Screening for preeclampsia -
best combined with Combined Test or with NIPT
The old name toxaemia (German for: pregnancy poisoning) is somewhat misleading. It suggests that there is some kind of toxic reaction in the pregnancy. Fortunately this is not completely true.
Preeclampsia is pregnancy complication affecting 2-5% of all pregnancies and has a high likelihood of reappearing in consequent pregnancies or if female family members (your sister or mother) were also affected by it.
Together with gestational diabetes, preeclampsia is the most common pregnancy complication.
Preeclampsia presents only in pregnancy, mostly in the late second or third trimester of pregnancy. Feeling good and having normal blood pressure values before and at the beginning of pregnancy unfortunately does not mean you can not be affected by preeclampsia.
The most common symptoms appearing only in the course of pregnancy are:
- maternal high blood pressure,
- losing protein in your urine (proteinuria),
- Later: abnormal liver parameters
- reduced growth of your baby.
Preeclampsia seems to be caused by a reduced compliance of the maternal cardiovascular system during pregnancy which is augmented by different maternal and placental metabolic factors.
Once preeclampsia has appeared current treatment protocols can not cure it, at best the progression can be slowed. The condition is caused by the pregnancy and can only be cured by removing the placenta, that means delivery. Depending on how late or how early in pregnancy preeclampsia appears, we are faced with different challenges.
- Late preeclampsia is mostly managed with medication to stabilise blood pressure, and the pregnancy can mostly go beyond 37 weeks. In most cases you can try a normal delivery.
- Early preeclampsia is more complicated, since the symptoms are present already before 34 weeks. Despite medications many pregnancies can not reach 37 weeks and the baby has to be delivered preterm. In many of these cases trial of labour is not an option and a caesarean has to be performed.
In contrast to foregone times, today it is possible to determine your individual risk for preeclampsia as early as the first trimester (11-14 weeks). All other methods, like taking your history can at best identify half (50%) of pregnancies at risk of developing early preeclampsia. With the screening test we offer you we can correctly identify as high as 95% of all pregnancies at risk for early preeclampsia. Starting a prophylactic treatment before 16 weeks can reduce the risk close to normal levels again.
- Women in their first pregnancy and women who already had preeclampsia have a higher risk of having preeclampsia.
Further risk factors include (allow detecting max. 50% of cases):
- high blood pressure before pregnancy,
- diabetes,
- assisted reproduction as method of conception
- medication for ovulation induction,
- being overweight,
- certain autoimmune conditions and
- history of preeclampsia in the family.
Short take
- Preeclampsia is one of the most common severe pregnancy complication (incidence 2-5%)
- Preeclampsia can not be cured during the pregnancy
- Early severe preeclampsia results mostly in preterm delivery
- The first pregnancy carries a 5x higher risk for developing preeclampsia
- You can learn about your personal risk of having preeclampsia
- The screening can correctly identify 95% of women at increased risk of severe early preeclampsia - without screening we can only find 50% of women at risk.
- It is possible to prevent preeclampsia, but only if a prophylaxis is started before week 16
- Women at risk need special, individualised pregnancy care
- To our best knowledge ultrasound does not harm the developing fetus