“PREECLAMPSIA AND ECLAMPSIA: 7 MANAGEMENT CHALLENGES (AND ZERO SHORTCUTS)”
JOHN T. REPKE, MD, AND BAHA M. SIBAI, MD (APRIL)
It was great to read such a thorough article on preeclampsia and eclampsia. This subject is often relegated to the “we don’t know much about it so why bother discussing it” category, which is clearly a problem considering preeclampsia’s relatively high prevalence and sometimes disastrous outcomes.
Dr. Repke and Dr. Sibai (who are both members of our Medical Board) did an excellent job of offering a thorough evaluation of some of the key challenges and underscoring the unpredictability of these disorders. The one critical piece missing from their recommendations is patient education, which is especially important because diagnosis is sometimes difficult and maternal and fetal health can go south so quickly. Our research—and that of others—has shown that most patients are not routinely and consistently informed about the signs and symptoms—information that is critical to their understanding of when to call or see their health-care providers. Prompt presentation can alleviate the 11th-hour crisis that often leads to disastrous outcomes.
Once preeclampsia is diagnosed—or indications are that the case is moving in that direction—patient education becomes more critical. In fact, it is often requested by the patient and her family. The Preeclampsia Foundation can help physicians bridge the gap in knowledge; we provide not only credible information in print and online, but also comfort and support during an often anxious and trying time.
Dr. Repke and Dr. Sibai respond: Signs and symptoms of preeclampsia may be protean
We are pleased to acknowledge Ms. Tsigas’ important point about patient education. Although our article was written for a physician audience, patient (and physician) education about the sometimes-subtle signs of preeclampsia is extremely important, especially in very high-risk individuals.
We also agree that patient education is a very important part of postdiagnosis management, as patients are often confused by how well they feel (in mild cases). A better understanding of the potential severity and swift progression of this disease can aid in maintaining compliance with a management strategy and elicit earlier reporting of signs or symptoms that might suggest worsening of disease.