampsia, also known as “toxaemia of pregnancy”, is a serious condition that affects about 2-8 of 100
pregnant women. It usually develops in the first three months of pregnancy although the symptoms usually
appear after 6th month of pregnancy. It affects both, the mother and the baby. The main symptoms include high
blood pressure and increased protein levels in the urine.
What are the consequences?
 Pre-eclampsia is one of the leading causes of maternal and foetal deaths
 It is responsible for the majority of preterm births and associated with
restricted foetal growth – a condition where the baby cannot develop
according to his/her age in the mother’s womb
The most common long term problems include:
For the child
For the mother
 Heart diseases
 8-fold higher risk of death from heart diseases
 Sensorial and motor disabilities
or stroke
 Learning and behavioural disorders
 Vital organs can be severely damaged
 Chronic lung disease
 Dementia
What are the challenges?
Pre-eclampsia is progressive – it continuously worsens during pregnancy. Until now, the practice is to deliver the
baby mostly too early. However, every single additional day in the mother’s womb is crucial for the baby’s
development.
What are the causes?
The exact cause of pre-eclampsia remains unknown but problems in the placenta, which usually nourishes the
unborn baby, resulting in an impaired blood supply to the baby, play a role.
Who is at risk?
Pre-eclampsia can affect any pregnant woman, but some are more at risk:
 First pregnancies
 Family or own history of pre-eclampsia
 Women over 40 years of age
 Assisted reproduction (IVF)
 Obese women (BMI >35)
 Women with existing chronic diseases e.g.
hypertension, kidney problems or diabetes
What can be done?
Early access to high quality prenatal care makes it possible to predict pre-eclampsia and to keep it under control.
Aspirin treatment works-if started early
It has been shown that early administration of low-dose aspirin, before 16
weeks of pregnancy, improves the function of the placenta and leads to:
 Risk reduction of pre-eclampsia by 50%
 A shift from pre-eclampsia requiring preterm delivery to later weeks of pregnancy by over 90%, giving the baby essential time in the womb to develop.
High risk women can be identified with pre-eclampsia screening
Prediction of pre-eclampsia in the first weeks of pregnancy (first trimester) helps to identify high risk groups of
women who need to be closely monitored by specialised healthcare teams and can benefit from treatment with
aspirin. There is first evidence that this
approach is cost-saving and gains quality
adjusted life years by avoiding preterm births
and child mortality – the two major
Maternal
history
Ultrasound
and blood
pressure
Blood test
High risk
or
Low risk
consequences of pre-eclampsia.
Pre-eclampsia screening
How to act:
There are targeted measures that should be implemented in order to reduce the burden of pre-eclampsia, e.g:
 Investing in research
 Implement European standards of prevention and care
 Establish an EU database on national pre-eclampsia data.
Increased awareness is the key!
Targeted information, better education and training:
All parents-to-be should be aware of pre-eclampsia and have an equal chance of prevention and treatment –
no matter which socio-economic class they belong to. Equally, all doctors and particularly gynaecologists
should be informed about this disease to save the mothers’ and babies’ lives. Their health and well-being
should be improved through early prediction and the know-how for timely and appropriate treatment.
About EFCNI
The European Foundation for the Care of Newborn Infants (EFCNI) is the first pan-European organization and
interactive network to represent the interest of preterm infants, ill newborns and their families. It gathers
together parents, professionals and other stakeholders from different disciplines with the common goal of
improving long-term health of preterm and newborn children by ensuring the best possible prevention,
treatment, care and support. www.efcni.org