When a woman is pregnant, any risk to herself or her baby is a significant problem. One issue that five to ten percent of pregnant women face is preeclampsia. A woman who before pregnancy had a normal blood pressure can develop high blood pressure and excess proteins in her urine after the first twenty weeks of pregnancy. When this occurs, a woman is diagnosed with preeclampsia, which puts herself, as well as, her baby at risk. Preeclampsia develops abruptly after twenty weeks, with a high increase in blood pressure, proteinuria, severe headaches, light sensitivity, nausea, dizziness, decreased urine output, or sudden weight gain (more than two pounds a week) as sudden symptoms.
No matter how severe, preeclampsia must be monitored and cared for. In mild cases, there is not a high risk of complications; however, in more severe cases, it can cause serious problems and can affect many organs for the mother. The high blood pressure that is caused by preeclampsia reduces the flow of blood to many organs. Usually, less blood flows to the uterus which can cause the baby to have poor growth, not enough amniotic fluid, and placental abruption (when the placenta separates from the uterine wall before delivery). Prematurity is also common among pregnancies in which the mother has preeclampsia.
The only cure for preeclampsia: delivery; however, lots of research has gone into understanding preeclampsia. In the past couple of decades, many new treatments and discoveries have emerged. Every insight into the disorder helps reduce the risks that are involved. With this in mind, research and treatment progression in the past thirty years concerning preeclampsia in pregnant women has mattered significantly in reducing the risk for the mother, as well as, the baby.
Uterine Artery Doppler Ultrasonography can now be used to predict if a mother is going to develop preeclampsia. This procedure begins with an abdominal ultrasound. Then, with the patient semirecumbent, the flow velocity waveforms of the right and left uterine arteries are imaged. If, when looking at the uterine artery, there are alterations in the normal waveforms, this can be a sign of preeclampsia. A study was conducted to test the accuracy of this method in predicting preeclampsia in the first or second trimester. It was found that this method was able to more accurately predict the likelihood of preeclampsia when used in the second trimester, instead of the first. With the Doppler, an increased pulsatility index is the best indicator of preeclampsia, with the high-risk patients' index being higher than that of their low-risk counterparts. This method has been used as a predictive tool for preeclampsia. This has impacted the overall scheme of expecting mothers because now, their doctors, as well as themselves are able to prepare for what is to come. Regular check-ups can be scheduled to monitor the development of preeclampsia and treatment can begin at the first signs of the disorder. Ultimately, this allows the patient to prepare and makes the pregnancy easier for the mother, as well as safer for the baby.
A research study was conducted on rats that showed the inhibition of nitric oxide synthesis in their pregnancy gave signs similar to those in preeclampsia. The study found that if a rat was infused with an inhibitor of nitric oxide synthesis during its pregnancy, then the rat would contract hypertension and fetal growth problems, but it would not affect gestational length. It was concluded that since this is similar to what occurs in pregnant women with preeclampsia, treatment with nitric oxide inhibitors can be used in animal models to test new therapeutic strategies. This has revolutionized the treatment of preeclampsia by allowing the link between these rats and humans to produce a more effective treatment. While this is still in the early stages of development, it will be able, in the future, to help women reduce the risk they have when preeclampsia is present.
Soluble endoglin was found to have been associated with preeclampsia in rats. Other antiangiogenic proteins, such as tyrosine kinase seem to be involved in the development of preeclampsia. With this in mind, researchers conducted an experiment to test whether or not soluble endoglin was a factor regarding the development of preeclampsia in expecting mothers. The researchers found that higher levels of soluble endoglin yielded more severe preeclampsia. This impacts today because it allows for new treatments to be developed. These treatments will be more specific to the actual causes of preeclampsia and will benefit the mother and her infant.
Antihypertensive drugs and diuretics can be used to treat preeclampsia. Antihypertensive drugs do pass through the mother, through the placenta, finally being integrated into the circulation in the fetus; however, of the many different types of this drug, none have been found to be teratogenic (harming to the fetus). For less severe cases, antihypertensive drugs are not typically used. Most physicians will initiate this treatment when the case is more severe and the blood pressure rises above one hundred and forty mmHg. There have not been many studies concerning the use of hypertensive drugs during pregnancy, but it has been determined that the use of these drugs decreases the risk of the mother developing severe preeclampsia. The use of diuretics to reduce blood pressure during pregnancy used to be widely used. Today, it has been found that these drugs put the mother and baby at risk for other effects, such as improper fetal growth. These drugs are controversial and not a widely accepted method of treatment anymore. As for antihypertensive drugs, the use of them is helpful; therefore this has allowed pregnant women with severe preeclampsia a safe treatment option for her and her baby. As for the use of diuretics, since it has been found to produce adverse effects, it has helped physicians to not prescribe something that is going to harm the patient and it has narrowed down the options for the mother, making only the safe and effective treatments left.
Nifedipine and Hydrazaline are two drugs that are more commonly used to treat severe preeclampsia, rather than mild preeclampsia. A study was done to test which was more effective, and the results were a little shocking. Before the study, one of these drugs was not used any more often than the other. This study found that effective control of blood pressure was achieved ninety-five percent of the time with nifedipine and only sixty-eight percent of the time with hydrazaline. This difference is statistically significant, meaning that nifedipine is a lot more effective than hydrazaline in treating preeclampsia. Also, in both groups, minor maternal side effects were noted; however, more extreme side effects in regards to the fetus were noted during the use of hydrazaline (acute fetal distress was developed in eleven subjects treated with hydrazaline and only one treated with nifedipine). Also, infants born to patients treated with nifedipine were able to be delivered at later gestational ages, weighed more, and had fewer, more minor complications compared to their counterparts. This was a major accomplishment in the study of treatment of preeclampsia. First, it allowed physicians to provide more effective treatment to their patients and enabled them to narrow the options of treatment to those that were most effective. Also, this provided information on the safer treatment for expecting mothers and it allowed patients with preeclampsia to have the best option between these two that would provide the least amount of complications for the baby, as well as herself.
All in all, preeclampsia is a disorder characterized by hypertension and proteinuria. Many different types of research have been conducted in regards to preeclampsia. Rats have been used as an animal link to test things like antiangiogenic factors to see if they play a role in preeclampsia in humans. Also, pregnancy complications in rats have been compared to preeclampsia to find new treatments. Also, the Uterine Artery Doppler Ultrasonography has been developed to help predict preeclampsia in expecting mothers. Along with the research that has been conducted, new treatments have emerged. Many new drugs have been made to help reduce the effects of preeclampsia. Also, studies comparing different drugs have been able to narrow down the effective treatments.
While the only cure for preeclampsia is still delivery, research and treatment progression in the past twenty years concerning preeclampsia in pregnant women has mattered significantly in reducing the risk for the mother, as well as, the baby. All of the research and new treatments have allowed expecting mothers to have better and more accurate options for prediction and reducing the risks involved in the disorder. Also, the new treatments have allowed for a safer pregnancy and delivery for the mother and less complications in relation to the baby. Overall, without the research that has gone into developing new treatments for preeclampsia, mothers would be at a larger risk than they are. Finally, with recent research aiming to develop new treatments, the risks and complications involved with this disorder can only continue to decrease and the hopefully, one day soon, a cure can be found for this disorder.
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