an ongoing battle to save lives

Paris (AFP) – Camille Abbey was two months away from giving birth to twins when she sensed something was wrong.

“I felt weird all week. I had swelled up enormously. I had a hard time moving,” said the 33-year-old French journalist.

Abbey’s midwife found her blood pressure to rise and sent her to hospital where doctors confirmed she had preeclampsia, a life-threatening complication.

The risks of preeclampsia have been known for centuries, but there is still no cure or prevention and lack of awareness remains a problem.

“Although one in 12 pregnancies is affected by preeclampsia, many pregnant women have never heard of the disease,” Patricia Maguire, director of the Institute for Discovery at University College, told AFP Dublin.

Doctors made a breakthrough 10 years ago that saw them develop the first diagnostic test, and Maguire is working on a second, with trials underway in Ireland.

Early diagnosis saves lives because the disease sets in without symptoms.

Once they appear, the only way to stop complications like liver and kidney failure, or death, is to deliver the baby, even if it is premature.

A 2021 study showed that hypertensive disorders in pregnancy have increased over the past 30 years, although better screening and population growth may account for the increase.

The study published in the journal BMC Pregnancy and Childbirth also indicated that most deaths occur in low-income settings where doctors say the toll is likely higher than reported.

According to a 2015 study published in the Journal of Family Medicine and Primary Care, 76,000 women and 500,000 babies die each year from hypertensive pregnancies such as preeclampsia and eclampsia, a rare complication.

Sarah Kilpatrick, an obstetrician and gynecologist specializing in preeclampsia at Cedars-Sinai Hospital in Los Angeles, says women’s education is crucial.

“The hardest part for women is often that they feel good,” Kilpatrick told AFP, “so you can’t even believe you have something like preeclampsia.”

– Like ‘lightning’ –

Emmanuelle Honor̩ is a survivor of eclampsia Рnamed after the Greek word for lightning Рwhich can develop if preeclampsia goes undetected and lead to life-threatening seizures.

His decision to walk to the hospital after monitoring his own blood pressure saved his life.

“They did not wait for the results of the blood tests to decide to have an emergency cesarean,” said the 37-year-old Parisian archaeologist.

Immediately after giving birth, she began to have seizures.

“It was a matter of minutes. The baby and I were incredibly lucky,” she told AFP. “During the seizure, I felt myself leaving my own body.”

Today, her son is in good health and will be three years old in February.

But the eclampsia left Honoré psychologically scarred and unable to give birth again.

“For me there is a before and an after, they are two different lives.”

“Dream of reaching everyone”

The world’s first diagnostic test, developed by kidney specialists Ananth Karumanchi and Ravi Thadhani by linking the levels of two proteins to the onset of the disease, has been available in Europe for a decade.

It is in clinical trials in the United States, where preeclampsia disproportionately affects black women due to a higher prevalence of risk factors like diabetes, obesity and stress, according to the American Heart Association.

“(The trials) include the diversity of women in the United States and by the end of this year we will be able to determine if the diagnoses have as much benefit and specificity as in Europe,” Thadhani said. to AFP.

The test developed by Maguire not only detects preeclampsia with a blood sample, it uses artificial intelligence to provide a time frame for a safe delivery, giving the fetus as much time as possible to develop.

An article published in May said the test has the potential to be streamlined so that kits can be sent to hospitals with easy-to-collect samples analyzed using online information.

“The big dream is to reach all the people who need this test across the world,” said Maguire.

Lifelong consequences

Even after work, people with preeclampsia are not necessarily safe.

Kilpatrick said about one in 10 women who had preeclampsia the first time she had high blood pressure should stay on antihypertensive drugs after giving birth.

When her twins were born in October 2020, Abbey thought her ordeal was over but her blood pressure did not return to normal.

She was subsequently diagnosed with the dangerous HELLP syndrome (hemolysis, elevated liver enzymes and low platelets) linked to preeclampsia, which affects about 15 percent of women with severe preeclampsia.

While her premature babies received state-of-the-art care, Abbey said she stayed in a postoperative recovery room for days when doctors could do little more than monitor her vital signs and try to control her blood pressure.

Vassilis Tsatsaris, an obstetrician-gynecologist at Port Royal Hospital in Paris, said research into finding treatments for preeclampsia and other complications has been hampered by the risks to the unborn baby.

“We live at a time when therapeutic innovations against cancer, vaccines or gene therapy are advancing very, very quickly,” he told AFP.

“Unfortunately, when it comes to pregnancy, things are going much more slowly.”

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