Hypertensive disorders affect an estimated 20-25% of all pregnancies in India, which is concerning, especially given the country's high incidence of lifestyle diseases such as obesity, diabetes, and late pregnancies. Normal blood pressure is 120/80 mm Hg, but preeclampsia can cause it to rise suddenly and unexpectedly to 140/90 mm Hg or higher. If not diagnosed and managed correctly, preeclampsia can lead to serious complications such as bleeding, epileptic fits, and neurological issues.
Recognizing Symptoms of Preeclampsia
Preeclampsia can manifest through various symptoms, including puffiness of the face, swelling of the feet, episodes of abdominal pain, and sudden, significant weight gain of 3-6 kg within 2-4 weeks. It often results in preterm birth, as delaying delivery can pose survival risks for both the baby and the mother.
Understanding the Causes of Preeclampsia
The exact causes of preeclampsia are not well understood, but it is believed to have a metabolic origin that causes the placenta to become dysfunctional. This dysfunction can lead to elevated blood pressure, organ damage, and other complications. Most obstetricians detect preeclampsia only after it has manifested.
Diagnosing and Treating Preeclampsia
Diagnosis of preeclampsia is achieved through a combination of clinical assessment, ultrasound reports, and lab tests. If it occurs close to the term of pregnancy, emergency intervention and delivery are typical management strategies. However, early-onset preeclampsia, occurring before 34 weeks of gestation, often requires neonatal ICU admission for the baby and potentially the mother. Each day gained closer to 34 weeks can significantly improve survival rates.
Advances in Preeclampsia Research
Researchers are striving to uncover the origins of preeclampsia and identify biomarkers for early detection and prediction. Advanced techniques like mass spectrometry and protein sequencing have identified several overexpressed proteins in preeclampsia. Fibronectin, a protein investigated as far back as 1984, plays a critical role in embryogenesis and has been shown to elevate in preeclampsia cases.
Eliminating Risks Through Early Detection
Assessing the risk of preeclampsia is now easier by measuring fibronectin levels in pregnant women. A device similar to a blood sugar meter, available in India, measures fibronectin from a finger-stick sample within ten minutes. This test, conducted in obstetricians' clinics, is simple and easy to use, allowing rapid intervention decisions in fast-progressing cases.
Path to Equality in Preeclampsia Management
Measuring fibronectin levels also helps categorize patients into mild, moderate, and severe risk levels. This test can be part of pregnancy surveillance at 12 weeks gestation, especially for women at risk of gestosis. It aids in identifying mothers needing closer monitoring and those who can be managed on an outpatient basis, promoting equality in preeclampsia management and care.
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