“Pregnancy poisoning”: Almost 70,000 mothers worldwide die from it
Other – 09/10/2012
Preeclampsia is one of the most dangerous complications for both mother and child in the last trimester of pregnancy. The causes of the life-threatening disease have long been unknown. Now a solution has been found for detecting the disease at an early stage.
by Cathrin Conradi
Image: D.aniel (Fotolia.com)
“In addition to severe bleeding and infectious diseases, preeclampsia is one of the three main causes of death for mother and child. Almost 70,000 mothers worldwide die of preeclampsia each year, ”Karumanchi explained in Berlin. The number of unreported cases is probably much higher, because preeclampsia is often undiagnosed and is fatal for both mother and child, especially in developing countries where pregnant women generally do not have access to medical care. Children born prematurely cannot usually be adequately cared for, so that the mortality rate is significantly higher than in countries with better medical facilities.
Cause of up to 20,000 premature births
But the disease popularly known as “pregnancy poisoning” is also a serious problem in industrialized countries. So far there is no therapy, the only option is an early delivery. In Germany, preeclampsia is the cause of up to 20,000 premature births annually.
Doctors always aim to keep the pregnancy going for as long as possible, because the longer the child is in the womb, the higher its chances of survival later. However, if the mother’s symptoms become too threatening, premature birth often has to be initiated. Because as soon as the child is born, the mother’s symptoms subside. Nevertheless, the woman is at risk of long-term consequences such as heart attack, high blood pressure and thyroid disease. Premature birth poses a considerable risk for the child. Depending on the stage of development of the newborn, death or lifelong severe disability can result.
Knowledge of molecular causes enables early diagnosis and therapy
Prof. Karumanchi was able to show that two proteins released by the placenta play an important role in preeclampsia. The protein PlGF (placental growth factor), a so-called angiogenesis factor, ensures that blood vessels grow to the placenta so that the fetus can be supplied with nutrients. Its counterpart sFlt-1 (soluble fms-like tyrosine kinase-1) inhibits vascular growth and binds PlGF so that it can no longer work.
Most common symptoms: high blood pressure and increased protein excretion
The right balance of both factors is crucial for a healthy pregnancy. In preeclampsia there is an excess of sFlt-1, whereas PlGF is found to a lesser extent. This leads to poor blood flow to the placenta and thus often to an undersupply of the fetus. Since the blood vessels are narrowed when PlGF is deficient, high blood pressure, the main symptom of the mother, develops
Pre-eclampsia. The kidneys are also affected, which can be seen in the increased excretion of protein in the urine.
Severe courses can be prevented by early detection
While preeclampsia could previously only be diagnosed on the basis of these symptoms, ie high blood pressure and protein in the urine, the findings of Prof. Karumanchi now enable early detection. Even before the first symptoms appear, it can be demonstrated in the blood that the ratio of sFlt-1 and PlGF has been abnormally changed. In this way, endangered patients can be monitored at an early stage. This can help prevent severe illnesses that can lead to seizures and liver failure.
First treatments successful – studies are to follow
Prof. Karumanchi’s research also plays a role in the treatment: a new process enables the harmful sFlt-1 to be filtered out of the pregnant woman’s blood. In
A pilot study that Prof. Ravi Thadhani (a colleague of Prof. Karumanchi at Harvard Medical School) carried out together with nephrologists and obstetricians from Cologne and Leipzig was able to lower the sFlt-1 level in five preeclampsia patients with a single treatment will.
In three other women with a particularly severe form of preeclampsia, repeated treatments were also used to stabilize blood pressure and prolong pregnancy, which benefited the health of the newborns. Prof. Karumanchi emphasized that further studies are needed to find out whether the successes can be reliably repeated and whether the procedure is actually safe.
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