Treatment of Preeclampsia

New therapies are showing promise in the treatment of preeclampsia

Preeclampsia during pregnancy can hurt your kidneys. Hero Images/Getty Images

I have described in other articles about how kidney disease affects pregnancy. Conversely, the state of pregnancy induces changes in the kidneys, some of which are normal, and others which in some cases are abnormal. One abnormal entity that can lead to adverse changes in the kidney during pregnancy through various mechanisms is something called "preeclampsia". An overview of preeclampsia and how it develops is covered here.

This article will focus on the treatment and prevention of this syndrome, as well as an exciting new development; one that could open up a novel approach to treat this concerning syndrome.  


Not every pregnant woman will develop preeclampsia. The number is about 4-5 pregnant women out every 100 pregnancies.  However there are certain risk factors that will increase the chances of it developing. This is not an all-inclusive list: 

  • Diabetes being present before pregnancy 
  • Preexisting high blood pressure 
  • Obesity
  • Family history of preeclampsia 


The ideal situation would be to prevent preeclampsia. However we do not have many proven preventive options. One which has shown promise is aspirin. Low-dose aspirin could have moderate benefits when used for prevention of preeclampsia.

If you have been diagnosed with preeclampsia during your pregnancy, extensive counseling and discussion would be required with your ob-gyn doc since  treatment options are not always straightforward.


Delivery of the baby is the only definitive way to treat preeclampsia.  This makes sense because the factors driving preeclampsia are thought to arise from an oxygen-deprived placenta. However the tricky part is determining the timing of delivery.  If preeclampsia becomes a major problem towards the end of pregnancy, inducing delivery might be an easier decision to take for the mother and for her physician.

 However it does present challenges in the earlier stages of the pregnancy, and as long as no sign of severe disease is present, the physician will often elect to monitor the mother and the baby. This is called expectant management. However if signs of severe disease are present, delivery of the baby is usually indicated regardless of the gestational age of the pregnancy.

One of the major concerns with preeclampsia is eclampsia wherein a pregnant woman with preeclampsia can have seizures.  Given this, mothers with preeclampsia will often be given anticonvulsant agents to prevent seizures and progression of preeclampsia to eclampsia.  The common medication used for this is intravenous magnesium sulfate.  Intravenous blood pressure medications are used to control blood pressure


Given the role of harmful factors produced by the placenta that could be hurting the maternal blood vessels and therefore creating eclampsia, it would make sense to think that if you could somehow remove these factors, you might be able to treat symptoms and signs of preeclampsia?

One of these factors is something called SFLT-1

This exact hypothesis was tested recently and the results published in a study conducted by the Harvard Medical School.  Researchers did remove SFLT 1 from the maternal circulation using a technique known as apheresis and the results were found to be promising. This intervention reduced protein loss in the urine and improved the mothers' blood pressure. Not only that, the pregnancy was able to continue for a longer period of time, therefore reducing the chances of a baby being born prematurely. The procedure was tested in 11 women. If these results are replicated on a bigger scale, we might see apheresis become a standard part of treatment of the preeclamptic woman.

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