Pre-eclampsia

Pre-eclampsia is a common pregnancy complication (3-5%) and is important because of the maternal and perinatal morbidity and mortality. It is strongly associated with iatrogenic pre-term birth and with SGA. You will learn about preeclampsia in Case 4 and there is some more information in the next module. 

We have evidence that two medications in particular can reduce the risk of preeclampsia in women who are high risk- aspirin and calcium. 

Groom KM, McCowan LM, Stone PR, Chamley LC, McLintock C, Eppi trial Study Group. Enoxaparin for the prevention of preeclampsia and intrauterine growth restriction in women with a prior history - an open-label randomised trial (the EPPI trial): study protocol. BMC Pregnancy Childbirth. 2016;16(1):367.

To have this desirable effect, the low dose (100mg) aspirin is best taken at bedtime

Who should receive low dose aspirin for prevention of preeclampsia?

• Preeclampsia in previous pregnancy and birth <37/40 or HELLP syndrome

• Predisposing medical conditions:

• Autoimmune conditions (eg SLE, scleroderma, Anti-phospholipid syndrome)
• Chronic hypertension
• Diabetes (type 1 and type 2)
• Chronic kidney disease

Calcium (1000mg/day) has also been shown to be effective in prventing preeclampsia, with the greatest effect in women with calcium deficient diets. 

Other preventative treatment for pre-eclampsia such as antioxidants, vitamins, and heparin have been studied. There is no evidence at present that they decrease the risk of developing preeclampsia.