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Preeclampsia: Prevention

Author
Phyllis August, MD, MPH
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG

INTRODUCTION

Preeclampsia refers to a syndrome characterized by the new onset of hypertension plus proteinuria, end-organ dysfunction, or both after 20 weeks of gestation in a previously normotensive woman (table 1). In women with preexisting (chronic) hypertension, accelerating hypertension plus proteinuria, end-organ dysfunction, or both after 20 weeks suggests superimposed preeclampsia.

Preeclampsia is a common risk factor for maternal and perinatal morbidity and mortality worldwide. Standard prenatal care, including close follow-up of high-risk women after midgestation, increases the chance that preeclampsia will be detected early in the course of disease. Early diagnosis followed by appropriate management, including delivery, may prevent some of the serious sequelae of the disease, such as eclamptic seizures and multiorgan failure. Since there is no curative treatment other than delivery, an intervention that could prevent preeclampsia would have a significant impact on maternal and infant health worldwide.

Many different strategies to prevent preeclampsia have been investigated in randomized trials. It is not surprising that most simple approaches have been unsuccessful, given the complexities in pathogenesis and the likelihood that multiple etiologies cause the syndrome. In women at high risk of developing preeclampsia, low-dose aspirin prophylaxis has preventive effects, but the magnitude of benefit in this group is variable and depends on a number of factors. By comparison, no intervention has been proven effective in the general obstetric population.

This topic will review several interventions that have been evaluated for prevention of preeclampsia. Other important aspects of preeclampsia are discussed separately:

(See "Preeclampsia: Clinical features and diagnosis".)

                        
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Literature review current through: Nov 2017. | This topic last updated: Nov 29, 2017.
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