Pregnant women should be screened for pre-eclampsia, an obstetrician-gynecologist in Taichung said, after a woman had an induced labor at 34 weeks after developing symptoms of the condition.
The patient, surnamed Hsu (許), was rushed to the hospital after exhibiting high blood pressure, shortness of breath, swelling and other symptoms, said Wei Pei-li (魏沛秝), head of the delivery room at Asia University Hospital.
Hsu had a body mass index of 35, weighed 80kg and after 20 weeks of gestation, her blood pressure exceeded 140/90mmHg on two separate occasions at least six hours apart, Wei said.
She was diagnosed with preeclampsia — also known as toxemia — and because the lives of her and her baby were at risk, she was given medications to lower her blood pressure and to speed up the maturation of the fetus’ lungs, and magnesium sulfate to control her seizures, Wei said.
Once Hsu’s situation stabilized, she was scheduled for induced labor, Wei said, adding that both the mother and child are safe.
Pre-eclampsia, which occurs when there is a problem with the function of the placenta, is the pregnancy-related condition obstetricians “worry most about,” she said.
It is also a major cause of maternal and neonatal deaths, as well as premature births, Wei said.
Pre-eclampsia is common in first-time or multiple pregnancies, as well as in pregnant women with prior hypertension, diabetes, kidney disease, excessive amniotic fluid or lupus; a history of gestational hypertension or molar pregnancy; or a baby with hydrops fetalis, she said.
In its early stages, most patients are unaware of the condition, she said.
By the time symptoms such as severe headaches, blurred vision, upper right abdominal pain, nausea, vomiting, swelling or weight gain have emerged, the condition has already worsened, Wei said.
To prevent pre-eclampsia, pregnant women should receive screenings between 11 weeks and 13 weeks and six days of gestation, she said.
Screenings are effective in identifying more than 90 percent of high-risk pregnancies with early-onset pre-eclampsia, she added.
Pregnant women identified to be at risk of pre-eclampsia should take 100mg of aspirin daily at about 16 weeks into pregnancy, Wei said, adding that this would lower the risk of early-onset preeclampsia by 50 percent.
If treatment does not begin until after 16 weeks, its effectiveness is reduced to 20 percent, she said.
In terms of diet, those at risk of pre-eclampsia should reduce sodium intake and eat more fruits and vegetables with potassium, Wei said, adding that they should also monitor their blood pressure and control their weight.
As women who experience pre--eclampsia have a higher risk of developing cardiovascular disease later in life, they should control their weight and receive physical exams annually, she added.
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