The main cause of maternal mortality often goes unnoticed. When the disease is diagnosed, it is sometimes too late to stop the damage.
Doctors don’t diagnose preeclampsia, a severe type of high blood pressure that occurs during pregnancy, until blood pressure and urine tests are very clear. When cases are diagnosed this late, women often go into preterm labor, with consequences for both babies and mothers.
Women of color, especially black and indigenous women, are at higher risk of developing the disease due to existing health problems.
The initiative announced this week aims to detect and treat preeclampsia earlier. If preeclampsia can be treated, many women will be able to carry their children into adulthood. Treatment can be as simple as prescribing aspirin to reduce or prevent the disease. Researchers hope that this initiative will encourage new treatments.
Tania Kamphaus, director of the nonprofit Metabolic Disorders Foundation for the National Institutes of HealthEven with small preventative measures, he said, “(a) you can make a dramatic difference in a person’s life and a child’s life.” If preeclampsia is allowed to run its course, it “affects both the mother and the baby — not just during pregnancy or the first year after,” she said.
preventable death; As maternal mortality continues to rise, the CDC is sounding the alarm on pregnant women’s doctor visits
of According to the Centers for Disease Control and Prevention, 1,205 women died In the year Maternal causes in 2021, increased from 861 in 2020. Black women die at twice the rate of white women. The CDC has determined that over 80% of deaths are pregnancy-related It can be prevented.
About one-third of pregnant women who die during childbirth have high blood pressure, a category that includes preeclampsia. Globally, 10 to 15 percent of maternal deaths are caused by preeclampsia and related complications, according to the non-profit organization. March of Dimes. Preeclampsia can also occur after childbirth.
The disease occurs after the first 20 weeks of pregnancy, in the middle of the second trimester, according to the Mayo Clinic. Preeclampsia is often found in blood pressure tests. It is also often diagnosed by urine tests that show a patient has high protein levels. Other symptoms are a decrease in the amount of platelets in the blood, increased liver enzymes, severe headache, changes in vision, as well as fluid in the lungs, difficulty breathing, upper abdominal pain, and nausea or vomiting.
However, doctors are limited in identifying the condition in patients, and often find it only when it is too late.
“The only way to identify a person’s risk of preeclampsia in the U.S. is clinically,” says Dr. Garita Sharma, MD, director of cardiovascular women’s health and cardio-obstetrics in the US. Innova Health Systemwhich has It studies the risks of preeclampsia In the black American population. “We don’t have any proven tests that we can use early in pregnancy or maybe in the second trimester to understand a person’s elevated risk.”
Risk factors include having preeclampsia in earlier pregnancies, as well as chronic hypertension, diabetes, kidney disease, obesity and increasing maternal age, Sharma said. Black women are more at risk than Indigenous women. Women in the US may have a higher incidence of chronic diseases that are considered risk factors for the disease.
Preeclampsia, if left untreated, can lead to organ damage and premature birth. Later, women are at higher risk of heart failure and heart disease, Sharma said.
Identify the symptoms of preeclampsia
The three-year project, a non-profit organization promoting the work of the NIH, seeks to evaluate data on two biomarkers, the molecules placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A), which can be detected by a person. He has preeclampsia.
Draw from the project Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) said data on more than 25,000 pregnancies in the US and Canada allowed researchers to have a more ethnically and racially diverse study group.
Aaron Pawlik, chief of the NICHD’s Obstetrics and Pediatrics Pharmacology and Therapeutics Branch, said this is important given how well the biomarkers work in other countries. The data measured PlGF and PAPP-A in blood collected from patients in cohort studies.
The presence of PlGF and PAPP-A does not necessarily mean a patient has preeclampsia, but it can help researchers identify patients at higher risk, Pavlik said.
Once these symptoms are detected, doctors closely monitor these women for changes in blood pressure, prioritizing Doppler ultrasounds to monitor blood flow, and blood work to monitor liver enzyme levels. In this way, Pavlik Aspirin can be used earlier.
The ultimate goal of the project is to have the Food and Drug Administration approve this type of detection. If the FDA approves it, the data will be publicly available, allowing companies to develop diagnostic tests. Companies may offer tests to pregnant patients during their routine blood work.
In addition to identification, this helps to develop treatments. According to the foundation’s Kamphaus, clinical trials have strict restrictions on the use of pregnant women in tests. Early detection may lead to better treatments for pre-eclampsia.
Eduardo Cuevas covers health and breaking news for USA TODAY. He can be reached EMCuevas1@usatoday.com.