Researchers hope to identify women with preeclampsia at risk of heart problems in later life

fiddle manson is a relatively new specialty and involves looking after the unborn baby we look after mothers as well of course but we are a referral center for the whole of the Southwest tames district for complicated pregnancies that are required very specialist care I think the best way to put it is that the pregnancy is a considerable strain in fact the mother's heart has to take endure changes that are equivalent to an Olympic athlete has to endure over two year period so you can imagine the sort of stresses and strains that the heart has to endure and in the vast majority cases mothers and do that extremely well and cook very well which we should respect however it's not surprising that in something like 2 to 5 percent of cases the heart doesn't cope as well with the strain of pregnancy and one of the manifestations have been during the pregnancies preeclampsia and what we're now finding is that it foretells a real serious condition in the heart that becomes clear much later one of the main issues about preeclampsia that's really gone unrecognized or unstudied is the fact that women who've had that brings you of preeclampsia tend to have eight to ten fold higher chance of having a stroke or a heart attack in later life and that translates into the fact that even in this day in the developed world women with heart problems are two to three times more likely to die than men with heart problems so there is a real health disparity to do with heart disease and well what we recognize is that preeclampsia is now not only a condition of the placenta but it's a condition of the fact that the mother's hearts are unable to cope with their pregnancies as well and that's something that's really new and something that we have led the way in discovery using standard techniques which are engineered towards 78 year old men developing heart problems we were unable to find anything and that's what previous studies have shown they said well the hearts are really quite good in the mothers but using very modern heart scanning techniques called speckle tracking we're able to find that the mothers hearts are actually quite severely compromised in pregnancy and more importantly following them up two to three years later show that about 50% of them continued to be compromised after the pregnancy and these are women who are asymptomatic that means they have no symptoms and we really didn't know the severity of the problem the techniques we use tend to tell us about the function of the chambers of the heart the heart has a few chambers that have to work using modern technology and especially speckle tracking we're able to look at the function of the muscles of the heart in a much more accurate and discernable way and that's essentially what we've done and what we've shown is that about 50% of women who have preterm that means early preeclampsia have hearts that function rather like 60-year old men two years after they've delivered their baby and these women are totally clueless as to the the severity of the condition and the importance of this is that it is theoretically possible for us to have interventions at this early stage which may prevent them from getting strokes and heart attacks ten to fifteen years later what we've done here the last two three years is study about a hundred women after their episode of preeclampsia up to two to three years after their delivery and shown a significant heart compromise in a in a majority of these patients we're planning to do now is to replicate this in a regional perspective and we have a very strong collaborative in Southwest Times called Stoke which is the Southwest Thames obstetric research collaborative and through this group of hospitals we're going to recruit patients who've had this relatively serious condition and follow them up personally to look at various aspects of their recovery from the preeclampsia and to map how they recover from the preeclampsia the idea is to optimize the identification of women who would most benefit from interventions to maintain their heart a cardiac health in the long term the consequence of this that we hope to have identified a technique to be able to pick out the women who are most at risk of long-term cardiovascular health and then instigate an appropriate plan of care to minimize the risk of them developing by the strokes or heart attacks in the long term and remaining good family mothers

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