Pregnancy: detecting complications earlier so women can get help sooner

Up to six per cent of pregnant women develop a mild form of a condition called pre-eclampsia.¹ Severe pre-eclampsia occurs in around one to two per cent of pregnancies, putting the lives of both mothers and babies at risk.¹ Sadly, an estimated 1,000 babies die each year because of pre-eclampsia.^2,3 Professor Christoph Lees, of London’s Queen Charlotte's & Chelsea Hospital, is looking for new ways to identify women at risk of developing pre-eclampsia much earlier in pregnancy, so they can access more tailored antenatal care sooner, before symptoms develop.

How are babies’ lives affected now?

Although most cases of pre-eclampsia cause no serious problems, when severe, the condition can endanger the lives of both mother and child. Sometimes this means babies have to be delivered prematurely.

“If a pregnant woman with pre-eclampsia becomes severely ill, the only ‘cure’ is to deliver the baby,” says Professor Lees. “Similarly, if her baby stops growing properly in the womb – a problem that can occur with or without pre-eclampsia– the baby sometimes has to be delivered early to avoid stillbirth.”

Babies who are born too soon, and babies who stop growing properly during pregnancy, can both face difficulties after birth.

“The onset of pre-eclampsia is often subtle, so pregnant women may not immediately realise that something is wrong,” says Professor Lees. “What’s more, we don’t fully understand what causes the condition, or why babies stop growing properly in the womb, which is hindering efforts to find new treatments.”

How could this research help?

“We’re investigating the possibility that problems with a mother’s heart and circulation could play a crucial role in the development of pre-eclampsia and in the poor growth of babies in the womb,” says Professor Lees. “We think these two complications might develop if the mother’s heart and circulation system don’t adapt properly to the additional demands that pregnancy places on them.”

The researchers are monitoring 600 women who are trying for a baby and tracking them until after birth if they get pregnant. The team is searching for early warning signs of later problems, by studying changes in heart function. (Women with pre-eclampsia have high blood pressure.)

“We hope our work will eventually lead to new screening tests so midwives and doctors can identify women and babies who are at risk very early in pregnancy, well before the onset of any noticeable symptoms,” says Professor Lees. “This could enable more tailored maternity care, with women at risk getting help sooner. A better understanding of changes in the body that lead to pre-eclampsia would also help in the development of new treatments.”

References

1. NHS Choices. Pre-eclampsia. http://www.nhs.uk/conditions/Pre-eclampsia/Pages/Introduction.aspx Website accessed 11 February 2016.
2. Davenport F. 2014 Imperial College London. Researchers track mums-to-be in search for pre-eclampsia risk factors. Available at: http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_21-10-2014-10-39-0 Website accessed 12/03/2016
3. NHS Choices. Pre-eclampsia – Complications. http://www.nhs.uk/Conditions/Pre-eclampsia/Pages/Complications.aspx Website accessed 12/03/2016