[KoK! Health] For Both Mother and Fetus... 'Preeclampsia' Must Be Managed from the Early Stage

Over 40% Increase in the Last 5 Years
Special Caution for Pre-Pregnancy Obesity and Hypertension
Regular Checkups and Management Are Best

Pregnancy. [Image source=Pixabay]

[Asia Economy Reporter Lee Gwan-ju] Preeclampsia is one of the most serious diseases that can occur in pregnant women. The incidence continues to rise due to causes such as advanced maternal age, an increase in chronic diseases, and stress, but there is no proper prevention method, causing great anxiety among expectant mothers. Early detection through regular prenatal checkups is currently the best approach.

According to the National Interest Disease Statistics from the Health Insurance Review and Assessment Service on the 15th, the number of patients visiting hospitals for preeclampsia increased by more than 40%, from 9,873 in 2017 to 14,074 last year. Professor Pyeon Seung-yeon of the Department of Obstetrics and Gynecology at Kangdong Kyung Hee University Hospital explained, "The increase in preeclampsia is related to advanced maternal age," adding, "In addition, exposure to stress, obesity, or chronic diseases such as hypertension or diabetes at a young age is also considered to have an impact."

Hypertension that develops after 20 weeks of pregnancy is called gestational hypertension. When gestational hypertension occurs in a pregnant woman and there is proteinuria or abnormal findings in other blood tests (such as worsening kidney function, liver dysfunction, thrombocytopenia), or symptoms like headache and visual disturbances appear, it is diagnosed as preeclampsia; if seizures accompany these symptoms, it is diagnosed as eclampsia.

The term "preeclampsia" can be easily misunderstood as a disease of being "addicted to pregnancy," but it is easier to understand if seen as "toxicity during pregnancy." When the fetus implants in the uterus, the placenta forms, and in a normal body, the overall immune response is suppressed to avoid rejecting the fetus. However, in preeclampsia, this response is relatively low, causing the formation of highly resistant blood vessels when the placenta settles. Also, although a mother's blood vessels normally increase blood volume during pregnancy, in preeclampsia, the vessels constrict, causing side effects in various parts of the body and systemic changes. For example, problems may occur in cerebral blood vessels, liver dysfunction may develop, or kidney issues may cause proteinuria and edema.

Professor Pyeon Seung-yeon of the Department of Obstetrics and Gynecology at Gangdong Kyung Hee University Hospital is seeing a patient.
[Photo by Gangdong Kyung Hee University Hospital]

Particular caution is needed if obesity or hypertension existed before pregnancy. Patients with chronic hypertension have a high likelihood of developing preeclampsia, and the same applies to those with kidney disease or diabetes. Reports indicate that obese women or those who gain weight rapidly during pregnancy have a 3.5 times higher risk of preeclampsia compared to normal pregnant women. The risk of preeclampsia also increases in cases of pregnancy through in vitro fertilization or twin pregnancies.

Since there is currently no proper prevention method, blood pressure and weight should be checked during regular hospital visits, and proteinuria should be monitored after 20 weeks of pregnancy. Even if blood pressure rises and proteinuria appears during pregnancy, differential diagnosis is essential as it could be diseases other than preeclampsia. Especially for high-risk groups such as those with a history of preeclampsia, chronic hypertension, multiple pregnancies, kidney abnormalities, or diabetes, detailed monitoring during regular checkups from early pregnancy and aspirin administration starting around 11 weeks can help prevent the occurrence of preeclampsia.

After diagnosis, blood pressure control is crucial. Ultimately, "delivery is the cure." The best approach is to monitor the progress, extend the gestational age as much as possible, and assist with delivery at the appropriate time. The baby in the womb is checked weekly to ensure proper growth. If the baby is not growing well, it may indicate that the placenta supplying nutrients is not functioning properly. In cases of gestational hypertension or mild preeclampsia, outpatient monitoring may be possible, but in severe cases, hospitalization is required to decide on delivery daily based on the condition of the mother and fetus. Mild cases help maintain pregnancy until after 37 weeks for the fetus's prognosis. In severe cases, if the baby is born before 34 weeks, there is a high possibility of needing ventilator treatment, so the gestational age is very important.