- Pre-eclampsia costs the lives of 1,000 unborn babies in Britain every year
- The condition struck Heidi Livesey 25 weeks into her first pregnancy
- Signs of pre-eclampsia include high blood pressure and headaches
- Risk factors include pre-existing high blood pressure, IVF and diabetes
A major breakthrough in testing for pre-eclampsia — a condition which costs the lives of 1,000 unborn babies in Britain every year — could save many families from suffering this huge loss.
Pre-eclampsia, where a defect with the placenta causes blood pressure to soar, is still impossible to cure.
But more reliable testing means more babies should survive, and fewer women given distressing and dangerous precautionary treatment — such as very early delivery — after inaccurate test results.
Heidi Livesey knows all too well how the condition can strike — 25 weeks into her first pregnancy, everything seemed fine.
Yes, the previous week her blood pressure had been slightly raised and her midwife suggested a further check, but she had no idea how much danger she and her baby were in.
In fact, that second check probably saved both their lives.
She was diagnosed with pre-eclampsia. This can lead to dangerously high blood pressure in the mother, increasing her risk of stroke, seizures, heart failure and organ failure, which threaten the lives of mother and baby.
‘I hadn’t had any of the common symptoms, such as swelling around the feet and ankles, and headaches,’ recalls Heidi, 36, an ambulance technician from Nottingham.
The only possible signs were a little dizziness and rib pain.
But at the second check, her blood pressure reading was even higher than before, and she was sent straight to hospital.
There, it continued rising and three days later, the doctors’ only option was to deliver her daughter by Caesarean, four months early.
This is the only way to stop pre-eclampsia, but doctors could not be sure if mother and child would make it.
Heidi’s daughter Ebony weighed just 1lb 1oz and while Heidi’s condition improved, Ebony remained in intensive care for four months. Now aged three, she is still prone to chest infections, coughs and colds.
One in ten women develops pre-eclampsia during their first pregnancy. For one in 100, such as Heidi, it is a serious condition.
When the placenta stops working properly, the body releases toxic substances to the lining of blood vessels.
As a result, the blood vessel lining — the endothelium — becomes inflamed, which damages organs and causes them to fail.
Signs of pre-eclampsia include high blood pressure, headaches, swelling and visual disturbances.
It can also restrict the baby’s growth as the placenta supplies nutrients and oxygen from the mother’s blood. Sometimes there are no symptoms.
Thousands of babies are delivered early to prevent the condition worsening and around 1,000 die because of pre-eclampsia every year, either because the failing placenta means their life-support is cut off or they are delivered too early to survive.
Experts still don’t understand why this condition occurs, although risk factors include pre-existing high blood pressure, IVF, kidney disease, diabetes, a twin pregnancy, first pregnancy, increased age, being overweight and previous pre-eclampsia.
However, these are all associations and we still don’t know exactly why the placenta stops working properly, and why only some women develop it,’ says Dr Cathy Nelson-Piercy, a professor of obstetric medicine at St Thomas’ Hospital, London, and chair of trustees for charity Action On Pre-Eclampsia.
Women identified as being at high risk are put on low-dose aspirin from 12 weeks of pregnancy.
But doctors have no clear way of telling which women can safely be monitored and which will get swiftly worse, leading to thousands of early deliveries.
But a new blood test, developed by British doctors and being introduced in some hospitals, could revolutionise treatment and save lives by identifying the worst cases.
Professor Andrew Shennan, a consultant obstetrician at Guy’s and St Thomas’ Hospital, who did the research into the test, says it will ‘radically change how we manage these women’.
The Alere test, which gives results in 15 minutes, measures levels of a protein known as placental growth factor (PLGF), which increases during pregnancy.
A one-year study with 625 women with suspected pre-eclampsia found that those with a very low PLGF level had severe pre-eclampsia, while those with high levels were very unlikely to have a severe form even if they had symptoms, and could safely carry their baby until full term.
The test correctly identified 96 per cent of women with the condition, sharply up from the 58 to 76 per cent detected with current methods.
For women like Heidi, it could make all the difference when considering having a second baby.