The Pregnancy Meeting™
We spent last week in New Orleans at the Society for Maternal-Fetal Medicine annual meeting, awaiting the results of the HYPITAT II study, and learned – probably to no one’s surprise – that expectant monitoring is recommended over immediate delivery for women with pregnancy-related hypertension between 34 and 37 weeks.
The first HYPITAT study – widely heralded for the size of the population it studied and therefore strength of its results – produced a somewhat controversial recommendation. Its findings suggested we should bail out of all pregnancies affected by pregnancy-related hypertension (e.g., preeclampsia, gestational hypertension) at 37 weeks, noting better outcomes for both mother and baby. This ...
Posted in Preeclampsia Information on September 06, 2013 by Website
Last month, we posted a lengthy article titled Screening Tests for Preeclampsia. On August 14, a press release from PerkinElmer announced the launch of its new screening test for early onset preeclampsia, Preeclampsia Screen™ | T1. This month we posed questions to PerkinElmer Labs/NTD. These are the answers we received to five of the questions, which are representative of the questions you asked us.
How much will the screening test cost?
The list price of the test is $495. This will be billed to a patient's insurance, if available. If the test is not covered by a patient's insurance and the patient takes advantage of applicable payment options, they can expect to spend approximately $200 out of pocket for the test.
Will my ...
Posted in Preeclampsia Information on June 05, 2013 by Website
This article appeared in the May 2013 edition of PRE-EMPT NEWS.
On May 27, 2013, PRE-EMPT in collaboration with MCHIP, organized “Preeclampsia 2013: Global Symposium” as a satellite event to the Women Deliver conference in Kuala Lumpur, Malaysia.
GUEST BLOG BY MARSHALL UKPOMA
From the shores of the Atlantic Ocean, Lagos-Nigeria, over the lovely Indian Ocean to the beautiful city of Kuala Lumpur (KL), Malaysia, it certainly was worth flying over 15 hours to arrive at the Kuala Lumpur convention center for the Women Deliver 3rd Global Conference.
According to President of Women Deliver Jill W. Sheffield, guests ...
Nadine Brunk, a Certified Nurse-Midwife, started a program called Midwives for Haiti (MFH). We’ve been talking to Nadine about how we can extend our work in patient and community education to prenatal care settings like those found in Haiti. I feel like we have much to learn from Nadine, as one minute with her blog will show you. Recently, she shared this amazing story with us.
Posted in Health Information on December 05, 2012 by Website
By Dr. Anne Wallis ~ Who remembers the first season ER episode "Love's Labours Lost"? The answer: pretty much anyone who ever watched ER! In the episode, a pregnant woman presents to the emergency room with a complaint of bladder problems, has a seizure and later dies. This was my first exposure to the hypertensive disorders of pregnancy. Eclampsia is, thankfully, rare, but it carries a high case fatality rate for the mother and/or the infant. Gestational hypertension and preeclampsia are far more common, affecting between 5% and 8% of all pregnancies in the US. Moreover, these conditions are on the rise and globally, these conditions are a leading cause of maternal and infant illness and death.
Obstetric providers are acutely aware of the dangers of preeclampsia because of its potential severity and rapidity of onset and progression, making high-quality prenatal ...
Posted in Preeclampsia Information on September 30, 2012 by Website
By Dr. Linda Burke-Galloway ~ October is Patient Centric Care Month, a term you will likely see more of as our healthcare system moves further into the 21st century. What does 21st century healthcare look like? It means that all of your records will be computerized and not on paper. It means that you will receive your "chart" on a flash drive so that when if you leave your physician's office and go to a hospital, your health records remain with you. Gone will be the days when your labs will have to be repeated because no one can locate your prenatal chart. Repeating labs is not only annoying, it's costly.
"Patient Centric Care" means that the emphasis will no longer center on your physician. Or a hospital. Or an ambulatory care center. It will be centered on you, the patient. Why? Because at the end of the day, if you're not well, if the outcome was less than expected, then the system has failed. The $2.3 trillion dollars spent each year on healthcare has not ...
Patient-centric care, a buzzword in healthcare reform, should be the obvious goal for any health care system. "What a concept," I utter with a hint of sarcasm. Put the patient at the center of the decisions, resources and desired outcomes?!
However, patient-centric care is also dependent on a related concept: the "empowered patient," a subject CNN medical correspondent and fellow preeclampsia survivor Elizabeth Cohen writes about in her column and book, The Empowered Patient, available in our Marketplace.
An empowered patient is one who has the information she needs to act proactively upon her preeclampsia symptoms. She also has an effective relationship with her care provider(s) so she can communicate her concerns, ask questions, comply knowingly with agreed upon treatments, ...
Posted in Research on August 02, 2012 by Caryn
The hypertensive complications of pregnancy are divided into four distinct classifications: Preeclampsia/eclampsia, Chronic hypertension, preeclampsia superimposed on chronic hypertension, and gestational hypertension. Many people are perplexed by the term "superimposed preeclampsia" which is preeclampsia complicating hypertension of another cause, most commonly chronic or "essential" hypertension. However women with hypertension associated with ...
Posted in Preeclampsia Information on April 30, 2012 by Website
Findings from several studies support the hypothesis that stress caused by a traumatic pregnancy and delivery can often override the ability to emotionally cope, leading to psychiatric complications such as post-traumatic stress disorder (PTSD) and post-partum depression (PPD). The combination of suffering a serious illness, combined with an unexpected caesarean section, birth of a premature child, or infant loss, is a heavy burden to bear both physically and psychologically.
Preliminary research findings, including a study initiated by the Preeclampsia Foundation, suggest that women who have endured traumatic pregnancies such as severe preeclampsia, eclampsia and HELLP syndrome have a higher incidence of PTSD and PPD than women without these complications. More research is needed to help move this information to clinical practice, but anecdotally enough of our survivors are impacted, that we offer these recommendations based on general trauma recovery practices.
May and Mother's Day are so intertwined that it's hard to think about one without the other, especially here at the Preeclampsia Foundation, where we've built a nationwide campaign at www.promisewalk.org/campaign to get the word out about preeclampsia - the "thing" that for many survivors turned our entrance into motherhood into a nightmare.
I believe celebrating mothers is a commemoration of extremes. Not just because preeclampsia is an extreme condition, but because the mothers I am ...
Posted in Heard on the Hill on April 04, 2012 by Website
During the week of March 26, 2012, the Supreme Court of the United States heard arguments about the constitutionality of the Patient Protection and Affordable Care Act (ACA), otherwise known as the Health Reform Law. As the Preeclampsia Foundation continues to advocate before state and federal policymakers on maternal health issues, we are watching closely to understand what affect the Court's decision(s) will have on women and their families.
The following is an overview of the key questions being considered by the Court after three days of debate - the longest hearing on a single case heard by the Supreme Court since 1966.
Should the law even be considered by the Court at this time - the Anti-Injunction Act? The court must determine whether the case can be decided now, or whether the court must wait until 2015, when the tax provisions of the law (individual mandate requiring individuals to purchase health insurance) go into effect. ...
The October 2011 issue of Expectations (featuring patient-centered care month) highlighted two powerful, silver-screen accounts of parents confronted with the unthinkable: a child's health crisis with no known cure leading doctors to tell them "there is nothing more we can do." Those simple words - and the prospect that there was no hope - prompted these every-day parents to take on the most important "projects" of their lives: saving the lives of their children.
These extreme examples of patient advocacy provide a humbling reminder of how important our own voices - and understanding of our conditions - are in our individual health care (during pregnancy and otherwise).
In thinking about patient advocacy in relation to my own pregnancy, I am ashamed I didn't ask more questions when I was ordered to take my first (and then second!) 24-hour urine test. I didn't know that a 24-hour urine test wasn't routine, and my doctor was certainly not offering up any ...
Posted in Research on March 01, 2012 by Caryn
Is there a nutritional connection to preeclampsia? That idea seems plausible at first, as when the blood samples of women have been analyzed, some researchers have found altered levels of various vitamins and minerals. Furthermore, preeclamptic women have altered patterns of weight gain during pregnancy; and obese women are more likely to develop preeclampsia.
Such considerations may lead one to speculate that certain diets may prevent or reverse the disease, in which case the appropriate diet becomes a therapeutic intervention. However the best research to date suggests this just isn't so.
You can't trip through February without noticing that heart health organizations everywhere are using the month to raise awareness about women's heart disease. For preeclampsia survivors, this message comes with an important footnote - your pregnancy history matters to your long term health and especially your risk for heart disease. Last year, the American Heart Association updated their guidelines to draw attention to the fact that women with a history of preeclampsia are at higher risk for heart disease, some studies have equated our risk to that of a smoker. You can read more about this research on our Community Forum.
While some of us may shake our fists ...
Posted in Volunteer Happenings on February 04, 2012 by Website
Perinatal Outreach Educator Networks (POENs) are generally funded by individual states to provide perinatal (the care offered to a mother and child just before and just after birth) medical education to health care providers in the region, enhancing the quality of care for mothers and infants and reducing morbidity and mortality. Specialists share their experience and knowledge with other physicians and community hospitals across regions by offering or facilitating programs such as physician and nurse consultation services, continuing education for health care professionals, emergency medical transport for referring hospitals within the region, consultation and technical assistance on emerging perinatal issues, and sometimes even lending libraries.
For example, in Illinois, there are 10 perinatal centers designated by the state. Rush Hospital in Chicago is home to the the largest network, involving 18 hospitals delivering more than 30,000 infants. The Rush Perinatal ...
Posted in Research on December 04, 2011 by Caryn
Currently there's no way to know for certain whether preeclampsia will develop during any given pregnancy. This leaves pregnant women and their care providers with little choice but to wait for symptoms to appear... dangerous symptoms that mean the disease has progressed to the point where mother and baby are critically ill and will need intensive monitoring and carefully timed delivery to protect their health and lives. The only screening method to date is to measure those symptoms when they appear.
Early detection wouldn't be a treatment. But what if a screening test could let us know, weeks or even months in advance, that we'd probably be getting ill? Knowing might change the way we seek care - possibly choosing specialist care providers with the education and experience to manage medically complicated pregnancies. Women in parts of the world (like
In June, Americans celebrate Father's Day, a holiday that can be bittersweet for preeclampsia patients and their families, many of whom have experienced recent and past losses or endured harrowing scares. The Foundation often describes survivors of preeclampsia as members of "the Silent Club," for the way that such a devastating pregnancy experience can be both silent and isolating. Nevertheless, there is a group whose voice we hear far less when discussing our pregnancy experiences: our husbands, significant others and the fathers and grandfathers of our children.
These men often become the "silent-er" club, watching helplessly and recovering quietly as the blessed event they expected their wives' pregnancies to be turns out quite different. But many of them go on to stand next to us when we throw ourselves into volunteering for the cause, contributing their own expertise and perspective, and even stepping up to become leaders themselves as several members of our Board ...
Lauren Larsen thought she had a wonderful life: loving marriage, good friends, successful career and her first child on the way. Shortly after entering the ninth month of her pregnancy, Lauren's life took a perilous turn due to the rapid onset of preeclampsia. After more than a month in intensive care and years of recovery work ahead of her, Lauren emerged from her trials with the desire to build a life full of purpose and meaning. Zuzu's Petals: A True Story of Second Chances is Lauren's real-life memoir of her personal battle with preeclampsia and her drive to make her "second chance at life" count for more than the average person.
2010 Saving Grace co-chair Autumn Spear described Zuzu's Petals as one of the best books she has ever read. "Obviously I have a personal connection to the book having shared severe preeclampsia, ...
Posted in Research on November 18, 2010 by Website
Several major disorders that occur during pregnancy result from failure of the placenta to implant correctly into the uterus or womb. During early pregnancy cells from the placenta, known as trophoblast cells, invade into the uterus and tap into the mother’s blood supply to sustain the growing baby. Failure of this process can lead to insufficient supply of blood to the placenta resulting in preeclampsia, as well as low birth weight babies, stillbirth or recurrent miscarriage.
The invading placental trophoblast cells intermingle with maternal immune cells in the uterine lining. Trophoblast express not only maternal but also paternal genes and these will be different or “foreign” to the mother. Maternal immune cells can recognize these “foreign” fetal molecules and are thought to regulate the implantation process, allowing sufficient but not excessive invasion of the placenta. In the preeclamptic pregnancy this interactive process goes wrong and there is ...