Research Registry
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Links to Latest Research
Definitions (hypertensive disorders)
Current Standards of Care (ACOG working group report)
Easy to read Preeclampsia Explainer
http://www.newyorker.com/magazine/2006/07/24/the-preeclampsia-puzzle
Differences between Preeclampsia & HELLP Syndrome
"From what we can tell, in both PE and HELLP pregnancies levels of sFlt and sEng are elevated dramatically above the levels in a normal pregnancy. In PE the absolute value of sFlt is elevated above the absolute value of sEng; in HELLP it's the other way around. And in all women there's some threshold above which she will develop both complications regardless of which of the two is more elevated."
Mayo Clinic Preeclampsia Info
http://www.mayoclinic.org/diseases-conditions/preeclampsia/manage/ptc-20316176
Blood Pressure Definitions 2017
https://healthmetrics.heart.org/wp-content/uploads/2017/11/Highlights-from-the-2017-Guideline.pdf
Preeclampsia Patient Bill of Rights
Preeclampsia Signs and Symptoms
HELLP Signs and Symptoms
Upper right quadrant pain (under the rib cage, possibly radiating to right shoulder).
Sudden vomiting after first trimester.
Severe nausea after first trimester.
Unrelenting heartburn.
Preeclampsia Signs and Symptoms (after 20 weeks)
New blood pressure readings with systolic 140 or higher OR diastolic 90 or higher, OR 30/15 points over baseline if your baseline is very low. (Elevated BP before 20 weeks is considered chronic hypertension. If you are a chronic hypertensive, you may be allowed to run higher, but for chronic or gestational hypertension, BP that isn't controlled by meds or a doctor-prescribed increase in meds warrants a call to your doctor for evaluation for preeclampsia.)
Headache that is not relieved by ususal measures (such as acetominophen, fluids, electrolytes, sleep, caffeine).
Vision changes such as blurry vision, tunnel vision, black spots in the vision.
Sudden weight gain over a few pounds per week.
Swelling of hands beyond not being able to wear rings or swelling of face (especially around lips and eyelids).
Decrease in urine output when compared with fluid intake, especially if accompanied by swelling.
Foamy or cola-colored urine.
Nausea or vomiting after first trimester.
Upper right quadrant pain (under the rib cage, possibly radiating to right shoulder).
Shortness of breath.
Hyperreflexia, noticed as anxious feeling.
General sense of feeling unwell, confusion, or sense of “impending doom,” in conjunction with other symptoms.
Seizures - a symptom of Eclampsia.
Preeclampsa, Eclampsia, HELLP Syndrome Survivors Support Group Discussions on what are normal pregnancy symptoms and what are concerning:
Headaches: https://www.facebook.com/groups/preeclampsia/permalink/10160740659560006/
Swelling: https://www.facebook.com/groups/preeclampsia/permalink/10160281715300006/
Coming soon:
Visual disturbances
Upper right side pain
Blood pressure
Protein
Aspirin Research
A primer on the 2-5% prevention rate with low dose aspirin (81mg): The overall recurrence rate for PE is 20%. That means if you grabbed a random sample of survivors who had a second pregnancy, around 20 would get it again and 80 would not. If you put a random group of 100 on aspirin, only 15-18 would get it and 82-85 would not. 80 would be fine with or without aspirin, 15-18 would get sick with or without, 2-5 were helped. But we have no way of knowing ahead of time who are the lucky 2-5, so many of us choose to take it just in case. We also don't know after the fact who were the lucky ones. If you took aspirin and had a normal pregnancy, was it because of aspirin or would you have been fine regardless?
Future Health Concerns for Mom & Baby
International Standards of Care
Vitamins, Minerals, Supplements and Diet
Bedrest - Does it help Preeclampsia? (No)
Risk in Future Pregnancies
No! Oddly enough, no. Some of the time, the mother's immune system and that outer layer of the placenta, the trophoblastic cells that are controlled by the father's genes, manage to work together even in the case of a really awful initial implantation. Some of the time, there's no indication of shallow implantation until right before the placenta abrupts because those sets of genes just CANNOT work together any longer and the maternal tolerance for an implanted placenta is gone, abruptly. There's a strong connection to an initial failure of implantation, but there are exceptions where the ability of the placenta to stay implanted for the entire term is the real problem, in other words. Put another way - this could be like transplant rejection, where the mother's body rejects the grafted organ, or it could be graft vs host disease, where the grafted organ rejects the mother's body. Either way, the problem is that implantation isn't proceeding normally and continuing normally; that tolerance for a foreign body is failing/has failed. They settled on using "preeclampsia" as an umbrella term to try to catch all of the ways in which this can happen, because the important part is that we get *appropriate care* when this happens, and we don't want care providers dithering over whether or not this is the right metaphysics for preeclampsia. We just want them to be empiricists and respond to the sick pregnant woman.
Genetics
Because most women get PE only once, it's thought that first time around Mom's immune system overreacts to the foreign DNA (Dad's) in the baby. Second time around, she recognizes and accepts it. IF this is the reason you got PE, changing fathers would raise your risk because new, unrecognized DNA. However, PE is multi-causal. We've found a genetic link, and it's really complex, *thousands* of genes involved. Some men have a lot of "bad" DNA and would father a PE pregnancy no matter who the mother is. Some couples have enough genes together to trigger it, but would do better with another partner, assuming that partner had fewer "bad" genes. IF this is the reason you had PE, changing fathers would actually lower your risk. And some women would have PE no matter who the father is, either because they have enough bad genes on their own or because they have some other trigger going on, so changing or keeping fathers doesn't make a difference. It's nearly impossible to figure out which scenarios apply to which couples, so changing partners is counted as a risk factor even though it might not be in a particular case.
Magnesium Sulfate
Basics of Preeclampsia, Eclampsia, and HELLP Syndrome
Definition of Preeclampsia and Chronic Hypertension
What is HELLP Syndrome?
Current Management & Care Standards for Hypertensive Pregnancies: ACOG Working Report
The New Yorker Article
Why Pregnancy is a biological warfare between mother & baby
Hypertension guidelines beofre 20 weeks of pregnancy and preconception
Protein no longer needed for diagnosis of preeclampsia-1
Protein no longer needed for Diagnosis of Preeclampsia-2
Preeclampsia: A complex and variable disease