The Dubai Health Authority’s(DHA’s) live Twitter Clinic, known as #smart_clinic discussed today pre-eclampsia in pregnancy and ways to diagnose and manage the condition.
Dr Abeir Amar and Dr Nabilah Mashhrawi, Consultant Obstetricians and Gynaecologists at Latifa Hospital took part in the clinic and disseminated vital health information.
Dr Mashhrawi said, “Pre-eclampsia is a disorder of pregnancy characterized by high blood pressure and large amounts of protein in the urine. Left untreated, preeclampsia can lead to serious complications for both the mother and the baby. Pre-eclampsia affects between 5-7% of pregnancies worldwide.” She added, “Pre-eclampsia may develop after 20 weeks of gestation, though most commonly after 32 weeks. During pre-eclampsia in pregnancy, doctors need to take extra precautions and closely monitor the patient for the safety of the patient and the baby.”
In terms of risk factors, Dr Mashhrawi, said, “Women particularly those with his risk factors such as family history of hypertension, obesity, diabetes, previous history of high-blood pressure in earlier pregnancies, should visit a doctor prior to planning a baby, so that they can begin or change the medications to those which are safe during pregnancy. Women with multiple gestation and first pregnancy above 40 years are also at high-risk and need to visit their doctor regularly.”
She said, “Latifa Hospital has an early-pregnancy assessment clinic for high-risk patients under 18 weeks of gestation, after which these patients continue treatment with the pregnancy-assessment clinic, also dedicated for high-risk patients. The hospital chalks out a detailed plan for these patients to minimize the risk of complications during pregnancy. In terms of treatment, she said: “If the patient has a very high risk for pre-eclampsia or had it during her previous pregnancies, she needs to start taking aspirin medication at 12 weeks, in addition to anti-hypertension medications. She also needs to undergo regular blood tests and an ultrasound every three to four weeks to check the development of the baby.”
In terms of treatment, she said, “The only treatment is delivery of the baby but doctors try to control the blood pressure and keep the patient stabilized to postpone delivery until the patient enters into the 9th month of her pregnancy, so that pre-term delivery is avoided. However, if the mother or baby are unstable, doctors intervene and deliver the baby prematurely.”
She added, “Patients with this condition, need to take adequate rest during their pregnancy and avoid getting anxious. Pregnant patients with high-blood pressure should immediately visit the emergency department if they experience any symptoms such as headache, gastric pain with vomiting, sudden increase in weight, swelling of hands and legs or if the patient’s blood pressure is more than 140 over 90, if she experiences abdominal pain, bleeding or she cannot feel the movements of her baby.”
Dr Amar added, “These patients need to be delivered in a high-risk unit and require a multi-disciplinary team both during pregnancy and delivery. Patients with this condition must ensure the hospital they choose to go to has a fully-equipped NICU unit and specialists due to the high risk of pre-term delivery.” Dr Amar, said, “Post-delivery the risk of fits continues to be high for six weeks after delivery so if the mother experiences symptoms of the disease, she should head to the emergency department. In terms of post-delivery care, Amar added: “These patients need to have family support or a dedicated caregiver after delivery to take care of the baby, so that the mother can rest. This reduces the risk of high blood pressure. After delivery, every few months, the patient must get her blood pressure tested as there is risk of developing chronic hypertension post-delivery.”
High-risk patients who wish to attend the early-pregnancy assessment unit can call 04-2193111 to make an appointment. Those after 20 weeks of gestation, can visit the pregnancy assessment unit but will require a referral letter from their doctor.