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Preeclampsia PreventionAka: Preeclampsia Prophylaxis, PIH Prophylaxis

Indications: Preeclampsia risk factors
1. Preeclampsia in prior pregnancy
2. Chronic Hypertension
3. Diabetes Mellitus
4. Renal disease
5. Advanced maternal age
Management: Calcium Supplementation 1 gram per day
1. Lowers Preeclampsia risk
2. Lowers Blood Pressure
  1. Systolic lowered 5.4 mmHg
  2. Diastolic lowered 3.4 mmhg
3. Reference
  1. Bucher HC (1996) JAMA 275:1113
Management: Aspirin 81 mg/day
1. Benefits
  1. Prevents Pregnancy Induced Hypertension
  2. Prevents Intrauterine Growth Retardation
2. Greatest benefit if highest risk factors present
  1. Prior Severe Preeclampsia
  2. Diabetes Mellitus
  3. Chronic Hypertension
  4. Renal disease
  5. Autoimmune disease
3. Efficacy: Number Needed to Treat (NNT) to prevent one case of Preeclampsia
  1. NNT: 69 (overall)
  2. NNT: 18 (if highest risk factors present)
4. References
  1. Coomarasamy (2003) Obstet Gynecol 101:1319
Management: Agents to avoid due to low efficacy
1. Avoid routine magnesium supplementation
2. Avoid routine Omega-3 Fatty Acid Supplementation
3. Avoid antioxidant vitamin supplementation
References
1. Fontaine (2000) in ALSO, B:1-36
2. Sibai in Gabbe (2002) Obstetrics, p. 945-74
3. (2000) Am J Obstet Gynecol 183(1):S1
4. Zamorski (2001) Clin Fam Pract 3:329

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This page was written by Scott Moses, MD. This page was last revised on 9/19/2008 8:28:29 AM. This page was last published on 8/14/2009. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.