Materiały źródłowe

• #1 Preeclampsia – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-20355751

  The primary treatment for preeclampsia is either to deliver the baby or manage the condition until the best time to deliver the baby. This decision with your health care provider will depend on the severity of preeclampsia, the gestational age of your baby, and the overall health of you and your baby. […] Severe preeclampsia requires that you be in the hospital to monitor your blood pressure and possible complications. Your health care provider will frequently monitor the growth and well-being of your baby. […] Medications to treat severe preeclampsia usually include: Antihypertensive drugs to lower blood pressure, Anticonvulsant medication, such as magnesium sulfate, to prevent seizures, Corticosteroids to promote development of your baby’s lungs before delivery. […] If you have preeclampsia that isn’t severe, your health care provider may recommend preterm delivery after 37 weeks. If you have severe preeclampsia, your health care provider will likely recommend delivery before 37 weeks, depending on the severity of complications and the health and readiness of the baby. […] You need to be closely monitored for high blood pressure and other signs of preeclampsia after delivery. Before you go home, you’ll be instructed when to seek medical care if you have signs of postpartum preeclampsia, such as severe headaches, vision changes, severe belly pain, nausea and vomiting.

• #2 Preeclampsia Treatment & Management: Approach Considerations, Prehospital Treatment, Care in Preeclampsia Without Severe Features

  https://emedicine.medscape.com/article/1476919-treatment

  The optimal management of a woman with preeclampsia depends on gestational age and disease severity. Because delivery is the only cure for preeclampsia, clinicians must try to minimize maternal risk while maximizing fetal maturity. The primary objective is the safety of the mother and then the delivery of a healthy newborn. Obstetric consultation should be sought early to coordinate transfer to an obstetric floor, as appropriate. […] Patients with preeclampsia without severe features are often induced after 37 weeks’ gestation. Before this, the immature fetus is treated with expectant management with corticosteroids to accelerate lung maturity in preparation for early delivery. […] In patients with preeclampsia with severe features, induction of delivery should be considered after 34 weeks’ gestation. In these cases, the severity of disease must be weighed against the risks of infant prematurity. In the emergency setting, control of BP and seizures should be priorities. In general, the further the pregnancy is from term, the greater the impetus to manage the patient medically.

• #3 Pre-eclampsia – Wikipedia

  https://en.wikipedia.org/wiki/Pre-eclampsia

  The definitive treatment for pre-eclampsia is the delivery of the baby and placenta, but the danger to the mother persists after delivery and full recovery can take days or weeks. The timing of delivery should balance the desire for optimal outcomes for the baby while reducing risks for the mother. The severity of the disease and the maturity of the baby are primary considerations. These considerations are situation-specific, and management will vary with situation, location, and institution. Treatment can range from expectant management to expedited delivery by induction of labor or caesarean section. In the case of preterm delivery additional treatments, including corticosteroid injection to accelerate fetal pulmonary maturation and magnesium sulfate for prevention of cerebral palsy, should be considered. Important in management is the assessment of the mother’s organ systems, management of severe hypertension, and prevention and treatment of eclamptic seizures. Separate interventions directed at the baby may also be necessary. Bed rest is not useful and is thus not routinely recommended.

• #4 Preeclampsia and Eclampsia – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/preeclampsia-and-eclampsia

  Treatment of Preeclampsia and Eclampsia: Usually hospitalization […] Delivery, depending on factors such as gestational age, fetal status, and severity of preeclampsia […] Magnesium sulfate to prevent or treat new seizures or to prevent seizures from recurring […] Sometimes antihypertensive treatment, if patient meets criteria for severe hypertension. Definitive treatment for preeclampsia is delivery. However, risk of preterm delivery is balanced against gestational age, fetal growth restriction, fetal distress, and severity of preeclampsia. Usually, immediate delivery after maternal stabilization (eg, controlling seizures, beginning to control blood pressure [BP]) is indicated for the following: Pregnancy of 37 weeks […] Preeclampsia with severe features if pregnancy is 34 weeks […] Deteriorating renal, pulmonary, cardiac, or hepatic function (including HELLP syndrome)

• #5 Preeclampsia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK570611/

  Management of preeclampsia begins with early diagnosis and intervention, focusing on adequate blood pressure control and seizure prevention. […] Blood pressure control includes both immediate antihypertensive management in cases of severe hypertension (ie, 160 mm Hg systolic and/or 110 mm Hg diastolic) as well as maintenance antihypertensive management either in the antepartum or postpartum periods depending on the particular diagnosis of preeclampsia. […] Antihypertensive medications, which are efficacious and without adverse effects on the fetus, include the following medications: Beta-blockers, such as labetalol; Calcium-channel blockers, such as nifedipine; Alpha-2 agonists, such as clonidine; Vasodilators, such as hydralazine. […] The first choice for seizure prophylaxis in patients with preeclampsia with severe features is IV magnesium sulfate therapy.

• #6 Preeclampsia Treatment & Management: Approach Considerations, Prehospital Treatment, Care in Preeclampsia Without Severe Features

  https://emedicine.medscape.com/article/1476919-treatment

  In the setting of severe hypertension (SBP 160 mm Hg; DBP 110 mm Hg), antihypertensive treatment is recommended. […] Hydralazine is a direct peripheral arteriolar vasodilator and, in the past, was widely used as the first-line treatment for acute hypertension in pregnancy. […] Labetalol is a selective alpha blocker and a nonselective beta blocker that produces vasodilatation and results in a decrease in systemic vascular resistance. […] Nifedipine is the oral calcium channel blocker that is used in the management of hypertension in pregnancy. […] In a severe hypertensive emergency, when the above-mentioned medications have failed to lower BP, sodium nitroprusside may be given. […] Despite the presence of peripheral edema, patients with preeclampsia are intravascularly volume depleted, with high peripheral vascular resistance.

• #7

  https://www.nhs.uk/conditions/pre-eclampsia/treatment/

  Pre-eclampsia can only be cured by delivering the baby. If you have pre-eclampsia, you’ll be closely monitored until it’s possible to deliver the baby. […] Once diagnosed, you’ll be referred to a hospital specialist for further assessment and any necessary treatment. […] Medicine is recommended to help lower your blood pressure. These medicines reduce the likelihood of serious complications, such as stroke. […] Some of the medicines used regularly in the UK include labetalol, nifedipine or methyldopa. […] Your doctors may recommend one of them if they think it’s the most suitable medicine for you. […] Anticonvulsant medicine may be prescribed to prevent fits if you have severe pre-eclampsia and your baby is due within 24 hours, or if you have had convulsions (fits). […] In most cases of pre-eclampsia, having your baby at about the 37th to 38th week of pregnancy is recommended.

• #8 Preeclampsia, Eclampsia & HELLP – Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/preeclampsia-eclampsia-hellp-treatment/

  Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm. […] Recommended Treatment: Consult obstetrics. […] Arrange for fetal heart monitoring (in conjunction with OBGYN) +/- ultrasound +/- doppler. […] Severe Hypertension ≥160mmHg systolic or ≥110mmHg diastolic. […] Pregnancy Safe Options: Acute management of severe hypertension WITH end-organ damage: Labetalol 20mg IV over 2 minutes. […] Hydralazine 5mg IV over 2 minutes. […] Methyldopa 250 to 500 mg IV over 30 to 60 minutes every 6 hours, up to a maximum of 3 g/day. […] Nifedipine Oral Nifedipine LONG ACTING 30mg Tablet. […] First Line: Labetalol – Initial 100 mg PO BID. […] Second line: Clonidine, hydralazine and thiazides. […] DO NOT use ACE Inhibitors and Angiotensin RB in pregnancy or first few weeks post-partum or preterm babies if breastfeeding.

• #9 Preeclampsia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/preeclampsia

  Blood pressure medication is not recommended for patients with non-severe preeclampsia, but may be for those with severe preeclampsia based on their blood pressure levels. The most common medications used for blood pressure control are labetalol, nifedipine, and methyldopa. […] For severe preeclampsia, one or more of the following treatments may be recommended: Hospitalization for close monitoring and treatment, Medications to treat hypertension, such as labetalol, hydralazine, nifedipine, Magnesium sulfate to prevent seizures (this is only used when a decision to deliver is made), Early delivery (at 34 weeks of pregnancy); oxytocin may be used to induce labor, Corticosteroids to help the baby’s lungs mature more quickly if delivery is scheduled at 34 weeks or before. […] Preeclampsia sometimes occurs after delivery (postpartum). Health care providers will closely monitor a patient’s blood pressure readings for three days after delivery, particularly if they had high blood pressure during pregnancy or labor, or if they experience headaches and vision problems after delivery.

• #10 Pre-eclampsia – Wikipedia

  https://en.wikipedia.org/wiki/Pre-eclampsia

  The World Health Organization recommends that women with severe hypertension during pregnancy should receive treatment with anti-hypertensive agents. Severe hypertension is generally considered systolic BP of at least 160 or diastolic BP of at least 110. Evidence does not support the use of one anti-hypertensive over another. The choice of which agent to use should be based on the prescribing clinician’s experience with a particular agent, its cost, and its availability. Diuretics are not recommended for prevention of pre-eclampsia and its complications. Labetalol, hydralazine and nifedipine are commonly used antihypertensive agents for hypertension in pregnancy. ACE inhibitors and angiotensin receptor blockers are contraindicated as they affect fetal development. […] The intrapartum and postpartum administration of magnesium sulfate is recommended in severe pre-eclampsia for the prevention of eclampsia. Further, magnesium sulfate is recommended for the treatment of eclampsia over other anticonvulsants. Magnesium sulfate acts by interacting with NMDA receptors.

• #11 Preeclampsia Treatment & Management: Approach Considerations, Prehospital Treatment, Care in Preeclampsia Without Severe Features

  https://emedicine.medscape.com/article/1476919-treatment

  Women with preeclampsia with severe features who have nonreassuring fetal status, ruptured membranes, labor, or maternal distress should be delivered regardless of gestational age. […] If a patient presents with preeclampsia with severe features before 34 weeks’ gestation but appears to be stable, and if the fetal condition is reassuring, expectant management may be considered, provided that the patient meets the strict criteria set by Sibai et al. […] The basic principles of airway, breathing, and circulation (ABC) should always be followed as a general principle of seizure management. […] Magnesium sulfate is the first-line treatment for the prevention of primary and recurrent eclamptic seizures. […] Prophylactic treatment with magnesium sulfate is indicated for all patients with severe preeclampsia.

• #12 Preeclampsia and Eclampsia – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/preeclampsia-and-eclampsia

  Nonreassuring results of fetal monitoring or testing […] Eclampsia. Patients with preeclampsia with severe features or eclampsia are often admitted to a maternal special care unit or an intensive care unit (ICU). Pregnant patients at 34 to 37 weeks of gestation who do not require immediate delivery are hospitalized for evaluation, at least initially. If maternal and fetal status are reassuring, outpatient treatment is possible; it includes modified activity (modified rest), BP measurements, laboratory monitoring, fetal nonstress testing, and physician visits at least once a week. As long as no criteria for preeclampsia with severe features develop, delivery can occur (eg, by induction) at 37 weeks. In pregnancies at 34 weeks, if delivery can be safely delayed, corticosteroids are given for 48 hours to accelerate fetal lung maturity. Some stable patients can be given corticosteroids after 34 weeks and before 36 weeks (late preterm period) if they have not been given corticosteroids earlier in the pregnancy. All hospitalized patients with preeclampsia are evaluated frequently for evidence of preeclampsia with severe features, seizures, or vaginal bleeding; BP, reflexes, and fetal status (with nonstress testing or a biophysical profile) are also checked. Magnesium sulfate is given to prevent seizures. As soon as eclampsia is diagnosed, magnesium sulfate must be given to prevent seizures from recurring. Magnesium sulfate 4 g IV over 20 minutes is given, followed by a constant IV infusion of 2 g/hour. Dose is adjusted based on whether renal insufficiency is present. Magnesium sulfate is given for 12 to 24 hours postpartum. If seizures occur despite magnesium therapy, diazepam or lorazepam can be given IV to stop seizures, and IV hydralazine or labetalol is given in a dose titrated to lower systolic BP to 140 to 155 mm Hg and diastolic BP to 90 to 105 mm Hg. The most efficient method of delivery should be used. If the cervix is favorable and rapid vaginal delivery seems feasible, a dilute IV infusion of oxytocin is given to induce or accelerate labor; if labor is active, the membranes are ruptured. If the cervix is unfavorable and prompt vaginal delivery is unlikely, cesarean delivery may be considered. Preeclampsia and eclampsia, if not resolved before delivery, usually resolve rapidly afterward, within 6 to 12 hours. BP should be monitored closely until it normalizes after delivery. Patients should then be evaluated at least every 1 to 2 weeks postpartum with periodic BP measurement. If BP remains high after 6 weeks postpartum, patients may have chronic hypertension and should be referred to their primary care physician for management. Preeclampsia can develop after delivery. Signs and symptoms are similar to preeclampsia during pregnancy, and women should be counseled to call their providers if they experience these symptoms postpartum. In cases that meet criteria for severe preeclampsia, patients are hospitalized and treated with IV magnesium sulfate for 24 hours to prevent seizures.

• #13 Preeclampsia: Signs, causes, risk factors, and treatment

  https://www.babycenter.com/pregnancy/health-and-safety/preeclampsia_257

  If at any time your symptoms indicate that your condition is getting severe, or that your baby isn’t thriving, you’ll be admitted to the hospital and will probably need to deliver early. […] The only way to „treat” preeclampsia is by delivering your baby. […] You’ll probably be induced if any of the following happen: You’re at 37 weeks or more, especially if your cervix is starting to thin out and dilate; Your preeclampsia is getting worse; Your baby isn’t thriving. […] After delivery, you’ll remain under close medical supervision for a few days. Most women, especially those with non-severe (or „mild”) preeclampsia, see their blood pressure start to go down in a day or so. […] If you have severe preeclampsia, you’ll probably be given magnesium sulfate intravenously for at least 24 hours after delivery to prevent seizures.

• #14 Preeclampsia: Risk Factors, Symptoms, & Treatment – SOG Health Pte. Ltd.

  https://www.sog.com.sg/blog/preeclampsia-risk-factors-symptoms-and-treatment/

  Anticonvulsant Medications […] If you are diagnosed with severe preeclampsia, your obstetrician may recommend an anticonvulsant such as magnesium sulfate to prevent seizures. […] Corticosteroids […] Your obstetrician may prescribe corticosteroid medications to temporarily improve your platelet and liver function to prolong your pregnancy. Corticosteroids can also help your unborn baby’s lungs mature faster, which is a critical step in preparing a preterm baby for life outside your womb. […] Bed Rest […] If you are far away from your expected due date and your symptoms are mild; your doctor may advise you to have enough bed rest. Resting helps to lower your blood pressure, which increases blood flow to the placenta. In severe cases, you may be hospitalised and monitored closely.

• #15 Preeclampsia Treatment & Management: Approach Considerations, Prehospital Treatment, Care in Preeclampsia Without Severe Features

  https://emedicine.medscape.com/article/1476919-treatment

  Prehospital care for pregnant patients with suspected preeclampsia includes the following: Oxygen via face mask, Intravenous access, Cardiac monitoring, Transportation of patient in left lateral decubitus position, Seizure precautions. […] Before 37 weeks, expectant management is appropriate. In most cases, patients should be hospitalized and monitored carefully for the development of worsening preeclampsia or complications of preeclampsia. […] A pregnancy complicated by preeclampsia without severe features at or beyond 37 weeks should be delivered. […] Antepartum testing is generally indicated during expectant management of patients with preeclampsia without severe features. […] When preeclampsia with severe features is diagnosed after 34 weeks gestation, delivery is most appropriate.

• #16 Preeclampsia > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/preeclampsia

  Treatment includes monitoring, early delivery, medication. […] Treatments are available to help manage preeclampsia with the goal of preventing complications and, if possible, reaching term. However, the condition typically resolves only after delivery. […] For mild preeclampsia, one or more of the following treatments may be recommended: Blood pressure readings weekly or twice weekly, Frequent urine tests to check for protein, Monitoring kick counts, or fetal movement, Weekly blood tests to look at blood platelets, liver enzymes, and kidney function, Ultrasounds every 2 to 4 weeks to monitor fetal growth to ensure the baby is growing at the expected rate, Delivery at 37 weeks of pregnancy (delivery is considered the best treatment as symptoms resolve within a few days/weeks afterwards).

• #17 Preeclampsia, Eclampsia & HELLP – Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/preeclampsia-eclampsia-hellp-treatment/

  Usual seizure management/precautions. […] First Line – Magnesium sulfate (MgSO4) […] When to start: Intrapartum and postpartum for women with preeclampsia. […] Consult obstetrics, antenatal corticosteroids can be considered for all premature cases. […] Limit maintenance fluids to 80 ml/hour unless there are other ongoing fluid losses. […] Strict bed rest is not recommended, reduced activity may be beneficial. […] All women with suspected preeclampsia, HELLP or eclampsia are admitted for: Diagnosis and Assessment, Maternal and Fetal Monitoring, Treatment or Delivery. […] Women with preeclampsia with severe features, HELLP or eclampsia are not discharged.

• #18 Diagnosis and Management of Preeclampsia | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/1215/p2317.html

  Delivery remains the ultimate treatment for preeclampsia. […] Although maternal and fetal risks must be weighed in determining the timing of delivery, clear indications for delivery exist. […] When possible, vaginal delivery is preferable to avoid the added physiologic stressors of cesarean delivery. […] If cesarean delivery must be used, regional anesthesia is preferred because it carries less maternal risk. […] During labor, the management goals are to prevent seizures and control hypertension. […] Magnesium sulfate is the medication of choice for the prevention of eclamptic seizures in women with severe preeclampsia and for the treatment of women with eclamptic seizures. […] Antihypertensive drug therapy is recommended for pregnant women with systolic blood pressures of 160 to 180 mm Hg or higher and diastolic blood pressures of 105 to 110 mm Hg or higher.

• #19

  https://www.nhs.uk/conditions/pre-eclampsia/treatment/

  Delivering the baby early can also reduce the risk of complications from pre-eclampsia. […] Although pre-eclampsia usually improves soon after your baby is born, complications can sometimes develop a few days later. […] You’ll usually need to have your blood pressure checked regularly after leaving hospital, and you may need to continue taking medicine to lower your blood pressure for several weeks.

• #20 Treatment of Preeclampsia: Magnesium Sulfate Therapy

  https://www.healthline.com/health/pregnancy/preeclampsia-magnesium-sulfate-therapy

  Magnesium sulfate can help prevent seizures in those with severe preeclampsia, which can minimize the risk of complications. […] The recommended treatment for preeclampsia is delivery of the baby and placenta. […] In this case, your doctor may prescribe magnesium sulfate as well as medications to help reduce blood pressure. […] Magnesium sulfate therapy is used to prevent seizures in women with preeclampsia. […] In severe cases of preeclampsia, doctors often recommend antiseizure medications, such as magnesium sulfate. Magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia. […] Magnesium sulfate usually takes effect immediately. […] Doctors treat magnesium toxicity with: […] To prevent magnesium toxicity from happening in the first place, your doctor should closely monitor your intake. […] If you have preeclampsia, your doctor may continue to give you magnesium sulfate throughout your delivery.

• #21 Preeclampsia Treatment & Management: Approach Considerations, Prehospital Treatment, Care in Preeclampsia Without Severe Features

  https://emedicine.medscape.com/article/1476919-treatment

  Preeclampsia resolves after delivery. However, patients may still have an elevated BP postpartum. […] Elevated BP may be controlled with nifedipine or labetalol postpartum. […] Efforts to prevent preeclampsia have been disappointing. […] A systematic review of 14 trials using low-dose aspirin (60-150 mg/d) in women with risk factors for preeclampsia concluded that aspirin reduced the risk of preeclampsia and perinatal death. […] Low-dose aspirin (81 mg/d) prophylaxis is recommended for pregnant individuals at high risk of preeclampsia with one or more of the following risk factors: History of preeclampsia, multifetal gestation, chronic hypertension, pregestational type 1 or 2 diabetes, kidney disease, autoimmune disease. […] On the basis of limited evidence from a systematic review and meta-analysis, the addition of low-molecular weight heparin or unfractionated heparin to low-dose aspirin has the potential to reduce the prevalence of preeclampsia and birth of small-for-gestational-age neonates in women with a history of preeclampsia. […] Preeclampsia is an appropriate disease to screen, as it is common, important, and increases maternal and perinatal mortality.

• #22 Diagnosis and Management of Preeclampsia | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/1215/p2317.html

  The treatment goal is to lower systolic pressure to 140 to 155 mm Hg and diastolic pressure to 90 to 105 mm Hg. […] In women with preeclampsia, blood pressure usually normalizes within a few hours after delivery but may remain elevated for two to four weeks. […] Women with preeclampsia should be counseled about future pregnancies.

• #23 Postpartum Preeclampsia: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17733-postpartum-preeclampsia

  Postpartum preeclampsia can lead to strokes, seizures and other complications if not promptly treated. […] If you have symptoms of postpartum preeclampsia, you need immediate medical attention. Once diagnosed and treated, the prognosis for a full recovery is very good. […] If your healthcare provider determines you have postpartum preeclampsia, they may prescribe the following treatments: Blood pressure medicine to lower your pressure levels. Antiseizure medicine, such as magnesium sulfate, to prevent seizures (one of the most common risks of postpartum preeclampsia). Anticoagulant (blood thinner) medications to reduce the risk of blood clots. […] No. It requires immediate medical attention. If you have any symptoms of preeclampsia after childbirth, contact your provider immediately or go to the nearest emergency room.

• #24 Preeclampsia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745

  Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range. […] Left untreated, preeclampsia can lead to serious even fatal complications for both the mother and baby. […] Early delivery of the baby is often recommended. The timing of delivery depends on how severe the preeclampsia is and how many weeks pregnant you are. Before delivery, preeclampsia treatment includes careful monitoring and medications to lower blood pressure and manage complications. […] The best clinical evidence for prevention of preeclampsia is the use of low-dose aspirin. Your primary care provider may recommend taking an 81-milligram aspirin tablet daily after 12 weeks of pregnancy if you have one high-risk factor for preeclampsia or more than one moderate-risk factor. […] It’s important that you talk with your provider before taking any medications, vitamins or supplements to make sure it’s safe for you.

• #25 Low-Dose Aspirin Use for the Prevention of Preeclampsia and Related Morbidity and Mortality | ACOG

  https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/12/low-dose-aspirin-use-for-the-prevention-of-preeclampsia-and-related-morbidity-and-mortality

  Based on the updated USPSTF guidance and its supporting evidence, ACOG and SMFM are revising their recommendation regarding low-dose aspirin prophylaxis for the prevention of preeclampsia. Low-dose aspirin (81 mg/d) prophylaxis is recommended for pregnant individuals at high risk of preeclampsia with one or more of the following risk factors: History of preeclampsia, especially when accompanied by an adverse outcome; Multifetal gestation; Chronic hypertension; Pregestational type 1 or 2 diabetes; Kidney disease; Autoimmune disease (ie, systemic lupus erythematous, antiphospholipid syndrome); Combinations of multiple moderate-risk factors. […] These risk factors are consistently associated with the greatest risk for preeclampsia. Preeclampsia incidence would likely be at least 8% in a population of pregnant individuals having one of these risk factors. Pregnant individuals with more than one of several moderate risk factors: Nulliparity; Obesity (ie, body mass index 30); Family history of preeclampsia (ie, mother or sister); Black race (as a proxy for underlying racism); Lower income; Age 35 years or older; Personal history factors (eg, low birth weight or small for gestational age, previous adverse pregnancy outcome, 10-year pregnancy interval); In vitro fertilization. […] When recommended, low-dose aspirin should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery.

• #26 Improving preeclampsia care with new research and prevention strategies | Discovery | Your Pregnancy Matters | UT Southwestern Medical Center

  https://utswmed.org/medblog/preeclampsia-care-research-prevention/

  Ongoing research at UT Southwestern aims to prevent preeclampsia, or high blood pressure from developing during pregnancy, and provide better treatment options for when it does occur. […] Currently, delivering the baby early is the only way to treat preeclampsia. But in the future, doctors might be able to intervene with safer, less invasive treatment options. […] Researchers also discovered that these processes occur in the placentas of women with preeclampsia, even if the women did not have APS. This opens the door to developing treatments to potentially reduce maternal and fetal harm from preeclampsia. […] In 2018 the American Congress of Obstetrics and Gynecologists (ACOG) made a research-based recommendation that pregnant women at risk for preeclampsia take daily low-dose aspirin from week 12 of pregnancy through delivery.

• #27 New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations

  https://www.mdpi.com/1422-0067/24/15/12100

  Preeclampsia (PE) is a pregnancy-specific disorder affecting 4–10% of all expectant women. It greatly increases the risk of maternal and foetal death. […] Therefore, there is a need for further research into new pharmacological strategies for the treatment and prevention of preeclampsia. This review presents new preventive methods and therapies for PE not yet recommended by obstetrical and gynaecological societies. […] Among the drugs recommended by obstetrical and gynaecological societies, aspirin (ASA) seems to be the most efficient for preventing preeclampsia, with data indicating around a 60% reduction in risk. […] Although various gynaecological and obstetrical societies advise the use of ASA as a prophylactic for PE, the recommended dosage in not consistent. […] The drugs recommended by obstetrical and gynaecological societies for preeclampsia treatment are known to present broad mechanisms of action, i.e., reducing high blood pressure and improving inflammation and oxidative stress, and ameliorating both maternal endothelial cell and placental dysfunction; however, it remains unclear why the therapy confers no clear benefits to pregnant women, and why only “cure” for preeclampsia is delivery, often prematurely.

• #28 New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations

  https://www.mdpi.com/1422-0067/24/15/12100

  Therefore, there is a need to identify new preventive agents and drugs precisely focused on elimination at least one factor provoking the development or progress of preeclampsia. […] Statins inhibit Hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase; an enzyme implicated in the biosynthesis of cholesterol in liver cells. […] Statins are implicated in the regulation of inflammation, whose exacerbation is believed to play a role in preeclampsia development. […] Eculizumab (Soliris) is a humanised monoclonal antibody class (Ig)G2/4 kappa that binds to the C5 complement. […] The activation of the placental C5a/C5aR pathway results in placental dysfunction; in vitro studies indicate that complement C5a can inhibit angiogenesis and trophoblastic cell migration. […] The blockade of the complement system, leading to the inhibition of inflammation, might be an effective method for mitigating the symptoms of preeclampsia.

• #29 New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations

  https://www.mdpi.com/1422-0067/24/15/12100

  Hydroxychloroquine (HCQ) is an immunomodulatory agent that can relieve inflammation. […] Several studies indicate that HCQ is a promising agent against preeclampsia. […] The most invasive therapy under consideration for treating preeclamptic women is therapeutic apheresis adapted for extracorporeal removal of sFlt1 from maternal blood. […] Recent research has indicated another potential alternative therapy to apheresis, based on the inhibition of sFlt1 production using three mRNA particles: sFLT1-i13 short, sFLT1-i13 long, and sFLT1-e15a. […] The idea of use of peptides, i.e., small well-ordered chains of amino acids with a molecular mass not exceeding 5000 Daltons, for treating diseases was conceived in the first half of the twentieth century. […] The correct course of gestation is strongly related to the synthesis and bioavailability of nitric oxide (NO) for maternal and placental cells. […] The evidence regarding the value of polyphenol supplementation among expectant women to reduce the risk of PE is divided. […] Although a number of strategies for the prevention and treatment of preeclampsia are promising in clinical trials, their results remain inconclusive.

• #30 New mRNA injection is step forward in 'quest’ to find preeclampsia cure | Live Science

  https://www.livescience.com/health/fertility-pregnancy-birth/new-mrna-injection-is-step-forward-in-quest-to-find-preeclampsia-cure

  A new mRNA therapy tested in mice may target the root cause of the potentially fatal pregnancy disorder preeclampsia. It’s yet to be tested in humans. […] An mRNA therapy could treat the potentially deadly pregnancy disorder preeclampsia, which currently has no cure, a new study in rodents finds. […] There are currently no drugs that slow the progression of preeclampsia. The only way to cure the condition is to deliver the baby. Until then, the mother’s symptoms can be managed using drugs that lower blood pressure. […] To find a potential solution, the researchers created an experimental therapy for preeclampsia that harnesses the same technology found in the Pfizer-BioNTech and Moderna COVID-19 vaccines. […] Just one injection of the therapy, delivered halfway through the mice’s pregnancy, lowered their blood pressure to a healthy level until they gave birth.

• #31 Therapy developed at Boston Children’s stops preeclampsia before it starts – Boston Children’s Answers

  https://answers.childrenshospital.org/preeclampsia/

  This study showed that MEx prevented maternal symptoms of preeclampsia and fetal growth restriction when given early. […] “We were excited that our study also showed improvement in the fetus,” says Taglauer. “Infant outcomes of preeclampsia (preterm birth, lung disease, growth restriction) are often much worse than maternal outcomes.” […] “We hope that in the future, once this remedy has been tested in the clinic, we will be able to treat the moms who exhibit early signs of preeclampsia,” adds Kourembanas. […] “That will be important since preeclampsia usually develops later on in the pregnancy, usually around or after the 20th week,” she says. “Another goal will be to see if preventing preeclampsia by MEx therapy, the baby’s lungs will also function better.”

• #32 Preeclampsia: Antepartum management and timing of delivery – UpToDate

  https://www.uptodate.com/contents/preeclampsia-antepartum-management-and-timing-of-delivery

  Preeclampsia is a multisystem progressive disorder characterized by the new onset of hypertension and either proteinuria or evidence of other maternal end-organ dysfunction after 20 weeks of gestation or postpartum. […] If the diagnosis is made antepartum, delivery is the only intervention that will lead to disease resolution, although end-organ dysfunction may worsen in the first one to three days postpartum. Timing of delivery is based on a combination of factors, including disease severity, maternal and fetal condition, and gestational age. […] Low-dose aspirin can reduce the occurrence of preeclampsia in patients at moderate- and high-risk for the disease. Once the diagnosis has been made, antihypertensive therapy does not prevent disease progression but can prevent the occurrence and severity of hypertension and its sequalae (such as maternal stroke and placental abruption) and magnesium sulfate therapy can prevent maternal seizures (eclampsia).

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