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11 March 2005
A new guideline backed by a University of Glasgow Professor and published in this week's British Medical Journal (BMJ) will help to tackle pre-eclampsia, one of the leading causes of illness and death during pregnancy.
Pre-eclampsia is a serious condition in which abnormally high blood pressure, swelling and blood poisoning develop in the second half of pregnancy. It affects about seven per cent of pregnancies and is dangerous for both mother and child.
The most important risk factors for developing pre-eclampsia are a previous history and the presence of certain antibodies, show researchers at the John Radcliffe Hospital in Oxford. Diabetes and a high body mass index almost quadruple the risk, while mother's age and raised blood pressure are also significant.
Their guideline recommends a straightforward system of early risk assessment and referral to ensure that pregnant women with pre-eclampsia are offered specialist care at the appropriate time for the best outcome for them and their baby. It is aimed at those caring for pregnant women in the community and is a practical extension of NICE's antenatal guideline.
Professor Ian Greer, from the University of Glasgow's Medical School, said:'Pre-eclampsia matters. In both the developed and developing world pre-eclampsia is a leading cause of death. The new risk assessment will effectively offer women a suitable surveillance routine to detect pre-eclampsia.'
Many deaths from pre-eclampsia are associated with substandard care, claim the guideline authors. Poor management includes failure to identify or act on risk at the beginning of pregnancy or to recognise and respond to signs and symptoms after 20 weeks.
The University of Glasgow's Professor Ian Greer applauds the simplicity and practicality of the new guideline. 'We cannot be complacent in the face of the recurrent deficiencies. The pragmatic approach of PRECOG is essential. Clinicians currently spend a great deal of time and energy screening for problems in pregnancy - for example, syphilis and Down's syndrome- that have a much lower incidence than pre-eclampsia. We need to ensure that antenatal education makes women aware of the symptoms of pre-eclampsia and the importance of regular assessment.'
'The guideline is aimed at those caring for pregnant women in the community to raise awareness of the risk factors for and implications of pre-eclampsia, including the need for accurate diagnosis, assessment, and timely referral especially when proteinuria or severe hypertension are present.'
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