A new study published in the Journal of the American Society of Nephrology paves the way for a new treatment for one of the most common and devastating complications in pregnancy: preeclampsia.
Preeclampsia is one of the main causes of children being born prematurely. It is a hypertension disorder, meaning it is characterized by high blood pressure. Hypertensive disorders of pregnancy, such as preeclampsia, complicate up to 10% of pregnancies worldwide.
Preeclampsia typically occurs after the 20th week of pregnancy, and most often near term. There is a risk that preeclampsia goes unnoticed as it can be superimposed on other hypertension disorders.
Other characteristics of preeclampsia include unusually high amounts of protein in the patient’s urine. Spotting this in routine tests is often how preeclampsia is diagnosed.
Until now, the only way to respond to preeclampsia has been the early removal of the developing child and placenta from the uterus. For the long-term health of the baby, keeping it in the uterus for as long as possible, assuming growth continues, is preferable. Untreated, a pregnancy for women with preeclampsia will last only another 3 days.
Researchers have now come up with one of the first treatments for preeclampsia that may prolong pregnancy.
The treatment involves targeting the removal of soluble Fms-Like Tyrosine Kinase-1 (sFlt-1) in women with severe preterm preeclampsia.
- Preeclampsia and related hypertensive disorders of pregnancy affect 5-8% of all births in the US
- Worldwide, preeclampsia is responsible for up to 20% of the 13 million preterm births each year
- For every preeclampsia-related death that occurs in the US, there are probably 50-100 other women who experience a “near miss.”
Lead author Dr. Ravi Thadhani, professor of medicine at Harvard Medical School and Massachusetts General Hospital in Boston, MA, and his colleagues conducted an open pilot study to evaluate the safety and effectiveness of removing sFlt-1 from the blood through a process called apheresis.
The blood of the patient was passed through an apparatus lined with a material that binds to sFlt-1 and retains it while the rest of the blood is then returned to the circulation.
The procedure was tested in 11 pregnant women with very preterm preeclampsia (23-32 weeks’ gestation).
Those treated once sustained their pregnancy for an average further 8 days, while those treated multiple times lasted a further 15 days, according to the results.
Such a treatment is especially important for those woman suffering from very preterm preeclampsia.
“Prolonging pregnancy allows the baby to mature, markedly reducing complications,” notes Dr. Thadhani.
“Achieving an additional week of gestational age in a premature infant at the gestational ages studied is important and, given the cost of care in the neonatal intensive care unit, probably cost-effective,” says Dr. Thomas Easterling, of the University of Washington in Seattle, in an accompanying editorial.
The amount of protein excreted in the urine was significantly reduced by the treatment and for a short time, the women’s blood pressure was reduced.
Dr. Thadhani says:
“Based on recent advances in the understanding of this condition, we and others are developing treatments for preeclampsia to allow women to safely prolong their pregnancy if they are suffering from very preterm preeclampsia.”
However challenging to achieve, a randomized trial is needed, the research team says.
In December last year, Medical News Today reported on a study suggesting a link between preeclampsia and autism.
Written by Jonathan Vernon