University provides expertise for landmark Parliamentary debate

Pregnant woman

Pre-eclampsia is a complication of pregnancy which still has no cure. The condition is one of the most common causes of pre-term birth – and, despite good antenatal care in the UK, it claims many hundreds of babies’ lives a year. Now, with World Pre-Eclampsia Day looming on May 22, a Parliamentary debate, called by Patricia Gibson MP, is set for this afternoon (Thursday, 9 May) , to examine urgently what more can be done.

Research into pre-eclampsia conducted by Professor Louise Kenny, Executive Pro Vice Chancellor of the Faculty of Health and Life Sciences at the University of Liverpool, and her research group has been included or referenced in the materials that have been prepared for the debate.

APEC (Action on Pre-eclampsia) calls on the government to prioritise research into stillbirths from pre-eclampsia, and to increase the resources available to support parents through this trauma.

Research shows that black women are 5 times more likely to die in pregnancy, and Asian women are twice as likely to die in pregnancy from pre-eclampsia, so APEC calls on the Government to prioritise care for hard-to-reach and at-risk groups in order to reduce inequalities.

What is pre-eclampsia?

Pre-eclampsia is a syndrome of new-onset hypertension and significant protein in the urine after the 20th week of pregnancy.

It’s a complex multi-system disease. In the mother, the condition causes a number of symptomless disturbances – including raised blood pressure (hypertension) and leakage of protein in the urine (proteinuria) – which can progress to serious illness if undetected.

The unborn baby may grow more slowly than normal or suffer potentially dangerous oxygen deficiency, with long-term consequences.

There’s no cure, other than delivering the baby.

Good antenatal care means that women in the UK now have less than one in a million chance of dying from pre-eclampsia. But there are still high numbers of babies born prematurely because of pre-eclampsia. And there are women who are suffering from pre-eclampsia in pregnancy as well as from its long-term effects, so the morbidity remains high.

Long term effects

Studies show that women who develop pre-eclampsia are in the long term at greater risk of developing cardiovascular disease (high blood pressure, heart attacks and stroke) and kidney disease which also shortens their life expectancy. At the moment in the UK there are no standard care pathways to monitor the long term health of women who have had pre-eclampsia – we believe this needs to be addressed.

In addition, babies who are born underweight or prematurely due to pre-eclampsia are at greater risk of cardiovascular disease and diabetes themselves in later life. This highlights the need for ongoing research to find better treatments and/or a cure that might reduce these risks for the children of women who suffer from pre-eclampsia.

Why a debate in Parliament?

Action on Pre-eclampsia has been engaging with politicians for many years to discuss pre-eclampsia but it was after a round table discussion last year that APEC and Patricia Gibson MP realised this needed a wider audience and for it to be pushed up the political agenda

Patricia Gibson MP for North Ayrshire and Arran, said “I came into politics to drive change, especially in the Health Service since my son was stillborn. We know hundreds of families lose babies every year to stillbirth due to pre-eclampsia and it has never been discussed in Parliament. As I know only too well care is often inadequate and in the run up to World Pre-eclampsia Day on 22nd May I wanted to highlight to Ministers and colleagues the important work that is being done and push for more support for families and better care for expectant mothers who might develop pre-eclampsia.”

Professor Kenny, said: “Pre-eclampsia remains a leading cause of infant mortality and long-term maternal morbidity and yet, we still do not fully understand the cause and we have no effective treatment other than delivery. This condition kills far more children than HIV/AIDS and yet only receives a fraction of the funding.

“The fact that we need to act now to avert a significant public health problem for future generations of women makes this landmark debate in the House of Commons so vital and important.”

Professor Andrew Shennan OBE, Chairman of Trustees for Action on Pre-eclampsia, said: “This couldn’t have come as a better moment. I welcome this debate organised by Patricia Gibson MP as we are on the cusp of rolling out important test which will highlight mums who are at risk of developing pre-eclampsia. This is hugely significant and the recent PARROTT trial has shown just how important this intervention can be.

Marcus Green, CEO, Action on Pre-eclampsia, said “There is an urgent need to look beyond pregnancy at women who have had pre-eclampsia. We know, for example that the immediate cost in extra care for women who have the condition is over £80,000,000 per year. We call on the NHS to adopt a “life course focus” instead of just a pregnancy disease focus. Pre-eclampsia brings to light women who go on to have a greater risk of vascular and chronic kidney disease. This gives a valuable window of opportunity to intervene, if care between obstetric and primary care is improved.”

This debate has been widely welcomed by leading obstetricians and medics including APEC Patron and TV doctor Dr Dawn Harper.

Dr Dawn Harper adds “Screening and diagnosis are the cornerstones of good management, but women need to be aware of the condition, as do all health professionals who come into contact with pregnant women. The symptoms can include:

• Headaches
• Swelling of the face, hands, or feet
• Abdominal pain
• Visual disturbances such as flashing lights
• Reduced fetal movements
• Nausea and vomiting

“I would urge any woman who has these symptoms or if things just don’t feel right, I would get in touch with their midwife, GP or hospital. Clinicians would rather reassure you than you become seriously ill because you didn’t want to bother anyone.”

The landmark Parliamentary debate is scheduled for 1.30pm today (Thursday, 9 May). It is hoped that it will lead to change that will improve lives and save many babies from dying.