Early Markers for Preeclampsia Discovered

A recent study finds a new way to predict risk of developing preeclampsia, a sometimes deadly pregnancy disease, which means pregnant women can get tested sooner.

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Unless you skipped over the scary chapter on pregnancy complications in What to Expect When You're Expecting, you may know that preeclampsia happens when a pregnant woman's blood pressure rises to dangerously high levels, putting mom and baby in jeopardy. But a new study has found that early elevations in certain chemicals in the blood are red flags for preeclampsia, which could mean quicker detection and treatment.

The study, published this week in BJOG: An International Journal of Obstetrics and Gynecology, tested the amount of the naturally occurring chemicals asymmetric dimethylarginine (ADMA) and homocysteine (Hcy) in pregnant women's blood, both of which were already associated with preeclampsia. But the researchers found that the levels in the women who went on to develop preeclampsia became elevated a month before the onset of symptoms. In the women who did not develop preeclampsia, the levels stayed the same.

A simple, easy test

Signs of the disease that OBs currently watch for include high blood pressure and protein in the urine, and usually show up after 20 weeks of pregnancy. But because preeclampsia can progress rapidly, early testing for these new markers could help identify which women need to be monitored more closely before the situation becomes serious. "The test is not new, and is easy and available in most clinical labs," lead author Mardya Lopez-Alarcon, M.D., Ph.D., of the Mexican Institute of Social Security, tells Fit Pregnancy. "From this study we are proposing that if you are classified as at risk, then you are a candidate for [regular testing] of ADMA and Hcy because you can be diagnosed with preeclampsia before the clinical signs appear." Early screening is especially important if you have other risk factors, such as high blood pressure or kidney disease prior to pregnancy, a family history of preeclampsia, obesity, multiple babies and even being a first-time mom. Although the test is not yet standard, the results of this study could change that.

Preeclampsia affects up to eight percent of pregnancies, and in severe cases can lead to liver or renal failure, seizures and brain injury for pregnant and newly postpartum women. Because it can restrict blood flow to the placenta and often requires early delivery, babies can be affected as well. Eleni Tsigas, executive director of the Preeclampsia Foundation, says that early testing may be key to a good outcome. "Identifying patients early in pregnancy who are at higher risk to develop preeclampsia can affect the surveillance and interventions they receive, and the kind of OB care provider they see—midwife, OB generalist or maternal-fetal medicine specialist," she tells Fit Pregnancy.

Preventing preeclampsia

What can you do to reduce your risk of preeclampsia? Because the exact cause of the disease is not known, it's hard to say, but the American Pregnancy Association suggests limiting salt and fried foods, drinking six to eight glasses of water a day, elevating your feet, and getting enough exercise and rest. Call your doctor immediately if you have symptoms such as vision problems, a severe headache, sudden nausea or vomiting, sudden weight gain or swelling, or pain in your upper right abdomen (where your liver is).

If you do develop signs of the condition, your doctor will keep a close eye on you and your baby to make sure it doesn't get worse. "If you have preeclampsia, you are at a high risk for complications including premature delivery, low birth weight and progress to eclampsia, which may be mortal," Lopez-Alarcon says. "The major action to prevent preeclampsia is prenatal care. Therefore, the sooner you know that you are at risk the better to apply preventive strategies such as a closer monitoring of the pregnancy's progress."