Ask The Expert: What can I do to reduce the risk of getting pre-eclampsia?

Obstetrician Dr Pat O'Brien discusses how pregnant women can take steps to avoid developing the potentially dangerous condition pre-eclampsia

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Lisa Salmon

I HAD pre-eclampsia in my first pregnancy, and I've just found out I'm pregnant again. What can I do to reduce the risk of getting it during this pregnancy?

Speaking after a large study found eating a diet rich in vegetables and fish is associated with a lower risk of a pregnant woman developing high blood pressure and pre-eclampsia, consultant obstetrician Dr Pat O'Brien, spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG), says:

"Pre-eclampsia occurs when the placenta doesn't work properly. It usually occurs after 20 weeks of pregnancy and is a combination of raised blood pressure and protein in urine; blood tests may show the liver, kidneys and clotting systems are affected too. Although it's usually mild, easily managed and has very little effect on pregnancy, it can sometimes develop into a more serious illness which can be life-threatening for both the mother and baby.

"Around one in six women who've had pre-eclampsia will get it again in a future pregnancy. A woman should be given information about her individual risk of developing pre-eclampsia in a future pregnancy and about any additional care she may need. She should take low dose aspirin (75mg or 100mg a day), starting before 15 weeks of pregnancy. This will significantly reduce her chances of developing pre-eclampsia again.

"A woman has a higher risk of developing pre-eclampsia if her blood pressure was high before pregnancy, her blood pressure was high in a previous pregnancy and/or she had a medical problem or a condition that affects the immune system. If a woman has any of these risk factors, she will be advised by her doctor to take low-dose aspirin.

"The importance of other factors is less clear, but a woman is more likely to develop pre-eclampsia if it's her first pregnancy, her last pregnancy was more than 10 years ago, she's very overweight, her mother or sister had pre-eclampsia during pregnancy and/or she's carrying more than one baby. If she has more than one of these risk factors, she may also be advised to take low-dose aspirin.

"More recently, it's been shown that early in pregnancy a combination of a blood test, ultrasound scan and factors in a woman's history can predict her risk of developing pre-eclampsia later in pregnancy. If a woman is at increased risk, she should take low-dose aspirin.

"High blood pressure and pre-eclampsia can result in harmful complications for mother and baby. The latest study findings are encouraging as it shows there are additional steps a woman can take to reduce her risk of these conditions by eating healthily.

"It's also vital that women and their partners are encouraged to manage their weight and to have a healthy diet ideally before conception, to ensure the healthiest possible pregnancy and best start to their child's life."

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