Severe preeclampsia in the second trimester: recurrence risk and long-term prognosis

Article Abstract:

Preeclampsia is the development of high blood pressure during or following pregnancy. In rare cases, severe preeclampsia develops during the second trimester of pregnancy. This study examined whether women who developed severe preeclampsia during the second trimester of pregnancy had an increased risk for recurrence and other health problems. Medical records and outcomes of subsequent pregnancies were reviewed for 125 women who had developed severe preeclampsia during the second trimester of pregnancy. The women were followed-up on average for 5.44 years after the initial preeclampsia. In 110 of 169 (65 percent) subsequent pregnancies, preeclampsia occurred, and in 21 percent of the subsequent pregnancies severe preeclampsia during the second trimester occurred. A large number of the births involved complications, including 22 stillbirths, 6 neonatal deaths, 11 cases of abruptio placentae, and 39 cases of fetal growth retardation. A total of 44 of the women suffered from chronic hypertension. Women who suffered from preeclampsia in subsequent pregnancies were more likely to suffer from chronic hypertension. Two of the patients died and two suffered severe kidney disease. The results indicated that women who suffer severe cases of preeclampsia during the second trimester of pregnancy have an increased risk for preeclampsia during subsequent pregnancies, for chronic hypertension, and for other health problems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Hypertension in pregnancy, Gestational hypertension

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Risk factors for preeclampsia in healthy nulliparous women: a prospective multicenter study

Article Abstract:

Several risk factors associated with development of preeclampsia among healthy women who had not given birth previously. A group of 2947 women participated in a trial of low-dose aspirin as preventative treatment for developing preeclampsia. Women were randomly assigned to take aspirin or a placebo. They were monitored from between 13 and 27 weeks gestation until the end of pregnancy. No differences in predictive factors were found between aspirin-takers and the control women. Overall, preeclampsia developed in 5.3% of the group. Higher systolic blood pressure at study entry and obesity were the strongest predictive factors for preeclampsia. Prior pregnancy (miscarriages or abortions) and history of smoking reduced the risk of preeclampsia. Other studies have shown an association with black race, but that association was not found here. Smoking has been shown to reduce risk of preeclampsia in other studies, but smoking also is associated with increased risk of perinatal mortality and morbidity compared with nonsmokers.

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Low-dose aspirin in nulliparous women: safety of continuous epidural block and correlation between bleeding time and maternal-neonatal bleeding complications

Article Abstract:

Pregnant women who take low doses of aspirin for various conditions may not have an increased risk of bleeding if they receive epidural anesthesia at delivery. Researchers studied 1,629 pregnant women to assess the effects of low doses of aspirin and epidural anesthesia on bleeding time and amount during delivery. Of the 451 women taking aspirin and receiving epidurals, none experienced bleeding or blood clots in the epidural space. Women taking low doses of aspirin had significantly longer duration of bleeding at delivery, 10 minutes or more, but did not lose more blood than women who bled less than 10 minutes. Doctors currently recommend that women taking low doses of aspirin during pregnancy stop taking it seven to 10 days before delivery to prevent excess bleeding.

Prevention, Physiological aspects, Aspirin, Peridural anesthesia, Epidural anesthesia

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