Saturday, May 30, 2015

Chapter 1: Preeclampsia, Epigenetics, Stress, and Flu Shots

I'm finally getting the chance to start off the summer reading series with a review of Chapter 1. If you're just joining and would like a chance to read the book, I placed a link to purchase it at the bottom of this post! 

Chapter 1 of Dr. Lu's book gave a general overview of what to expect in the book! Starting off the chapter, the reader learned about how preeclampsia develops and what it means in terms of health of the mother and viability of placenta. I was interested in learning more about preeclampsia (formerly known as toxemia) as I know a few mothers who suffered from it and had to deliver babies early via emergency c-section. I realized I did not know what symptoms of preeclamsia were beyond elevated blood pressure, and the only symptom mentioned in the chapter by Dr. Lu in the chapter was high blood pressure.

I did some reading on the Preeclampsia Foundation website to learn more about signs and symptoms of the condition. I've detailed some of the symptoms below:
  • High Blood Pressure: "High blood pressure is traditionally defined as blood pressure of 140/90 or greater, measured on two separate occasions six hours apart." I was interested in seeing if the website had anything to say about pre-pregnancy planning, and found the following useful... "Know your blood pressure prior to pregnancy, especially if it's normally considered low.  Ask, "What is my blood pressure?" during each prenatal visit with your healthcare provider."
  • Protein in your Urine (Proteinuria): Readings of 1+ or greater can be indicative of preeclampsia developing, even when blood pressure is within the normal range. I did not know that you can purchase test strips to monitor protein in the urine at home, if you're concerned about develop preeclampsia. 
  • Swelling: From the website, it sounds like mild swelling (particularly in the feet) is expected as a common occurrence in pregnancy. Swelling consistent with preeclampsia appears to often present as excessive facial swelling or pitting edema. Pitting edema is identified by swelling where an indentation from pressing with a finger "holds" for a few seconds, instead of immediately returning to its normal position.
  • Headaches: Painful, light-sensitive headaches are a cause for concern. Headaches accompanied by any changes in vision are immediate cause for concern. Any sudden changes in vision (seeing "auras," sensitivity to light, or blurry vision/seeing spots) should be immediately evaluated.
  • Nausea/Vomiting: GI problems are common in early pregnancy, but sudden onset of nausea and vomiting in the 2nd or 3rd trimester is not. It's recommended women who experience that have their blood pressure and urine checked immediately.
  • Pain in the Liver Area: This can either occur around the liver directly, or as "referred pain" in the shoulder or lower back. 
  • Sudden and excessive weight gain: Defined as 2+ pounds within a week. Prior to pregnancy, it is helpful to maintain a BMI of 30 or less, as obesity increases the risk of developing preeclampsia. Drinking an adequate amount of water is also important.
  • Sudden shortness of breath: May be indicative of fluid accumulating in the lungs.
As highlighted by Dr. Lu, these symptoms cannot be ignored because preeclampsia can quickly lead to life-threatening emergencies or even maternal death. The Preeclampsia Foundation noted that "by conservative estimates, these disorders are responsible for 76,000 maternal and 500,000 infant deaths each year."

What can be done pre-conception to decrease risk factors of preeclampsia? Adopt a healthy weight-management routine (if your BMI is above 30), reduce sodium intake, and know your typical blood pressure. 

Overall, the chapter made an excellent case for why it was so important to attend to several variables of maternal health prior to conception. Dr. Lu pointed out that many women don't see a doctor or even know they are pregnant until a few weeks after conception. At that point, the baby already has developed the beginnings of a cardiovascular system and the neural tube (which will later develop into the brain and spinal cord). 

Another important factor Dr. Lu briefly highlighted was epigenetics and maternal stress, and how this contributes to the overall long-term health of the fetus. For example, women who experienced influenza during pregnancy increased the risk three-fold that their baby would develop autism or schizophrenia later in life! 

Questions to reflect on in the comments:What did you think about Paula's decision to wait to have a c-section despite having serious symptoms of preeclampsia? Are there any pre-conception lifestyle changes you have thought about implementing to help prevent pre-eclampsia?

For myself, I have been trying for some time now to reduce sodium in my diet, but will be focusing more seriously on this goal as I get closer to TTC (trying to conceive). I also strongly agree with Dr. Lu's conclusions about the negative impacts of stress on the fetus; I'm working on mindfulness and other stress reduction techniques I hope to reflect on in future posts!

Want to join in the reading series but haven't purchased the book yet? Click the image of the cover below to purchase it! 

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