Preeclamsia & Prematurity

Pre - Eclampsia is a serious health problem affecting 5-8% of pregnancy worldwide

(8-10)% of pregnant women in India gets affected by it. 40% indicated or medically induced prematurity is caused by pre - Eclampsia and eclampsia in order to save life of mother and baby as delivery is the final option for this disease of placental origin. Main indications of premature delivery are

Fetal:

• Fetal disease
• Intrauterine growth restriction
• Oligo hydramnios
• Placental abruption
• Abnormal blood to fetus or abnormal doppler study

Maternal indications :

• Recurrent eclampsia
• HELLP syndrome
• D/C
• Liver hematoma
• Renal failure
• Hypertensive encephalopathy
• Pulmonary edema

Can pre-elcampsia, eclampsia and prematurity can be prevented?

Primary prevention:

To prevent disease from happening

• Avoid smoking and alcohol (It reduces disease by 30 - 40 %)
• Maintain healthy weight
• Avoid late marriage and late pregnancy
• Diet rich in antioxidant such as Vit C, Vit E,Magnesium,. Zinc and calcium if positive family history of hypertension pre-eclampsia and eclampsia
• Medication
• Role of low dose of ecospirin is still no confirmed

SECONDARY PREVENTION

• Medicines as such as Nifedipine, Labetalol, Hydralazsine
• Sodium nitro prusside sodium

Tertiary Prevention to avoid recurrence by Magnesium sulphate The main culprit of Pre-Eclampsia and eclampsia is placenta, which provides nourishment for baby. There is no 100% effective screening method to prevent it. So, final outcome depends on experienced and dedicated obstetrician for early diagnosis organized antenatal care and family decision of delivery

Authored By : Dr Deepmala