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Prevention

of Pre-eclampsia

Max MongelliWomen & Childrens Health

Nepean Hospital

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Sources:

NICE Guideline (2010) Cochrane Database Medline Pubmed

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What can reduce risk of PET:

ASPIRIN

CALCIUM SUPPLEMENTS

?Vitamin D

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Who should receive

prophylaxis for PET?

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Women with one of the

following risk factors:

Previous PIH or PET

Chronic hypertension Chronic renal disease

Diabetes

SLE or anti-phospholipid syndrome

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Two or more of the

following risk factors:

Primigravidas

Age over 40 Inter-pregnancy interval >10 yrs BMI > 35 at booking Multiple pregnancy Family history of pre-eclampsia

OR

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When should aspirin be

started and for how long?

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ASPIRIN

75-150 mg/day

Start at 12 weeks Until delivery

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How effective is aspirin?

17% reduction in the risk of PET

8% reduction in risk of preterm birth

10% reduction in risk of SGA baby

14% reduction in risk of perinatal death Duley L, Henderson-Smart DJ, Meher S, King JF. Antiplatelet

agents for preventing pre-eclampsia and its complications.

Cochrane Database of Systematic Reviews 2007, Issue 2. Art.

No.: CD004659. DOI: 10.1002/14651858.CD004659.pub2

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Calcium and Pre-eclampsia

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Calcium Requirements in

Pregnancy

Most common mineral in the body

Role in vasoconstriction andvasodilation RDA: 1 1.5 g/day

About 40% of Australian womenhave inadequate intake

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Efficacy of Calcium Supplements

50% reduction in risk of PET 35% reduction in risk of PIH More effective if low calcium intake More effective in high risk women Reduced risk of preterm delivery

Reduction in serious maternal morbidity Hofmeyr GJ, Lawrie TA, Atallah N, Duley L. Calcium supplementation during

pregnancy for preventing hypertensive disorders and related problems. CochraneDatabase of Systematic Reviews 2010, Issue 8. Art. No.: CD001059. DOI:10.1002/14651858.CD001059.pub3

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Vitamin D and Pre-eclampsia

Vit D regulates expression of a large number ofgenes in reproductive tissues PET more common in winter than summer

Women with

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Heliotherapy