Warning signs of pre-eclampsia to be spelled out to mothers

Pre-eclampsia is a major cause of illness and death in both mothers and babies worldwide but more awareness is needed, experts say.

Dr Karim Elmasry addresses an audience at the International Conference of Al Noor Hospital. March 20, 2014. Sammy Dallal / The National

ABU DHABI // Disorganised ante-natal care, a lack of unified records and limited awareness are putting pregnant women and their unborn children at risk of a potentially fatal illness.

Pre-eclampsia is a major cause of illness and death in both mothers and babies worldwide but many do not know about the symptoms.

“What we need to do as practitioners is to educate women abut the symptoms because this is a condition that happens very suddenly,” said Dr Yuliya Burmagina, a specialist in obstetrics and gynaecology at the Femiclinic in Dubai Healthcare City.

While many women with pre- eclampsia, a multi-system disorder characterised by high blood pressure, will deliver a healthy baby and fully recover, if left untreated the condition can progress to eclampsia. This can cause seizures in the mother and brain damage in the baby.

“It can be fatal. Women can have multi-organ failure, swelling of the brain, then they could suffer a seizure and die,” said Dr Burmagina.

Pre-eclampsia, which affects 5 to 10 per cent of women, has serious risks to the unborn child too. It can cause growth delays, low birth weight, pre-term birth or even death.

Dr Karim Elmasry, chief of gynaecological oncology at Mafraq Hospital in Abu Dhabi, believes the medical sector should be doing more to educate women about the importance of continuity of care during pregnancy.

“It is an area we could improve on, both in private and government sectors,” he said.

Some women will “shop around” and visit different obstetricians during a pregnancy, he said. But in the absence of unified health records, doctors are unaware of any underlying problems.

“It is a bit like shopping. But when a patient goes from place to place – we don’t have their notes so you don’t know what has been going on.

“So that is the problem. The care is disorganised and that is what actually results in suboptimal care of the women.”

While the only cure for pre-eclampsia begins with delivery of the baby and placenta, experts agree that expectant mothers can protect themselves by knowing the symptoms and having regular antenatal check-ups.

Warning signs include severe headaches, changes in vision, rapid weight gain and swelling in the limbs.

If doctors are aware of the condition – marked by high-blood pressure and a high level of protein in the urine – there are treatments that can prolong the pregnancy and increase the baby’s chances of health and survival.

Dr Burmagina said the prevalence of pre-eclampsia in the UAE was difficult to measure.

“This is a relatively common condition, I would say, ranging from 3 to 5 per cent,” she said.

Pre-eclampsia has no known cause and so is difficult to predict, she said, while those in their first trimester can be screened but it is expensive.

Risk factors include obesity, a history of high blood pressure, diabetes and kidney disease.

Women over the age of 35 or those having multiple births are also at risk. Pre-eclampsia does not always present symptoms and that it why regular check-ups are vital, said Dr Burmagina.

Dr Fady Hachem, a consultant in obstetrics and gynaecology at Abu Dhabi’s Burjeel Hospital, said it was those having their firstborn who needed to know more.

“Know the risk factors,” he urged.

Although there is no sure-fire way to prevent pre-eclampsia, Dr Hachem said that optimising health before pregnancy is key.

That means having a normal body mass index, exercising and a healthy diet.

Studies have shown a low dose of aspirin in the early stages of pregnancy can also reduce the risk.

“There is a lot of awareness needed in the UAE,” said Dr Saleema Wani, an obstetrics and gynaecology consultant at Abu Dhabi’s Corniche Hospital.

“If you don’t know what to look for it is a problem. ”

jbell@thenational.ae

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