Hannah Gamble, Alexa Diersen, Lindsey Korth Pre-eclampsia Hannah Gamble, Alexa Diersen, Lindsey Korth ALEXA - introduce “We will be looking at this from the biological, psychological, and social perspectives - also emphasizing the cultural and political aspects”

What is Preeclampsia? A pregnancy complication characterized by high blood pressure, sometimes with fluid retention and proteinuria *Causes/Risk Factors * Symptoms * Treatments *Complications *Postpartum Preeclampsia ALEXA - first two points and last point

Misconceptions of Preeclampsia 1) Bedrest can delay the onset of preeclampsia, or at least make your case progress more slowly. 2) Only overweight women get preeclampsia. 3) Preeclampsia only happens in first pregnancies. 4) If you eat right, you won't get preeclampsia. 5) Preeclampsia is rare. 6) Preeclampsia only happens right before term 7) Preeclampsia doesn't affect the baby. 8) Delivery is the cure for preeclampsia. Lindsey

Preeclampsia around the world Preeclampsia is a problem in both developed and developing countries, but it is more severe and maternal death is much more common in developing countries Shows a political and social need More access to adequate health care, especially prenatal care, in developing countries Preeclampsia awareness saves lives worldwide ALEXA

Postpartum psychiatric episodes/disorders Almost all women who experience preeclampsia also experience some psychological or psychosocial complaints Most common: general complaints (fatigue, concentration problems, memory loss, sleeping problems), PTSD, and anxiety/depression Risk of postpartum depression increases Post Traumatic Stress Disorder Women with traumatic pregnancies, 4 times more likely to test positive for PTSD Symptoms could include intrusion, avoidance, and hyperarousal Lindsey’s Personal Experience Cultural effects Causes social problems Alexa - first bullet point Hannah PTSD Lindsey personal experience Alexa - last two bullet points

Social, Cultural, and Political Influenced Risk Factors Weight Elevated body mass index is associated with preeclampsia 77% of women in the United States are overweight or obese Increased risk present in both Caucasians and African Americans Smoking Studies in Nordic countries suggest smoking reduces the risk of preeclampsia Others say that not smoking reduces risk by 50% Race/Ethnicity In the US, risks are higher for ethnic minority women than non-Hispanic white women Influences due to differences biologically, socially, politically, and culturally Hannah - weight and smoking Alexa - race/ethnicity Smoking: not smoking cigarettes during pregnancy decreases the risk of preeclampsia by up to 50%

Treatment Advances History Also known as toxemia, pregnancy-induced hypertension, or pre-eclamptic toxemia First described by Hippocrates in 400 B.C. Early “treatments” Major focus in therapy is focus on preventing eclamptic convulsions Prenatal care and diagnosis remain largely unchanged Risk has increased since the 1990s Hannah - first three bullet points Alexa - Major focus in therapy: avoid and treat eclamptic convulsions; intramuscular injections of magnesium sulfate was introduced in the early 1900s, and intravenous routes began in 1920s. However, it wasn’t until 1990s that major controlled studies demonstrated superiority over other anticonvulsants. Since 1960s, prenatal care and the diagnosis process have remained largely unchanged (routine blood pressure measurement and urinalysis. Risk of preeclampsia has increased since the 1990s in the US because of rising rates of chronic hypertension, diabetes, and obesity

Social and Cultural Support Preeclampsia Foundation Patient Support Network Volunteer The Promise Walk for Preeclampsia Facebook Support Groups QUESTIONS?? Lindsey

Sources http://www.mayoclinic.org/diseases-conditions/preeclampsia/basics/definition/con-20031644 www.preeclampsia.org http://www.emedicinehealth.com/preeclampsia/article_em.htm http://www.mayoclinic.org/diseases-conditions/postpartum-preeclampsia/basics/definition/con-20035395 https://www.preeclampsia.org/health-information/149-advocacy-awareness/332-preeclampsia-and-maternal-mortality-a-global-burden https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871181/ https://www.uptodate.com/contents/preeclampsia-beyond-the-basics https://www.preeclampsia.org/history-of-preeclampsia Poel, Yvonne H. M. et al. (March 2009) Psychological treatment of women with psychological complaints after pre-eclampsia. Journal of Psychosomatic Obstetrics & Gynecology, 30(1): 65–72 DOI: 10.1080/01674820802545990 Chang JJ, Strauss JF III, Deshazo JP, Rigby FB, Chelmow DP, et al. (2014) Reassessing the Impact of Smoking on Preeclampsia/Eclampsia: Are There Age and Racial Differences? PLoS ONE doi:10.1371/journal.pone.0106446 Currie S, Sinclair M, Murphy MH, Madden E, Dunwoody L, et al. (2013) Reducing the Decline in Physical Activity during Pregnancy: A Systematic Review of Behaviour Change Interventions. PLoS ONE 8(6): e66385. doi:10.1371/journal.pone.0066385 Fleury C, Parpinelly M, Makuch M. Y. (August 2010) Development of the mother–child relationship following pre-eclampsia. Journal of Reproductive and Infant Psychology. 28 (3), 297–306. DOI: 10.1080/02646831003729104 Bergink V, et al. (2015) Pre-eclampsia and first-onset postpartum psychiatric episodes: a Danish population-based cohort study. Psychological Medicine. 45, 3481–3489. doi:10.1017/S0033291715001385 Osungbade KO, Olusimbo K. Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening. Journal of Pregnancy. doi:10.1155/2011/481095 Goldenberg RL, Jones B, Griffin JB, Rouse DJ, Kamath-Rayne BD, Trivedi N, et al. (2015). Reducing maternal mortality from preeclampsia and eclampsia in low-resource countries – what should work? Acta Obstet Gynecol Scand. 94: 148–155.DOI: 10.1111/aogs.12533