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Preeclampsia

All About Preeclampsia

What is preeclampsia?

Preeclampsia is a serious pregnancy complication characterized by high blood pressure (hypertension) and protein in the urine (proteinuria) and often accompanied by damage to organs such as the liver and kidneys. Preeclampsia affects 5-8% of pregnancies worldwide, causing over 76,000 maternal deaths and 500,000 infant deaths each year [1].

Symptoms

Despite its origins early in pregnancy, the fact that symptoms typically do not manifest until the late second or third trimester in women with previously normal blood pressure represents a primary concern in preeclampsia. Even when symptoms appear, we possess a limited number of effective treatments; for this reason, delivering the placenta and baby (regardless of gestational age) represents the only definitive cure. Of note, this approach contributes to increased rates of preterm birth, a serious issue affecting 1 in 10 births.

Causes

While the exact causes of preeclampsia remain unclear, research led by Dr. Tamara Garrido at the Carlos Simon Foundation has identified abnormal endometrial decidualization or resistance to decidualization as a potentially significant factor [2]. Women with preeclampsia suffer from defective decidualization – the process by which the uterine lining prepares for pregnancy – suggesting a uterine contribution to the disease.

Risks for the mother

Preeclampsia can lead to severe maternal complications, including:

  • Eclampsia: a condition causing seizures and coma
  • HELLP syndrome: a disorder damaging the liver, red blood cells, and platelets
  • Kidney failure: when the kidneys stop functioning properly
  • Premature placental abruption: when the placenta prematurely detaches from the uterine wall
  • Additional long-term consequences: can include cardiovascular diseases

Risks for the Fetus

Preeclampsia can also endanger the baby, causing:

  • Fetal growth restriction: when the baby does not grow sufficiently in the womb
  • Preterm birth: when the baby is born before 37 weeks of gestation
  • Fetal death: preeclampsia can lead to death in severe cases

Diagnosis

The effectiveness of currently existing preventive measures depends on detecting preeclampsia risk before symptoms arise. Current risk assessments primarily rely on the patient’s medical history and the detection of specific markers in laboratory tests; however, many patients can remain unidentified. Significant efforts are underway to find an effective method for early detection to enable timely preeclampsia prevention and treatment. Finding a means to diagnose preeclampsia in the early stages of pregnancy remains crucial to reducing maternal and infant mortality and morbidity.

Treatment

No definitive cure exists for preeclampsia; managing symptoms and controlling the disease until delivering the baby is safe represent the primary treatment approach. Treatment depends on preeclampsia severity:

  • Symptom management: Medication can lower blood pressure and prevent seizures, while bed rest and constant monitoring are also recommended
  • Placental delivery: Childbirth represents the only definitive solution for preeclampsia, given that the placenta is the underlying cause of the condition; severe cases of preeclampsia may require the early induction of labor to protect the health of both mother and baby

Research Advances in Preeclampsia

Through a research line led by Dr. Tamara Garrido, The Carlos Simon Foundation is making significant progress in understanding preeclampsia and developing novel treatments. Dr. Garrido and her team are currently investigating the causes of preeclampsia and seeking biomarkers to identify women at risk of developing the disease before symptoms appear. They are also developing novel therapies to prevent and treat preeclampsia more effectively.
For more information, please visit: https://fundacioncarlossimon.com/investigacion/contribucion-materna-en-el-origen-de-la-preeclampsia/

 

References:
1. WHO recommendations for prevention and treatment of preeclampsia and eclampsia. https://www.who.int/publications/i/item/9789241548335

2. Garrido-Gomez, T., Dominguez, F., Quiñonero, A., Diaz-Gimeno, P., Kapidzic, M., Gormley, M., Ona, K., Padilla-Iserte, P., McMaster, M., Genbacev, O., Perales, A., Fisher, S. J., & Simón, C. (2017). Defective decidualization during and after severe preeclampsia reveals a possible maternal contribution to the etiology. Proceedings of the National Academy of Sciences of the United States of America, 114(40), E8468–E8477. https://doi.org/10.1073/pnas.1706546114