Risk factor screening can reduce risk of pre-eclampsia during preganancy - Ob-Gyn

29 May 2023 09:17am
Image for illustrative purposes only. - FILE PIX
Image for illustrative purposes only. - FILE PIX
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KUALA LUMPUR - Pregnancy is a life-changing experience for every woman, but some may face difficulties due to health conditions such as pre-eclampsia.

Pre-eclampsia, a potentially life-threatening hypertensive disorder of pregnancy, affects not only the health of pregnant mothers but also their baby’s growth and causes premature birth.

Worldwide, pre-eclampsia is responsible for over 500,000 foetal and neonatal deaths and over 70,000 maternal deaths annually, while a study conducted in 2010 in a tertiary healthcare centre in Kuala Lumpur involving 40,212 deliveries found that the prevalence of pre-eclampsia was 1.6 per cent.

Sunway Medical Centre, Sunway City, consultant obstetrician and gynaecologist Dr Syeda Nureena Zaidi said although there is no clear answer available as to why pregnant mothers get pre-eclampsia, the risk can be reduced.

"As the underlying cause is not yet fully understood, there is no way to fully prevent the condition, but risk factors have been identified, and there are steps that can be taken to reduce the chances of developing pre-eclampsia.

"Ideally, women who are planning to get pregnant should be screened for risk factors,” she said in a statement in conjunction with World Pre-Eclampsia Day.

Dr Syeda Nureena said taking aspirin starting at 12 weeks of pregnancy has been shown to reduce the risk of pre-eclampsia.

Meanwhile, she said that as hypertension is becoming an increasingly common condition affecting Malaysians, a healthy lifestyle is essential, especially before embarking on a pregnancy, and this includes eating healthy with plenty of fruits, vegetables and staying hydrated.

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She said in general, those over the age of 40 or with a body mass index (BMI) of 30kg/m2 or higher are at risk of getting pre-eclampsia.

Other risk factors include family history of hypertension in pregnancy, hypertension during previous pregnancy, chronic kidney disease, autoimmune disease (Systemic Lupus Erythematosus), type 1 or 2 diabetes mellitus and chronic hypertension.

Dr Syeda Nureena said pregnant mothers should also look out for early signs of pre-eclampsia such as facial puffiness and lower limb swelling, but as the hypertension worsens, other symptoms such as headache, blurred vision, nausea, vomiting, and epigastric pain could appear.

"The puffiness and swelling occur because of the loss of protein through the urine, which causes fluid in the body to shift out into the third space. As the hypertension worsens, the increased pressure causes the other symptoms to occur,” she said.

She cautioned that if left untreated, pre-eclampsia may progress into eclampsia, which is the occurrence of seizures in pregnancy that can be life-threatening to both mother and baby.

Dr Syeda Nureena said that if diagnosed with pre-eclampsia, medication is used to control the blood pressure, but that does not fully treat the disorder.

"Once a patient has been diagnosed with pre-eclampsia, it is important to closely monitor the mother and baby. As long as the pregnancy continues, the risk of pre-eclampsia worsening remains,” she said.

Dr Syeda Nureena added that mothers are also at risk of developing pre-eclampsia after giving birth, as blood pressure can rise progressively over the first five days after delivery.

There is also a risk of premature delivery as there may be a need to end the pregnancy to control the blood pressure, she said.

The doctor said education for the mothers, their partners, and their families is important to ensure that everyone is aware of what to look out for as well as to eradicate uncertainties regarding the condition. - BERNAMA