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Disorder of Pregnancy Linked to Placenta Irregularity,
Say NICHD Grantees

A team of investigators has discovered that preeclampsia -- a life threatening complication of pregnancy -- results from a failure of the placenta to invade the wall of the uterus and to appropriately mimic the tissue which lines blood vessels. The finding has important implications for the diagnosis and treatment of this sudden, mysterious, and potentially fatal disorder of pregnancy.

The research, funded by NICHD, appeared in two papers published in the May 1 issue of the Journal of Clinical Investigation.

About 7 percent of first-time mothers and 1 to 2 percent of mothers having subsequent pregnancies develop preeclampsia. The condition occurs suddenly, without warning, and sometimes in as little as a few hours. Usually, a pregnant woman with preeclampsia develops dangerously high blood pressure and begins excreting protein in the urine. In some cases, the condition may progress to eclampsia, a series of potentially fatal seizures.

Preeclampsia is still one of the leading causes of maternal mortality. The need to screen for and detect preeclampsia early was one of the original reasons the medical community began recommending regular prenatal visits many years ago.

In cases where the condition does not progress to eclampsia, the children born to mothers with preeclampsia may be extremely small for their age or may be born prematurely. This may, in turn, place them at risk for a variety of other complications of birth. Infants born to mothers with preeclampsia may also grow more slowly during infancy than infants whose mothers do not have the condition.

Although the high blood pressure accompanying preeclampsia can be treated with blood pressure lowering drugs, the only effective treatment for the condition is immediate delivery. Known risks for preeclampsia are: diabetes, preexisting hypertension, kidney disease, being pregnant with twins, and having previously had the condition.

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