Preeclampsia is a pregnancy-related condition characterized by a rapid rise in blood pressure, leakage in protein in the urine and swelling of the legs after 20 weeks gestation. If left untreated, it can result in the development of eclampsia, a sudden onset condition that can result in seizures, stroke, multiple organ failure and death. Affecting about 7 percent of pregnancies worldwide, the condition is considered to be the second leading pregnancy-related cause of death during pregnancy.
Women considered to have the highest risk of developing preeclampsia are: women who have had it during a previous pregnancy, women who are pregnant for the first time, women with a family history of preeclampsia, women over the age of 40, women who are carrying multiple fetuses, women who are overweight, women with chronic high blood pressure, women who have chronic kidney disease, and women that have diabetes. But not all women who have these conditions end up getting preeclampsia, and not all women who get the condition have these risk factors.
Currently, the only method available for detecting women at high risk for developing preeclampsia is a uterine artery Doppler scan. While this test is helpful in predicting the risk of preeclampsia in some women, the test is only accurate about 50 percent of the time. Unfortunately, this means that doctors must hope that they catch preeclampsia cases early on in the other half of women who end up with the condition. In developed countries, it is usually caught by checking protein in the urine, but in countries without adequate medical care, the condition often becomes fatal.
It is because of the accuracy issues that researchers from St. George’s University, London, wanted to develop a more accurate method of testing. They previously had conducted a study back in 2001 in which they found that women who had the condition had a significantly fewer number of capillaries (small blood vessels that connect arteries to veins) than those that did not have the condition. They recently expanded on this research to determine if monitoring the number of capillaries could accurately predict preeclampsia risk in pregnant women.
For their study, researchers from England followed 305 women throughout their pregnancies. Data indicated that the number of capillaries in women at risk started to decline as early as 20 weeks gestation, and even when conducted this early, the capillary measurement test was able to predict women at risk for preeclampsia with an accuracy of 87 percent. When repeating the test at 27 weeks gestation, the screening was able to identify the presence of preeclampsia, without any other form of testing, 75 percent of the time. What’s more, the test was less likely to include women that would not go on to develop preeclampsia. This is a huge improvement on the current form of testing.
“We found that if we examine the microcirculation and measure the changes in capillaries, we can predict preeclampsia in a more accurate way, and this is exciting news. This evaluation is totally non-invasive, painless and takes only 20 minutes while the patient sits comfortably with their hand under a specially designed microscope,” Tarek Antonios, MD, St. George’s University of London, and the study’s lead author told English FARS News. “We found that the predictive value of measuring [relative] changes in the capillaries far exceeds that of [the uterine Doppler] scan that is currently used.”
Dr. Antonios added that combining the new capillary testing with the Doppler testing could also further increase the accuracy of preeclampsia prediction. However, it should also be noted that Dr. Antonios said that further testing needs to be done to see if the results stand firm during a larger-scale, more diverse study. But if the results do hold up, this new method of testing could save the lives of countless women and their babies.
“If the results of this research are confirmed in a larger study, this technique could change clinical practice and be used as a novel way to predict preeclampsia so that more timely medical care can be provided to these pregnant women and prevent thousands of women and hundreds of thousands of infants from dying from this disease,” Dr. Antonios said.
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