The Magnesium Project - Diseases
Pre-eclampsia/Eclampsia (toxemia of pregnancy)
Pre-eclampsia is defined as the combination of high blood pressure (hypertension), swelling (edema), and protein in the urine (albuminuria, proteinuria) developing after the 20th week of pregnancy (Roberts, 2001). Pre-eclampsia ranges in severity from mild to severe; the mild form is sometimes called proteinuric pregnancy-induced hypertension (Roberts & Cooper, 2001) or proteinuric gestational hypertension (Page, 2000).
In severe pre-eclampsia, symptoms are more pronounced. Severe pre-eclampsia may lead to eclampsia, which is characterized by seizures or convulsions and can cause death of both the mother and fetus if left untreated. Like eclampsia, severe pre-eclampsia is a medical emergency requiring hospitalization. Pre-eclampsia, a syndrome affecting 5% of pregnancies, causes substantial maternal and fetal morbidity and mortality.
Around 210 million women become pregnant annually around the world and every minute a woman dies in pregnancy or childbirth, with a quarter of these deaths due to a condition called pre-eclampsia which can lead to the more severe and mortal condition called eclampsia. Women may develop high blood pressure during pregnancy (pre-eclampsia) and during or prior to birth may experience life-threatening seizures (eclampsia). About 5-10 percent of women in their first pregnancy develop pre-eclampsia.
For many years, high dose intravenous magnesium sulfate has been the treatment of choice for preventing eclamptic seizures that may occur in association with preeclampsia-eclampsia late in pregnancy or during labor. Magnesium is believed to relieve cerebral blood vessel spasm, increasing blood flow to the brain (Ref. 2 from the Micronutrient Information Center, Jane Higdon, Ph.D. at at Oregon State University).
In the majority of third world countries there is a high incidence of maternal and neonatal deaths. In these mostly rural locations people often have few resources, little or no electricity, lack of clean water, poor transportation, and there are few trained health professionals or functional hospitals. Through a better understanding and implementation of knowledge about the role of magnesium ions in hypertension and convulsions, millions of lives can be saved. Developing an inexpensive means to deliver a treatment that will substantially reduce the occurrence and severity of both pre-eclampsia and eclampsia may save both mother and child.
The pathophysiology of pre-eclampsia remains largely unknown. It has been hypothesized that placental ischemia is an early event, leading to placental production of a soluble factor or factors that cause maternal endothelial dysfunction, resulting in the clinical findings of hypertension, proteinuria, and edema. (Maynard, et al., 2003). There is evidence of a genetic component that increases the risk of having pre-eclampsia/eclampsia (Mützea, et al., 2008; Roberts, 2001).
Many of the deaths may be attributed to hypertensive disorders (pre-eclampsia) leading to hemorrhage and convulsions (eclampsia) for mothers and subsequent premature delivery for infants. Several factors have been shown to contribute. Pre-eclampsia has been found to be more common in women during their first pregnancy (Mounier-Vehier et al., 1999), and in women who are obese, diabetic, gestationally hypertensive (Saudan, 1998; Myatt; 1999; and Sibai, 1997), and who have had pre-eclampsia during a previous pregnancy. Pre-eclampsia has also been associated with calcium deficiencies (Hojo, 1997), antioxidant deficiencies (Gulmezoglu et al. 1997) and older maternal age. Magnesium deficiency has been implicated as a possible cause of pre-eclampsia. (Wynn, 1988; Spatling, 1988; Sibai, et al. 1989; Standley et al., 1997; Handwerker et al., 1995). Magnesium supplementation has been shown to reduce the incidence of pre-eclampsia in high-risk women in one study (Conradt, et al., 1985), but not in another double-blind trial (Spatling et al., 1988).
Genetic conditions that may be pre-disposing to the foregoing conditions are yet to be evaluated. For further treatment of genetics see the Genomics pages.
For a detailed listing of references relating to Pre-eclampsia/Eclampsia and related conditions and research in a printable form see the following: Pre-eclampsia References