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Friday, 13 June 2014

How Gospel singer, Kefee Died of Pre-eclampsia. Plus All you Need To Know About Pre-eclampsia.




It’s another sad story and a big loss for the Nigerian music industry with the announcement of the death of the popular gospel star, Kefee.
Despite all prayers rendered to save her life, death still struck and decided to take her away, leaving her teeming fans mourning the sudden loss.
A few weeks ago, the singer had embarked on a 14-hour flight to Chicago for an event. She went into a coma on the flight, which caused the plane to make an emergency landing in Los Angeles for urgent medical attention. It was earlier reported that the singer had pre-eclampsia, i.e. pregnancy induced high blood pressure.

Doctors at the time revealed that her chances of recovery were slim because of her 6 months pregnancy, and Nigerians were urged to pray for a miracle.
Although her family/management is yet to make an official statement, some celebrities have started to send in their condolence messages to the' Kokoroko' crooner's family.

ALL YOU NEED TO KNOW ABOUT PRE-ECLAMPSIA
Pre-eclampsia or preeclampsia is disorder of pregnancy characterized by high blood pressure and large amounts of protein in the urine. Though present in the majority of cases, protein in the urine need not be present to make the diagnosis of preeclampsia. It involves many body systems and evidence of associated organ dysfunction may be used to make the diagnosis when hypertension is present. This includes the presence of a low blood platelet count (thrombocytopenia), impaired liver function, the development of new kidney dysfunction, fluid accumulation in the lungs (pulmonary edema), and/or new-onset brain or visual disturbances. If left untreated, preeclampsia can develop into eclampsia, the life-threatening occurrence of seizures during pregnancy. Preeclampsia is associated with multiple maternal and fetal adverse effects.

The cause and pathogenesis of preeclampsia has yet to be definitively uncovered, though the syndrome is almost certainly the result of multiple factors. It is now thought that abnormal placentation (development and arrangement of the placenta) and placental function is a strong predisposing factor for preeclampsia, though there are a host of contributing and related factors that complicate finding a precise mechanism for preeclampsia.  These include immunologic, hematologic, genetic, and environmental factors. Central to the effects of preeclampsia are the resulting presence of uteroplacental hypoxia (inadequate oxygen supply), an imbalance in angiogenic and anti-angiogenic proteins, oxidative stress, maternal endothelial (lining of blood vessels) dysfunction, and elevated systemic inflammation. Given the syndromic and mulitfactorial nature of the disease, it is not yet possible to routinely predict preeclampsia.
Preeclampsia affects between 2-8% of pregnancies worldwide. It may develop after 20 weeks of gestation, though most commonly after 32 weeks. Preeclampsia occurring before 32 weeks is considered early-onset and is associated with increased morbidity. Most cases are diagnosed before the predicted time typical labor would begin. Delivery of the fetus and placenta is the only known treatment for preeclampsia. Rarely, preeclampsia may also occur in the postpartum period.
An outdated medical term for pre-eclampsia is toxemia of pregnancy, a term that originated in the mistaken belief that the condition was caused by toxins.
Signs and symptoms
Swelling or edema (especially in the hands and face) was originally considered an important sign for a diagnosis of preeclampsia. However, because swelling is a common occurrence in pregnancy, its utility as a distinguishing factor in preeclampsia is not great. Pitting edema (unusual swelling, particularly of the hands, feet, or face, notable by leaving an indentation when pressed on) can be significant, and should be reported to a health care provider.
In general, none of the signs of preeclampsia are specific, and even convulsions in pregnancy are more likely to have causes other than eclampsia in modern practice. Further, a symptom such as epigastric pain may be misinterpreted as heartburn. Diagnosis, therefore, depends on finding a coincidence of several preeclamptic features, the final proof being their regression after delivery.

Causes

There is no definitive cause of preeclampsia, though it is likely related to a number of factors. Some of these factors include:
  • abnormal placentation (formation and development of the placenta)
  • Immunologic factors
  • Prior or existing maternal pathology - preeclampsia is seen more at a higher incidence in individuals with preexisting hypertension, obesity, antiphospholipid antibody syndrome, and those with history of preeclampsia
  • Dietary factors, e.g. calcium supplementation in areas where dietary calcium intake is low has been shown to reduce the risk of preeclampsia
  • Environmental factors, e.g. air pollution
Those with long term high blood pressure have a risk 7 to 8 times higher than those without.
Physiologically, research has linked preeclampsia to the following physiologic changes: alterations in the interaction between the maternal immune response and the placenta, placental injury, endothelial cell injury, altered vascular reactivity, oxidative stress, imbalance among vasoactive substances, decreased intravascular volume, and disseminated intravascular coagulation.
While the exact cause of preeclampsia remains unclear, there is strong evidence that a major cause predisposing a susceptible woman to preeclampsia is an abnormally implanted placenta. This abnormally implanted placenta is thought to result in poor uterine and placental perfusion, yielding a state of hypoxia and increased oxidative stress and the release of anti-angiogenic proteins into the maternal plasma along with inflammatory mediators. A major consequence of all this is generalized endothelial dysfunction. The abnormal implantation is thought to stem from the maternal immune system's response to the placenta and refers to evidence suggesting a lack of established immunological tolerance in pregnancy. Endothelial dysfunction results in hypertension and many of the other symptoms and complications associated with preclampsia.

Prevention

Preventative measures against preeclampsia have been heavily studied. Because the pathogensis of preeclampsia is not completely understood, prevention remains a complex issue. Below are some of the currently accepted recommendations.

Diet

Protein or calorie supplementation have no effect on preeclampsia rates, and dietary protein restriction does not appear to increase preeclampsia rates.  Further, there is no evidence that changing salt intake has an effect.
Supplementation with antioxidants such as vitamin C and E has no effect on preeclampsia incidence,  nor does supplementation with vitamin D.  Therefore, supplementation with vitamins C, E, and D is not recommended.
Calcium supplementation is recommended during pregnancy for prevention of preeclampsia where dietary calcium intake is low, especially for those at high risk. Calcium supplementation in women with low-calcium diets found no change in pre-eclampsia rates but did find a decrease in the rate of severe preeclamptic complications.  Low selenium status is associated with higher incidence of preeclampsia.

Aspirin

The WHO recommends low-dose aspirin for the prevention of preeclampsia in women at high risk and should be initiated before 20 weeks of pregnancy.  Taking aspirin is associated with a 10% reduction in preeclampsia and gestational prematurity. In high risk women this means that 69 need to be treated for one to benefit.

Physical activity

There is insufficient evidence to recommend either exercise or strict bedrest as preventative measures of pre-eclampsia.

Smoking cessation

In low-risk pregnancies the association between cigarette smoking and a reduced risk of preeclampsia has been consistent and reproducible across epidemiologic studies. High-risk pregnancies (those with pregestational diabetes, chronic hypertension, history of preeclampsia in a previous pregnancy, or multifetal gestation) showed no significant protective effect. The reason for this discrepancy is not definitively known; research supports speculation that the underlying pathology increases the risk of preeclampsia to such a degree that any measurable reduction of risk due to smoking is masked. However, the damaging effects of smoking on overall health and pregnancy outcomes outweighs the benefits in decreasing the incidence of preeclampsia. It is recommended that smoking be stopped prior to and during pregnancy.

Source: Wikipedia

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