by caryn (10111 Posts), Fri Feb 08, 2013 01:22 pm
There is no standard workup, which is why you're seeing so many conflicting reports. There are a handful of underlying disorders that are more common in preeclampsia, but in most cases treating them is not thought to improve pregnancy outcomes - just (just!) to improve your underlying health. There's also one disorder that should quite clearly be treated to improve the odds of a successful subsequent pregnancy, which is APS (or antiphospholipid syndrome.)
Most commonly docs will test for chronic hypertension (the most common underlying condition), diabetes, PCOS (or polycystic ovarian syndrome), APS, and thrombophilias. Chronic hypertensives will often be managed in subsequent pregnancies with blood pressure drugs that are known to be safe in pregnancy; this doesn't reduce risk of preeclampsia but does make really high maternal pressures less likely, which lowers your risk of stroke. Most thrombophilias aren't thought to contribute to PE risk but are correlated with it, and some docs will use heparin or Lovenox in patients with particular thrombophilias but not all. PCOS and diabetes can be brought under control before pregnancy and managed aggressively in pregnancy, much like chronic hypertension.
But most women who develop this syndrome don't have anything that's obviously treatable outside of pregnancy - because most of the time, it's a placental issue that is not caused by these conditions. It's just that women who have these conditions or who will develop them as they age are also more likely to get preeclampsia.