Raising awareness about pre-eclampsia

Pre-eclampsia claims the lives of 76,000 women and half-a-million babies globally each year. To mark the first World Pre-eclampsia Day this week, LIZ O’BRIEN spoke to world experts carrying out research into the condition, here in Cork
Raising awareness about pre-eclampsia

LIGHTING IT UP: Outside Cork City Hall, which was lit up for World Pre-eclampsia Day were, left to right, Dawn Fisher, research midwife, INFANT Centre, Gráinne Meehan, research midwife, INFANT Centre, Prof Louise Kenny, director, INFANT Centre, Nicolai Murphy, Project Manager, INFANT Centre. All four work on the IMPROvED project. Picture: Darragh Kane

YOU may have noticed some of Cork’s iconic buildings turned orange this week. Cork City Hall, University College Cork and Blackrock Castle Observatory were among the buildings in the new shade on Monday night.

In Dublin, the Mansion House; Rotunda Hospital; National Maternity Hospital; RCSI and Trinity College Dublin were also lit.

Ria O’ Sullivan, of INFANT (Science Foundation Ireland research centre, UCC and CUMH), hopes the lit buildings tweaked people’s interest and caused them to ask why they were orange. It was to mark the first World Pre-eclampsia Day.

Given that pre-eclampsia claims the lives of 76,000 women and half-a-million babies globally each year — either at birth or within a few hours of being born — it’s important to create awareness, according to Dr O Sullivan.

“Pre-eclampsia can affect any woman, and Cork is no stranger to it. We would have about 240 cases diagnosed a year or about five new cases a week, nationally there would be nearly 2300 cases a year” Dr O’ Sullivan said.

Pre-eclampsia is most common in the second half of pregnancy and can still strike up to six weeks after delivery.

CIT Blackrock Castle Observatory lit up to mark Preeclampsia Day. Picture. Darragh Kane
CIT Blackrock Castle Observatory lit up to mark Preeclampsia Day. Picture. Darragh Kane

“Because one symptom can be similar to morning sickness, signs of pre-eclampsia can often be dismissed. So, recognising signs of the condition is important.”

One of the condition’s challenges is that it can have an ‘insidious presentation’ according to CUMH obstetrician and INFANT director, Louise Kenny.

“But as healthcare professionals we don’t ever, ever mind seeing someone, or reviewing a mum who is worried about herself in pregnancy,’ she said. “We would much rather see 100 women and reassure them that they are fine, than miss just one who has signs and symptoms of pre-eclampsia and who has dismissed them or ignored them.

“All maternity units are 24/7 and there’s always a senior duty midwife available on the phone 24/7, whether you’re public or private, so if mum is concerned she should make that call.”

To assess the presence of pre-eclampsia is quick and easy — urine is tested for protein and blood pressure is taken.

Prof Kenny is leader in pre-eclampsia research and said signs and symptoms to worry about are flu-like symptoms and rapid swelling, particularly of the fingers and face.

The Quad, UCC lit up to mark Preeclampsia Day. Pre-eclampsia. Picture. Darragh Kane
The Quad, UCC lit up to mark Preeclampsia Day. Pre-eclampsia. Picture. Darragh Kane

“Most pregnant mums get swelling of the feet and we don’t particularly worry about that because it is very, very, common but if mum suddenly gains weight and feels like she is retaining a lot of fluid, particularly around the fingers or face, then again its probably worth contacting the healthcare professional,” she said.

“More worrying signs are headaches, particularly a throbbing frontal headache, accompanied by classic visual disturbances; many women who have quite worrying pre-eclampsia complain of seeing flashing light.

“Also, gastric pain — pain that feels a little bit like heartburn, but it tends to be more severe than that and it tends not to be relieved by antacids or by drinking milk or moving — they would be the real worrying signs.”

See www.preeclampsia.org for more information about the event and search the #WorldPreeclampsiaDay on Twitter. For more about pregnancy research in Cork visit www.infantcentre.ie

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NEXT month a free event will shine a spotlight on infant mental health at the ‘From Bump to Beyond: Public Forum’.

The event focuses on the social and emotional well being of infants and toddlers. Parents can take part in hands-on demonstrations and activities aimed at helping them bond with their babies. Obstetrician Louise Kenny and Helen Shanely — a psychologist specialising in infant mental health — are among the key speakers, as well as ‘Bad Mammy’ blogger Lisa Ryan, and researchers from INFANT. The free workshops and open public forum will be held on June 15 at Cork University Hospital’s auditorium. Registration on Eventbrite is advised.

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Kate O'Sullivan and baby Neasa.
Kate O'Sullivan and baby Neasa.

Volunteering for life-saving study 

BABY Neasa O’ Sullivan is almost two weeks old.

She’s a first baby for her mum Kate and dad Brian from Ballincollig, and thankfully the pregnancy was pretty straight- forward.

But, it’s not like that for all mums; so, while pregnant, Kate signed up for an EU-funded study that would help benefit women diagnosed with pre-eclampsia.

The condition is developed during pregnancy — characterised by high blood pressure and protein in the urine — and if not picked up, can be life-threatening.

Kate is one of 1,500 women in Cork to volunteer for the potentially life-saving study.

“At my 12-week appointment I saw posters for the IMPROvED study in the waiting room.

“I contacted the girls about it and they were great because they fit my appointments in around work,” Kate said.

If pre-eclampsia is caught early, it can be managed, the danger is if it’s not caught and if you don’t know what to look out for, it can become really serious.

Early signs of pre-eclampsia include high blood pressure, protein in the urine and in some cases swelling of the feet, ankles, face and hands, severe headaches, problems with vision, and pain under the ribs.

The IMPROvED study aims to develop a predictive blood test for pre-eclampsia because at the moment there isn’t one.

Kate says such studies are important to improve outcomes for mums and their babies.

While she knew what pre-eclampsia symptoms were, she said many don’t so it’s vital that it’s highlighted.

“I knew about the dangers of it and what to watch out for, plus two of my husband’s family have had pre-eclampsia,” Kate said.

“The main thing is that people are aware of the study and the importance of taking part in these kinds of studies, because you can help them find a new target or marker and that’s really important to make life better for people down the road.” The study also benefitted Kate, as she had extra check-ups.studies, because you can help them find a new target or marker and that’s really important to make life better for people down the road.

HAPPY AND HEALTHY: Baby Neasa’s mum Kate took part in the IMPROvED study.
HAPPY AND HEALTHY: Baby Neasa’s mum Kate took part in the IMPROvED study.

“The more checks you do the better,” she said.

“You have lot of appointments — definitely three to four extra checks — and it was with a midwife and they were more than happy to help!

“The girls I met were Grainne and Dawn and they were asking how you were in your pregnancy, giving extra tips if you weren’t feeling great, and they both went above and beyond the call of duty really.” Obstetrician, at CUMH, Louise Kenny said pre-eclampsia is a common enough condition, affecting between three to five per cent of women in Ireland.

“Most of the time it occurs late in pregnancy, but occasionally it can occur at a very early stage, and that’s important, because the only cure we have is to deliver the baby, and it’s the unpredictable nature in the fact that it can appear quite early and if it appears later it can deteriorate and become a very serious condition within a matter of hours.

“The condition is more common in first pregnancies and it’s associated with increased risk of growth restriction and premature delivery of stillbirth.

“It often is a first pregnancy that’s complicated by pre-eclampsia — then it can have a very profound effect.

“If mum and baby are lucky enough to escape unscathed it has a re-occurrence risk associated with it; so if you did get it in your first pregnancy, you’re much more likely to get it in your second.” Prof Kenny said evidence shows babies born early or small or as a result of pre-eclampsia are more likely to have significant health complications — hypertension, stroke, Type 2 diabetes — as adults.

She added: “And for mums, there’s very good data now that shows that if any pregnancy was complicated by pre-eclampsia, you’re much more likely to develop cardiovascular disease around the time of the menopause, much more likely to develop renal failure and require dialysis, potentially even transplantation and risks for both mum and baby that go on for years after.” For information on the IMPROvED study, see www.infantcentre.ie

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