Pre eclampsia screening in early pregnancy

Pre eclampsia is a term that denotes the development of high blood pressure in pregnancy. It is a specific problem that only occurs in pregnancy. It may occur out of the blue, unexpectedly. In other women with pre existing high blood pressure, then it may supervene on top of that. Irrespective, it may cause major problems affecting multiple body systems like the liver, brain, heart and disruption to the blood clotting system. There is a wide spectrum of changes that can occur and one of the earliest signs will be rising blood pressure, generalised swelling of the body and changes in the urine with protein being present. Sometimes it can be accompanied by symptoms of headaches, visual changes like flashing light, loss of vision , feeling unwell and so on. The manifestations are varied and unpredictable.

Pre eclampsia usually manifest late in pregnancy although in some, this can occur early on.This is one of the reasons why women are seen more often in the later part of their pregnancy. They can be monitored more then to pick the development of this problem.

Now we have an option of trying to screen in early pregnancy for the risk of pre eclampsia developing in the individual mother. The rationale is that if the risk is higher, then steps can be taken to reduce the risk and more monitoring can be instituted check for its effects during the pregnancy. Some of the steps could include:

  • Initiating aspirin use early in the second trimester
  • Considering the use of magnesium
  • Management of weight issues if present
  • Dietary advice
  • Monitoring for effect on the placenta causing reduced growth of the baby.
  • Undertaking more comprehensive kidney function testing
  • Consideration of more frequent visits for blood pressure monitoring
  • Undertaking home blood pressure monitoring
  • Increasing one’s awareness of the potential symptoms to watch for and report.

The screening if so desired is taken early in the pregnancy. It is a combination of the 12 week ultrasound that we use routinely as well as blood testing. The blood tests look at a number of chemicals and hormones from the placenta. Some of the blood tests are related to the Combined Screening test for Downs Syndrome. Others are separate.  It goes without saying that there is a cost for these tests and they are currently not covered by Medicare. The costs of the blood tests I understand varies from $100 to 150.00 depending on the types of test and the laboratory used.

Currently Pre eclampsia screening is not a routine part of antenatal care but I believe it is worthy of consideration. It is important to understand that it is not a perfect test. Even in those with a low risk, pre eclampsia can develop it for a whole variety of reasons. I believe its importance is to try to detect those at higher risk so measures can be put in place to try to mitigate those risks.

These notes reflect my personal opinion and are intended for general advice only. It should not be used for any one individual case. You should consult your own doctor to determine the appropriate management of your own individual situation.