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3 Concept of Preeclampsia Prevention

Diet Patterns Antioxidants Antenatal Care Preeclampsia PreventionAccording to Cuningham et al. (2005), various strategies have been used in an attempt to prevent preeclampsia. Usually, these strategies include dietary pattern and pharmacological efforts to modify the estimated pathophysiological mechanisms involved in the occurrence of preeclampsia. Pharmacologic efforts include the use of low-dose aspirin and antioxidants.

1. Diet Patterns

One of the earliest efforts aimed at preventing preeclampsia is the restriction of salt intake during pregnancy, Knuist et al. (1998)

Based largely on studies outside the United States, found that women with low calcium diet was significantly higher risk of experiencing pregnancy-induced hypertension. This encourages the execution of at least 14 randomized clinical trials that generate meta-analysis showed that calcium supplementation during pregnancy causes a significant decrease in blood pressure and prevent preeclampsia. But that seems definitive study done by Lavine et al., (1997) cited by Cuningham (2005).

This study is a randomized clinical trial sponsored by "the National Institute of Child Health and Human Development". In a test that uses a double-mimetic, the 4589 healthy nulliparous women were randomized to receive 2g calcium supplements, or placebo.

Other dietary manipulation to prevent preeclampsia that has been investigated is the provision of four to nine capsules containing fish oil every day. This daily supplement is selected as an attempt to modify the balance of the expected role of prostaglandins in the pathophysiology of preeclampsia.

2. Antioxidants

Serum of normal pregnant women has an antioxidant mechanism that serves to control lipid peroxidation is expected to play a role in endothelial cell dysfunction in preeclampsia. serum of women with preeclampsia showed a marked decrease of antioxidant activity. Schirif et al., (1996) cited by Cuningham (2005), to test the hypothesis that a decrease in antioxidant activity play a role in pre-eclampsia by studying the dietary intake and plasma concentrations of vitamin E in the 42 pregnancies in 90 controls. They found that plasma levels of vitamin E higher in women with preeclampsia, but the consumption of vitamin E in the diet is not associated with preeclampsia. They speculated that high levels of vitamin E were observed due to the response to oxidative stress in preeclampsia.

The first systematic study designed to test the hypothesis that antioxidant therapy for pregnant women would change the endothelial cell injury associated with preeclampsia. A total of 283 pregnant women 18 to 22 weeks are at risk of preeclampsia were randomized to receive antioxidant therapy or placebo. Antioxidant therapy significantly reduced endothelial cell activation and suggest that such therapy may be beneficial to prevent preeclampsia. Also significantly decreased the incidence of preeclampsia in those who received vitamin C and E compared with the control group (17 versus 11 percent, p <0.02).

3. Antenatal Care

Regular antenatal care and quality as well as meticulous, recognize early signs (mild preeclampsia), and given adequate treatment so that disease does not become more severe. Must always be alert to the possibility of preeclampsia if there are predisposing factors, providing information about the benefits of rest and sleep, calmness, and the importance to set a low salt diet, fat, and carbohydrates and high in protein, as well as maintaining excessive weight gain (Mochtar, 2007 ).

The most effective treatment is prevention. At the beginning of prenatal care, identification of high-risk pregnant women, recognition, and reporting of physical symptoms is a warning to optimize the core component of the maternal and perinatal outcomes. The ability of nurses in examining the factors and symptoms of preeclampsia on the client can not be too expected. Nurses can do many things in support tasks. Action must be taken to increase knowledge and public access to antenatal care. Counseling, delivery of public resources, the deployment system support, nutritional counseling and information about the normal adaptation to pregnancy prevention is an essential component of the treatment (Bobak, Jensen.2000).

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