Hypertensive disorders of pregnancy (HDPs), including life-threatening conditions like preeclampsia and HELLP syndrome, affect thousands of women in Canada every year and can cause grave complications like maternal stroke, preterm delivery and stillbirth.
Dr. Laura Magee (pictured, right), a CFRI scientist, Clinical Professor in the Department of General Internal Medicine at UBC, and physician in the Department of Specialized Women's Health at BC Women's Hospital & Health Centre, recently published a paper outlining up-to-date recommendations for treating women who have or who are at risk for these disorders.
The paper was published in Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health and was co-authored by Dr. Peter von Dadelszen.
What did you learn as a result of your research?
The purpose of our study was to review existing research on the best ways to diagnose and treat HDPs and make evidence-based guidelines for the care of women who have or are at risk for HDP.
We found a number of areas where clinicians could improve the ways they diagnose and treat HDP; for example, we determined the importance of monitoring maternal blood pressure with an instrument that is regularly checked against a calibrated device to ensure accurate readings.
Not all Canadian hospitals and doctors’ offices currently do this on a regular basis. We also highlighted the importance of educating expectant mothers about HDPs and providing appropriate care to women who may suffer from post-traumatic stress after experiencing complications in pregnancy or childbirth due to HDPs.
How will your work improve the care for pregnant women who have or who are at risk for pregnancy hypertensive disorders of pregnancy?
In settings with appropriate medical resources, almost all preeclampsia-related maternal deaths involve substandard care. Although there’s still a great deal of research left to be done on HDPs, these guidelines will help clinicians provide the best care for their patients based on existing evidence and result in improved outcomes for mothers and their babies.
How will this research help expectant mothers in British Columbia?
Preeclampsia is one of Canada’s leading causes of maternal mortality; more than 10,000 women develop preeclampsia in this country every year. An estimated 15% of women with preeclampsia go onto develop HELLP syndrome, which is difficult to diagnosis and causes serious complications in up to 25% cases if not treated during its early stages.
By reviewing the existing research on HDPs, we’ve developed clear, up-to-date recommendations that will help clinicians obtain accurate diagnoses and provide appropriate treatment for HDPs.
What are your next steps?
I have just completed the CHIPS Trial (Control of Hypertension In Pregnancy Study), an international randomized control trial of 1028 women that investigated the best way to manage non-severe hypertension in pregnancy. CHIPS examined whether ‘less tight’ (vs. ‘tight’) control of maternal blood pressure during pregnancy will result in fewer complications for mothers and their babies.
We hope the results of this trial will allow clinicians to better manage hypertension during pregnancy and reduce the incidence of serious complications that threaten the lives of mothers and babies.
For more information:
Laura A. Magee, Anouk Pels, Michael Helewa, Evelyne Rey, Peter von Dadelszen. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. DOI: 10.1016/j.preghy.2014.01.003