"Preeclampsia" is very harmful, pregnant mothers must not take it lightly!

Pregnancy is a special physiological period, and all body systems undergo significant adaptive changes. Drugs can directly or indirectly act on the embryo, thus affecting it. Therefore, medications during pregnancy should be used with extreme caution.

However, recently the doctor prescribed aspirin to Xiaotong, who was 15 weeks pregnant. Xiaotong was confused about this: Why should I use this medicine during pregnancy? It turned out that Xiaotong was a 37-year-old pregnant woman with high baseline blood pressure and insulin resistance before pregnancy. Based on Xiaotong's physical condition, the doctor diagnosed her as a high-risk group for preeclampsia (PE) and recommended that she take aspirin in small doses for prevention. Seeing this, pregnant mothers may be a little confused: What is preeclampsia? What medicine can be taken to prevent it?

Serious dangers to beware of

Preeclampsia is a serious idiopathic disease during pregnancy, with an incidence of about 3%-5%. It is one of the important causes of maternal and perinatal morbidity and even mortality. It has adverse effects on both the mother and the fetus: if not treated in time, the fetus may suffer from complications such as intrauterine growth restriction, placental abruption, premature birth, neonatal respiratory distress syndrome, retinopathy of prematurity, and even death; the mother may suffer from complications such as hypertension, kidney damage, liver damage, central nervous system damage, stroke, cardiomyopathy, pulmonary edema, respiratory distress syndrome, etc., which need to be vigilant.
The pathogenesis of preeclampsia is not fully understood, but it is widely believed to be multifactorial, centered on endothelial dysfunction and caused by a complex interaction between inflammatory, immune, and coagulation pathways.

Risk factors need to be identified

Although the cause of preeclampsia is still unclear, studies have found that some factors increase the risk of pregnant women suffering from this disease (see the table below). For example, antiphospholipid antibody syndrome, although rare, is one of the main risk factors for preeclampsia.

A large number of epidemiological studies have shown that chronic kidney disease, especially chronic nephritis caused by lupus, significantly increases the risk of the disease in pregnant women. In addition, risk factors for preeclampsia include a history of preeclampsia, primipara, chronic hypertension, diabetes, family history of cardiovascular disease, obesity, etc.

Studies have shown that the incidence of preeclampsia in twin pregnancies is 6%-31% higher than that in single pregnancies. In addition to being able to analyze some patients with preeclampsia characterized by angiogenic factor imbalance and coagulation dysfunction who have an increased risk of disease, the onset and progression of most patients is unpredictable.

Risk factors for preeclampsia in pregnant women

Note: 1 mmHg = 0.133 kPa; BMI stands for body mass index. Warning information of preeclampsia includes pathological edema, excessive weight gain, blood pressure at the upper limit of normal (also called prehypertension), blood pressure fluctuations (relative blood pressure increase), fetal growth restriction trend, decreased platelet count and unexplained hypoproteinemia.

Proper use of medicines can prevent

Evidence-based medicine shows that low-dose aspirin (LDA) can prevent high-risk pregnant women from developing preeclampsia and reduce their adverse pregnancy outcomes. The Chinese Society of Obstetrics and Gynecology's "Guidelines for the Diagnosis and Treatment of Hypertension Complicating Pregnancy (2020)" states that LDA is suitable for pregnant women who are at risk of recurrence of preeclampsia, such as those with a history of the disease; pregnant women with a history of placental disease, such as fetal growth restriction and placental abruption; and pregnant women with high-risk factors for the disease, such as kidney disease and hypercoagulable conditions.

The above groups can start taking low-dose aspirin (50-150 mg) daily in the early and middle stages of pregnancy (12-16 weeks of pregnancy). The specific dosage and course of treatment must be strictly followed according to the doctor's instructions, and preventive use can continue until the 26th to 28th week of pregnancy.

Preeclampsia is a complex disease with rapid changes, so close monitoring and evaluation are very important. We should closely monitor blood pressure changes, increase the number of prenatal examinations, and pay attention to the symptoms felt by pregnant women, so as to understand the severity and progress of the disease and intervene in a timely and reasonable manner to avoid adverse pregnancy outcomes.

Enteric-coated aspirin tablets are resistant to acid but not alkali and should be used on an empty stomach half an hour before meals. Diet and nutrition are important factors affecting the development of diseases throughout pregnancy. A healthy diet should be followed strictly according to the doctor's orders to ensure protein intake.