Blog: World pre-eclampsia day 2020 – Dr Jenny Myers
For World Pre-Eclampsia Day 2020, Dr Jenny Myers, Consultant Obstetrician at Saint Mary’s Hospital Maternal & Fetal Health Research Centre and Senior Clinical Lecturer at The University of Manchester shares how we support women with the condition, through pioneering research.
In the past few days I have met six women with pre-eclampsia; a pretty standard week for me at the Manchester Maternal & Fetal Health Research Centre, Saint Mary’s Hospital.
These women all have different stories – for some it’s their first pregnancy and the development of a major complication is a huge shock. For other women, they have had the condition before and know only too well how difficult the journey ahead could be.
Two out of three women who develop pre-eclampsia do so in the last few weeks of their pregnancy. In countries with access to good healthcare, the outcome for these mums and babies is usually good, although complications frequently happen along the way.
One in three women with pre-eclampsia however, develop the condition many weeks before their due date. For these women the only option is for the baby to be born prematurely – heartbreakingly this means that some babies are born too small and too early to survive.
The Manchester Antenatal Vascular Service (MAViS) clinic was established in 2011 by myself and Midwife Catherine Chmiel. Our vision was to provide a holistic package of care for women with, and at risk of developing, pre-eclampsia.
The clinic has grown and grown and now provides care throughout the week for women with high blood pressure and pre-eclampsia. We receive over 300 referrals a year, and women are cared for by a fantastic team of midwives and clinical research fellows, who work tirelessly to ensure our patients receive the highest quality care.
In the MAViS clinic we not only provide specialist care and support for women with pre-eclampsia, but also the opportunity to participate in research, which is embedded at the heart of the clinic.
We have run several clinical trials evaluating new therapies for high blood pressure, and we are continually testing new monitoring and screening techniques to improve the care and outcomes for women with high blood pressure and pre-eclampsia.
I am perpetually humbled by the bravery and generosity of the many women who participate in our research, at a time when sometimes their whole world has been turned upside down.
On World Pre-eclampsia Day I am also reminded of how fortunate we are in Manchester to have a healthcare system which means the risk to our women and their babies is much, much lower than in settings where antenatal care is less accessible.
Every six minutes around the world, a woman dies of pre-eclampsia; almost all of these deaths happen in countries with less developed healthcare.
In my career of 20 years, I have been involved in the care of three women who have tragically died having developed pre-eclampsia. A stark difference which speaks volumes. This difference is not because the condition is less common here, but reflects the lack of access for millions of women around the world to blood pressure monitoring and treatment and to trained birth attendants and midwives.
Efforts by charities such as Action on Pre-eclampsia (APEC) and Tommy’s continue to have a huge impact, by raising awareness and providing support to families affected by pre-eclampsia and related pregnancy complications.
APEC have developed a wide range of educational materials for healthcare practitioners and run study days across the UK to improve the skills of midwives and doctors involved in pregnancy care. Thank you, and keep up the great work.
My final and perhaps most important reflection, is that pre-eclampsia is not just a disease of pregnancy; its legacy goes much further. Babies born to mothers who develop pre-eclampsia are usually smaller and often born prematurely because the placenta does not function normally. These children are more likely to develop heart disease and diabetes in later life.
Furthermore, women who develop pre-eclampsia are at dramatically increased risk of developing cardiovascular disease in the years after their pregnancy. Despite this, pre-eclampsia is still not considered as a routine component of cardiovascular disease screening.
We have recently performed a clinical trial “PICK-UP”, which is the first step towards the wide-spread testing of an intervention designed to reduce future cardiovascular risk for this group of women.
World Pre-eclampsia Day is an opportunity to remember the precious lost babies, and sick mothers with whom we have shared devastation and joy.
It’s about encouraging everyone involved in women’s healthcare to be alert to the development of pre-eclampsia.
It’s about providing the very best care we can and remembering that the impact of this condition doesn’t end with the birth of a baby. Pre-eclampsia is a common and devasting condition, it warrants a special day of contemplation.