The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
If you are
Disorders of Pregnancy - from the UK, a look look at the
midwife’s role in caring for women with hypertensive disorders of
Pre-eclampsia - from the CAM
Newsletter, Feb. 2011 - This is a great update.
Compiled by Tenaya Jackman from the sources listed
pre-eclampsia in first and subsequent pregnancies: prospective
cohort study. [full
Hernández-Díaz S, Toh S, Cnattingius S.
BMJ. 2009 Jun 18;338:b2255. doi: 10.1136/bmj.b2255.
Conclusions: Having pre-eclampsia in one pregnancy is a poor predictor of subsequent pregnancy but a strong predictor for recurrence of pre-eclampsia in future gestations. The lower overall risk of pre-eclampsia among parous women was not explained by fewer conceptions among women who had had pre-eclampsia in a previous gestation. Early onset pre-eclampsia might be associated with a reduced likelihood of a future pregnancy and with more recurrences than late onset pre-eclampsia when there are further pregnancies. Findings are consistent with the existence of two distinct conditions: a severe recurrent early onset type affected by chronic factors, genetic or environmental, and a milder sporadic form affected by transient factors.
Ed: In simpler language: Yes, pre-eclampsia is more common
in first pregnancies, BUT this may be because many women who
develop severe pre-eclampsia in a first pregnancy never get
pregnant again. The rate of pre-eclampsia in non-first
pregnancies was around 1% for women without a history of
pre-eclampsia but 14.7% in the second pregnancy for women who had
had pre-eclampsia in their first pregnancy.
of maternal triglycerides as a risk factor for pre-eclampsia.
Ray JG, Diamond P, Singh G, Bell CM.
BJOG. 2006 Apr;113(4):379-86.
AUTHOR'S CONCLUSIONS: There exists a consistent positive
association between elevated maternal TG and the risk of
pre-eclampsia. Given that maternal hypertriglyceridemia is a
common feature of the metabolic syndrome, interventional studies
are needed to determine whether pre-pregnancy weight reduction and
dietary modification can lower the risk of pre-eclampsia.
Poor Pregnancy Outcomes Linked To Increased Uric Acid
is as important as proteinuria in identifying fetal risk in
women with gestational hypertension.
Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB, Powers RW.
Hypertension. 2005 Dec;46(6):1263-9. Epub 2005 Oct 24.
Women with only hypertension and hyperuricemia have similar or
greater risk as women with only hypertension and proteinuria.
a Maternal-Fetal Conflict by Michel Odent, MD
Consumption of Cola May Be Linked to Hypertension in Women
CME - 11/8/05 [Medscape registration is free]
Hypertension – A Case Summary By: Lisa Murray-Doran B.Sc.,
Paternal role in pre-eclampsia etiology confirmed - A study of Norwegian birth registry data has confirmed that fetal genes from both the mother and father, as well as maternal genes, contribute to the risk of pre-eclampsia.
pre-eclampsia across generations: exploring fetal and maternal
genetic components in a population based cohort
Skjaerven R, Vatten LJ, Wilcox AJ, Ronning T, Irgens LM, Lie RT.
BMJ. 2005 Sep 16; [Epub ahead of print]
CONCLUSIONS: Maternal genes and fetal genes from either the
mother or father may trigger pre-eclampsia. The maternal
association is stronger than the fetal association. The familial
association predicts more severe pre-eclampsia.
vitaminshoppe.com has surprisingly good resources about Pregnancy-Induced
Hypertension and Nonproteinuric
pregnancy disorder found [10/11/04] Scientists believe they
are closer to understanding why a condition that can threaten
Preeclampsia - Here's a great handout for parents from
the Perinatal Education Associates, Inc. except that they're still
using the OLD definition of PIH as being relative to baseline
values, i.e. rise in diastolic blood pressure of at least 15 mm Hg
or in systolic blood pressure of 30 mm Hg. It should be
defined as a sustained blood pressure to levels of 140 mmHg
systolic or 90 mm Hg diastolic.
Pressure Variability as a Function of Parity in Normotensive
Pregnant Women [Medscape]
According to ACOG technical bulletin (Number 219 January 1996), hypertension is defined as a sustained blood pressure to levels of 140 mmHg systolic or 90 mm Hg diastolic. The concept of increase in blood pressure of 30 mm Hg systolic or 15 mm Hg diastolic from second trimester values as diagnostic is no longer considered valid.
the Canadian Hypertension Society Consensus Conference: 1.
Definitions, evaluation and classification of hypertensive
disorders in pregnancy.
Helewa ME, Burrows RF, Smith J, Williams K, Brain P, Rabkin SW
CMAJ 1997 Sep 15;157(6):715-25
This is also the definition used by ACOG.
Here's the old information for comparison - OBGYN.net - Definitions of Preeclampsia
and Eclampsia Revisited - (12/16/2003) [Medscape
registration is free.]
Pregnancy Woe Uncovered: Protein may underlie preeclampsia (March 8, 2003)
" Many of the symptoms of preeclampsia, a major cause of maternal
death and premature birth worldwide, stem from a single protein,
researchers have found. The discovery could lead to new ways of
detecting and treating the disease.
Polymorphism Contributes to Pre-Eclampsia Risk (J Med
Genet 2002;39:44-45. ) [medscape registration is free]
Hypothesis: Preeclampsia as a Maternal-Fetal Conflict [Medscape registration is free]
Theoretically, the most direct way to prevent preeclampsia would be to consume sea fish that is rich in n-3 polyunsaturates and also in minerals that are essential nutrients for the brain (eg, iodine, selenium, and zinc).
in Preeclampsia Shed Light on High Blood Pressure [Medscape
registration is free]
Issue 143 Fruit, vegetables and blood pressure
Arbor Clinical Nutrition Updates 2002 (Dec);143:1-2 ISSN 1446-5450
It is feasible to increase people’s fruit and vegetable intake with a relatively simple intervention in a general practice setting.
This will increase antioxidant levels and may reduce blood pressure.
[Editor's Note - some of my clients do well with compressed Wheat Grass tablets.]
Summary of Pre-Eclampsia Issues
in the Real Organism: A Paradigm of General Distress Applicable
in Infants, Adults, Etc. from RayPeat.com
Pre-eclampsia is a set of symptoms associated with pregnancy that includes high blood pressure and increased protein in the urine, and which can eventually be harmful to both mother and child.
Pregnant females who had a previous history of developing pre-eclampsia during past pregnancies, and who were supplemented with a combination of L-arginine and antioxidants, demonstrated a significantly decreased risk of developing pre-eclampsia during their current pregnancy.
In the body, arginine is instrumental in the formation of nitric oxide. One function of nitric oxide is as a blood vessel dilator, meaning it can help decrease blood pressure.Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial
comparison of walking versus stretching exercises to reduce the
incidence of preeclampsia: a randomized clinical trial.
Yeo S, Davidge S, Ronis DL, Antonakos CL, Hayashi R, O'Leary S.
Hypertens Pregnancy. 2008;27(2):113-30.
of omega-3s associated with preeclampsia
Williams MA, Zingheim RW, King IB, Zebelman AM; Omega-3 fatty acids in maternal erythrocytes and risk of preeclampsia; Epidemiology 1995;6(3):232-237.
After adjusting for confounders, women with the lowest levels of
omega-3 fatty acids were 7.6 times more likely to have had their
pregnancies complicated by preeclampsia as compared with those
women with the highest levels of omega-3 fatty acids (95% CI =
use reduces the risk for preeclampsia, particularly in lean
women - CME
Role of Regular Physical Activity in Preeclampsia Prevention
[01/04/2005 - Medscape registration is free]
as a Maternal-Fetal Conflict
Michel Odent, MD
APPPAH Journal : 20 (4). Summer Issue
ABSTRACT: The association of preeclampsia with both high and low
birth weight challenges the current belief that reduced
uteroplacental perfusion is the unique pathophysiologic process in
preeclampsia. Preeclampsia is thus presented from a new
perspective, in the framework of maternal/fetal conflict.
Interspecies comparisons encourage us to raise new questions
concerning the potential for conflict among humans. The
spectacular brain growth spurt during the second half of fetal
life is a specifically human trait. A conflict between the demands
expressed by the fetus and what the mother can do without
depleting her body leads us to consider first the needs of the
It's possible that an overly acidic system may contribute to the problem.
role in chronic disease and detoxification.
Minich DM, Bland JS.
Altern Ther Health Med. 2007 Jul-Aug;13(4):62-5.
In conclusion, the increasing dietary acid load in the
contemporary diet can lead to a disruption in acid-alkaline
homeostasis in various body compartments and eventually result in
chronic disease through repeated borrowing of the body's alkaline
reserves. Adjustment of tissue alkalinity, particularly within the
kidney proximal tubules, can lead to the more effective excretion
of toxins from the body. Metabolic detoxification using a high
vegetable diet in conjunction with supplementation of an effective
alkalizing compound, such as potassium citrate, may shift the
body's reserves to become more alkaline.
of the urine calcium-lowering effect of potassium bicarbonate in
Frassetto L, Morris RC Jr, Sebastian A.
J Clin Endocrinol Metab. 2005 Feb;90(2):831-4.
Potassium bicarbonate (KBC) potently reduces urine calcium
excretion in adult humans, including patients with hypertension or
calcium urolithiasis, and postmenopausal women.
My recommendation would be to increase fluids as well as protein (110-115 grams
Remember back to basic biology class where the cell membranes are composed of protein molecules which govern the passage of fluid into and out of each cell. Blood vessel walls are particularly sensitive to this lack of protein. As the protein is needed in third trimester for the needs of the fetus, protein molecules are robbed from wherever they are most available. Unfortunately, in a protein deficient diet, the likely source of protein will be the blood vessel walls, leaving them with the appearance of swiss cheese. The fluid "leaks" out due to the lack of sufficient protein molecules, dropping the blood pressure inside the blood vessel and causing edema. The heart senses the drop in pressure and increases the pressure to compensate. This causes increased pressure in the kidneys which can further reduce the protein absorption necessary to the fetus, and feed this vicious cycle. Also causes increased pressure across the placenta, which lowers the amounts of nutrients available to the fetus (hence the connection with PIH and IUGR).
So, logically, one would increase dietary protein, and allow sufficient water to ease the strain on the kidneys and allow protein re-absorption into the general blood flow. But not to overload the kidneys with excess fluid, which dulls the appetite.
I have cared for many women with pre-existing PIH, and some with
a history prior pregnancies with full blown pre-eclampsia.
With dietary and fluid adjustments, they all safely delivered at
home, and did well, without any reoccurrence of blood pressure or
for Pregnancy by Linda Woolven from Mothering Magazine - has a
section on Preeclampsia.
disease is associated with an increased risk for preeclampsia.
Boggess KA, Lieff S, Murtha AP, Moss K, Beck J, Offenbacher S.
Obstet Gynecol 2003 Feb;101(2):227-31
"[A]ctive maternal periodontal disease during pregnancy is associated with an increased risk for the development of preeclampsia."
It's not at all clear whether this is a causative relationship,
but if I were developing PIH and also noticed increasing gum
problems, I'd certainly want to start treating the gum
problems. Increased dental hygiene could include more
diligent brushing, flossing and use of herbal or chemical oral
disinfectants. You could use an echinacea mouthwash or use
tea tree oil on your gumline after brushing. Also, herbal
and vitamin immune support would also seem sensible.
Placental Defect May Cause PIH/Eclampsia
(Reuters) Two studies shown high-stress occupations triple the
risk of pregnancy-induced hypertension, and high levels of
personal stress in pregnant women double the risk of premature
birth. Drs. Landsbergis and Hatch say pregnancy-induced
hypertension occurred independently of a number of factors,
including parity, amount of physical work involved in the job and
total hours of paid work. "In particular, was associated with low
decision latitude and low job complexity among women in
lower-status jobs," the Cornell researchers report. In a study
conducted by researchers at Aarhus University in Copenhagen Dr.
Morten Hedegaard and others report that: "Women who had one or
more highly stressful life events had a risk of preterm delivery
1.76 times greater than those without stressful events... was
observed primarily with events experienced between the 16th and
30th week of gestation." Epidemiology 1996:7:339-345, 346-351.
Another study referred to ( referenced elsewhere in this thread )
showed ( as I recall ) pre-eclampsia to be more common in short
duration relationships than in longer one's in multips also. A
number of studies have shown PE to be more common in multips with
new partners than women sticking with the same partner.
In regards to a recent post that mentioned research published in the last year about immunological intercourse preventing pre-eclampsia:
I have a copy of a couple of articles about this subject that were published in Lancet 344: 8 Oct 94 #8928. One is found on page 969, and is titled: Does immunological intercourse prevent pre-eclampsia?
The other article is page 973 and 975, and is titled: Association of pregnancy-induced hypertension with duration of sexual cohabitation before conception.
Lastly, there was an article published in Science news 146: 246, dated 15 Oct 94. This article basically sums up what is in the articles in Lancet. This article's concluding paragraphs say (and I quote):
"Something in male ejaculate may help protect a woman from pre-eclampsia - - If she's been repeatedly exposed to it, says David A. Clark of McMaster University in Hamilton, Ontario. Researchers don't know whether the sperm itself, the accompanying white cells, or the nourishing liquid called seminal plasma is responsible for the shielding effect.
Such a concept is not as far-fetched as it may sound. For
example, scientist already know that substances from the father
lead to a beneficial immune response in the mother that helps
sustain a healthy placenta. In pre-eclampsia, blood flow through
the placenta in inadequate. -K.A. Fackelmann"
excretion as a marker for preeclampsia.
Garovic VD, Wagner SJ, Turner ST, Rosenthal DW, Watson WJ, Brost BC, Rose CH, Gavrilova L, Craigo P, Bailey KR, Achenbach J, Schiffer M, Grande JP.
Am J Obstet Gynecol. 2007 Apr;196(4):320.e1-7
CONCLUSION: Podocyturia is a highly sensitive and specific marker
for preeclampsia. It may contribute to the development of
proteinuria in preeclampsia.
Hormone Test for Eclampsia
Make sure you check her hemoglobin because if she doesn't have a
contracted hemoglobin then she isn't toxic. There have to be other
things in place before she would have toxemia. I have had clients
who had high BP and protein and swelling and no contracted blood
volume so no toxemia. Have her eat a very high protein diet and
see what happens. Usually this will correct the protein problem.
What are your experiences using deep tendon reflexes in
management of pih?
It's been several years since I did a thorough investigation of this, in association with a case where an L&D nurse thought the clonus much more significant than I did. Generalized hyperreflexia can be a normal result of labor. Because it is a highly non-specific and insensitive finding, no authoritative case definition of pre-eclampsia uses the presence or absence of hyperreflexia to contribute to the diagnosis. (I'll append below the list I've sent here before, with the repeated caution that it was assembled several years ago and newer versions may have superseded these. I also have not gone through and niced up the line formatting, non-ASCII characters, etc. I believe that this is also now on the list's web site.)
IMHO, it is a test that should not be performed, as it does not
contribute information of sufficient quality to base a clinical
for Hypertension in Pregnancy Not Backed by Strong Evidence
Preventing Pregnancy Induced Hyptertension (PIH)
"I know PIH far too well... Here's what has worked for me, but others should research for themselves to see what works.
1. Drink water, drink some more, and drink some more. You'll know
the bathrooms around town like no one else. We're talking 2+
2. Up your protein to 80 - 100 mg, a day.
3. Calcium... up that as much as possible, combining w/ magnesium.
4. Take baths w/ Epsom salts (the magnesium helps) [see Homemade Detox Baths]
5. Visualizations and affirmations (sounds corny, but if you can visualize your blood pressure going down and your body relaxing, it CAN help)
6. Eat a cucumber each day; as well, bananas help with potassium, too, so eat one/day.
7. Herbs like Passionflower help relax the circulatory system. Uva Ursi helps reduce edema, but talk with an herbalist/midwife before consuming.
8. I also take Grape seed extract (w/ some vit E and C) and garlic capsules and Evening Primrose Oil.
9. Stop wearing a bra. I have no scientific evidence to support this, but relaxing the chest area from a tight fitting bra can help relax everything.
Also: spend at least 30 mins a day in a pool. Studies have shown
that full body immersion (in a pool, not a tub) for 30+ minutes a
day will help bring the BP down." -Heather McCue
Role of Regular Physical Activity in Preeclampsia Prevention
[01/04/2005 - Medscape registration is free]
the Canadian Hypertension Society Consensus Conference: 2.
Nonpharmacologic management and prevention of hypertensive
disorders in pregnancy.
Moutquin JM, Garner PR, Burrows RF, Rey E, Helewa ME, Lange IR, Rabkin SW
CMAJ 1997 Oct 1;157(7):907-919
Magnesium Deficiency in Pre-Eclampsia
In the Dec. 1997 issue of Journal Watch/Women's Health, there is a synopsis of a Lancet article on Ketanserin, an antihypertensive drug that also prevents platelet aggregation and its ability to reduce the rate of preeclampsia. In the study of 138 pregnant women with diastolic BP higher than 80 before 20 weeks, some were given ASA and Ketanserin, the rest given ASA and placebo. The rates of preeclampsia were higher with placebo (19% vs 3%). Delivery was significantly earlier with placebo (mean 36.2 vs 37.6 wks) and mean birthweights in babies born between 28-34 weeks was significantly lower with placebo (2791 vs 3074 g). There were 6 perinatal deaths in the placebo group and 1 in the Ketanserin group, but this was nonsignificant (!).
Anyway, I have never heard of this before - does anyone know if
this drug is being used anywhere in the U.S.?
In my state a rise of 30 systolic and/or a rise in diastolic of
30/15 on 2 occasions is an indication for a consult. Of
course, I start on
125 g of protein and 2000 mg of ca++ and 3 qts h2o- probably the same as you- after the 1st high bp. I've only had one mom not respond, so the second bp is usually back to nl.
There is an article by Anne Frye in MT#35 called TURNING TOXEMIA
AROUND. Here, Anne says two things in regard to protein in the
urine: (1) Minor degrees of proteinuria frequently occur during
pregnancy due to the increased filtration rate of the kidneys and
is not a problem.... (2) Proteinuria appears as toxemia becomes
most severe, not in its early stages, and indicates the kidneys
are being severely stressed. However, as mentioned previously, the
majority of proteinuria cases in pregnancy is related to vaginal
discharge, urinary tract infection, or is benign.
Does anyone out there know anything about cream of tartar taken
by the teaspoonful being a picnoginol source?
I use 2 t cream of tartar with the juice of half a lemon taken 3
days skip a day repeat to treat high blood pressure. It will drop
the pressure about 20/10 right away.
As the Guide to Effective Care in Pregnancy reminds us, "Although treatment of hypertension does not strike at the basic disorder, it may still benefit the mother and the fetus. One of the important objectives in severe hypertension in pregnancy is to reduce blood pressure in order to avoid hypertensive encephalopathy and cerebral haemorrhage."
effect of a bath. Study in healthy pregnant females and patients
with edema and gestosis]
Schnizer W, Mesrogli M, Seichert N, Schops P, Knorr H, Schneider J, Wassmann M
Zentralbl Gynakol 1989;111(13):864-70
comparison of bed rest and immersion for treating the edema of
Katz VL, Ryder RM, Cefalo RC, Carmichael SC, Goolsby R
Obstet Gynecol 1990 Feb;75(2):147-51
daily immersion on the edema of pregnancy.
Katz VL, Rozas L, Ryder R, Cefalo RC
Am J Perinatol 1992 Jul;9(4):225-7
head-out water immersion on plasma renin activity, aldosterone,
vasopressin and blood pressure in late pregnancy toxaemia.
Kokot F, et al. (Proc Eur Dial Transplant Assoc. 1983)
to immersion and exercise in pregnancy.
Katz VL, et al. (Am J Perinatol. 1990)
exercise in water on maternal blood circulation].
Asai M, et al. (Nippon Sanka Fujinka Gakkai Zasshi. 1994)
uterine responses to immersion and exercise.
Katz VL, et al. (Obstet Gynecol. 1988)
of blood pressure, heart rate and left ventricular performance
during and after isometric exercise in head-out water immersion.
Fujisawa H, et al. (Eur J Appl Physiol. 1996)
intravascular pressures in conscious dogs during head-out water
Miki K, et al. (Am J Physiol. 1989)
My daughter is 37 weeks pregnant, and having BPs, this week for
instance, 136/100, and thereabouts. Generalized edema, 2+
reflexes, trace protein, no headaches. The midwife said she needs
to get into water (pool) up to her neck and soak twice a day. It
really helps the BP after swimming and floating around in the
pool, her BP is 98/62........Of course she is resting on her side
a lots, and not going to work any more. No shopping, just 'makin a
Ran across this
weblink through the Perinatal List: it has information
regarding the McMaster's University study on PIH reduction through
increased Calcium intake during pregnancy (recommendation of 1,500
to 2,000 mg. daily). Offhand, the numbers look good to me.
Problem is, it's a meta-analysis, which means that they took a
bunch of small RCT's, assessed their quality and crunched the
numbers therein. Although meta-analyses can be quite valid, and
certainly indicators of where to look next, they can also be
flawed. There's certainly some controversy about their usefulness
(although that's essentially what the Cochrane database is). In
this case, a more recent RCT published in the New England Journal
of Medicine last July which enrolled 4589 women appears to
demonstrate that calcium supplementation does not prevent
pre-eclampsia. I haven't read either work at source, so can't
comment further than that. But it does demonstrate that you have
to be careful about what you accept as an authoritative source. To
me, this is one of the fascinating things about research.
Calcium Supplementation May Reduce the Severity of Preeclampsia CME/CE - Calcium supplementation does not reduce the incidence of preeclampsia but does reduce the severity
World Health Organization randomized trial of calcium
supplementation among low calcium intake pregnant women.
Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali MM, Zavaleta N, Purwar M, Hofmeyr J, Nguyen TN, Campodonico L, Landoulsi S, Carroli G, Lindheimer M; World Health Organization Calcium Supplementation for the Prevention of Preeclampsia Trial Group.
Am J Obstet Gynecol. 2006 Mar;194(3):639-49.
CONCLUSION: A 1.5-g calcium/day supplement did not prevent
preeclampsia but did reduce its severity, maternal morbidity, and
neonatal mortality, albeit these were secondary outcomes.
Study Shows Calcium Doesn't Reduce
I have the perfect "cure" for PIH with almost total
L K C H O C O L A T E .................CALCIUM AND
MAGNESIUM............................. now about the dose!
The article quotes JAMA -- A new Canadian study analysed 14 calcium trials (1966 to 1994) and finds strong evidence that calcium supplementation "results in an important reduction in blood pressure and pre- eclampsia.. in pregnant women".
Drs. McCarron and Daniel Hatton from OHSU are quoted in an accompanying editorial -- McCarron says that 2000 milligrams of calcium would be closer to our needs than is the government-NIH recommendation of 1500.. and he says the average US woman enters pregnancy consuming only 600 milligrams a day!, prenatals contain only 200 milligrams of calcium.. McCarron is quoted "I tell women that at a bare minimum they need to be getting at least another 1,000 milligrams of calcium from a calcium- carbonate supplement every day during pregnancy".
Now we all 'know" that there are probably better sources of calcium than calcium carbonate[grin].... but the research was DONE with calcium carbonate so it clearly absorbs well enough to show an effect -- It works! If we can recommend something better than we should, but I hate to hear people say "calcium carbonate is worthless" or "calcium carbonate doesn't absorb" or "calcium carbonate is a poor source of calcium".. (and I do hear this pretty often; calcium carbonate has a bad reputation around here[Grin]). There may be better sources, but it must absorb "well enough" because it does work to reduce blood pressure and the incidence of pre-eclampsia.
Questions..... Would anyone with a nutritionist background like
to translate this "2000 milligrams" into servings of
milk/dairy/broccoli/whatever? Can a non-dairy user get enough
calcium without supplementation, and if not, which supplements
would you recommend over calcium carbonate (and why?)?
Experts Urge Pregnant Women: Get Your Calcium! This point was
supported in an accompanying editorial written by David A.
McCarron, M.D., Co- Director of the Calcium Information Center,
Co-Head of the Division of Nephrology, Hypertension and Clinical
Pharmacology at the University of Oregon Health Sciences
University and an accomplished hypertension researcher in his own
right. "There is a calcium crisis in this country ," said Dr.
McCarron. "The most recent government survey shows that women of
child-bearing age are consuming less than 600 mg of calcium a day,
with many getting less than 400! The pre- natal vitamins most
doctors prescribe just don't make up the difference -- they
contain 200, maybe 300 mg of calcium. The bottom line is that
pregnant and lactating women should increase their calcium intake
to recommended levels through dietary means whenever possible, by
including low-fat dairy products (such as milk, cheese, yogurt),
certain dark green vegetables (such as broccoli and kale), and
making up the difference by adding a reliable calcium supplement.
JOURNAL OF AMERICAN MEDICAL ASSOCIATION REPORTS: CALCIUM DURING PREGNANCY COULD SAVE LIVES
A woman's need for meeting the current recommended levels of calcium just took on new urgency. In today's Journal of the American Medical Association (JAMA), scientists from McMaster University (Ontario, Canada ) report that consuming sufficient calcium during pregnancy can reduce the risk of pregnancy-induced hypertension (PIH) and pre- eclampsia, a potentially fatal disorder of high blood pressure and kidney failure. Pregnancy-induced hypertension and pre-eclampsia affect up to one in seven American women and are leading causes of c- sections, pre-term births and low birth-weight babies, making them among the most important issues in pregnancy care.
The most extensive summary of randomized controlled trials in this area to date, McMaster researchers reviewed the data from 14 trials involving nearly 2,500 pregnant women. The compelling results indicate that 1,500 to 2,000 mg daily of calcium supplementation can lower the risk of pregnancy-induced hypertension by 70% and the risk of pre- eclampsia by over 60%!
Experts Urge Pregnant Women: Get Your Calcium! This point was supported in an accompanying editorial written by David A. McCarron, M.D., Co- Director of the Calcium Information Center, Co-Head of the Division of Nephrology, Hypertension and Clinical Pharmacology at the University of Oregon Health Sciences University and an accomplished hypertension researcher in his own right. "There is a calcium crisis in this country ," said Dr. McCarron. "The most recent government survey shows that women of child-bearing age are consuming less than 600 mg of calcium a day, with many getting less than 400! The pre- natal vitamins most doctors prescribe just don't make up the difference -- they contain 200, maybe 300 mg of calcium. The bottom line is that pregnant and lactating women should increase their calcium intake to recommended levels through dietary means whenever possible, by including low-fat dairy products (such as milk, cheese, yogurt), certain dark green vegetables (such as broccoli and kale), and making up the difference by adding a reliable calcium supplement (like TUMS(R)) . This simple, yet significant intervention could save thousands of lives and billions of dollars every year if employed by all women of child-bearing age."
Calcium Information Center To reach a healthcare professional regarding today's news about the importance of calcium during pregnancy, phone the CIC CALCIUM INFORMATION LINE -- 1-800-321-2681. Established in 1991, The Calcium Information Center is a component of the Clinical Nutrition Research Units of the New York Hospital--Cornell Medical Center and Memorial Sloan-Kettering Cancer Center and Oregon Health Sciences University.
To receive a fax of further information on this study, call toll free, 1-800-753-0352, ext. 707, or contact Anne FitzSimons, 212-326-9800.
The study linking high intake of milk during pregnancy to
pre-eclampsia was published in the American Journal of
Epidemiology, April 1, 1995.
I was recently told of a study where women on a high protein diet
(about 70-80 g I believe) had a significantly smaller incident of
pre-eclampsia than the average ( 0.5% compared to 17%). Does
anyone know anything about this study and if it exists?
Tom Brewer MD has written several books covering this. I suggest reading his book "Metabolic Toxemia of Late Pregnancy: A disease of mal- nutrition" Keats Publishing 1982. Other sources of knowledge on this topic are most of the direct entry midwifery community (it has been standard practice for most of us to Rx a 100g protein diet as a preventive for years). In your reading of Brewer please note that he had great success with REVERSING the pre-eclampsia process utilizing increased fluids (gallon of water a day) salting of food to taste and protein. My sources list the toxemia hot line [Tom Brewer MD] as  778 1476 or 66 High Street, Exter, NH 03833 USA
Other documents/presentations: James,Dawn, "New Thoughts About
Pre-eclampsia" presentation 9/15/89 Royal College of Medicine,
London Eng. Available thru President, Pre-eclamptic Toxemia
Society, Ty Iago, High Street, LLANBERIS, Caerarvon, Gwynedd, LL55
Brewer diet articles about the importance of high-quality protein
for treatment of elevated
blood pressure and pre-eclampsia
Vitamin D deficiency is a major cause of high blood pressure
Vitamins may not protect against pre-eclampsia - "Concomitant supplementation with vitamin C and vitamin E does not prevent pre-eclampsia in women at risk, but does increase the rate of babies born with a low birth weight," the team writes. "As such, use of these high-dose antioxidants is not justified in pregnancy." [King's College London, Lancet 2006; Early online publication]
This contradicts a previous study:
Vitamins May Help to Prevent Pre-Eclampsia in High-Risk Women
9/3/99 LONDON (AP) - Women at high risk for toxemia, one of the most dangerous complications of pregnancy, might avoid the condition by taking vitamin C and E pills, new research suggests. But the British scientists who conducted the study - the first to investigate the vitamins' potential to prevent the condition also known as pre-eclampsia - warned pregnant women should not rush to start taking large doses of the vitamins, since the findings are preliminary. Researchers haven't even yet determined if the high doses are safe for the developing fetus. The benefit suggested by the study must be confirmed in large-scale experiments, said lead researcher Lucilla Poston, a professor who runs the fetal health research group at Guy's, King's and St. Thomas' School of Medicine in London.
Women should talk with their care providers about vitamin
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According to Susun Weed in her book Wise Woman Herbal for the Childbearing Year Crataegus (Hawthorn Berry) is a strong and relatively safe vasodilator. "[hawthorn] berries work cumulatively and are taken for extended periods for best results. Essential hypertension then, rather than gestational hypertension, is the focus of Hawthorn berry use. The standard preparation is a cold infusion: one ounce of crushed dried berries steeping in two cups of cold water overnight brought quickly to a boil, strained and taken in sips, one cup per day , every day. The tincture dose is 15 drops, two or three times daily."
Here's what Weed recommends for hypertension in order of strength (and probably toxicity):
Weed also mentions nettles and raspberry leaf teas to tone and nourish in general (nettles are especially good for kidneys). And raw beet juice (up to 4 oz daily) or a raw salad of equal parts of one freshly grated raw apple and one grated raw beet. Raw beet is the fastest and most effective way to naturally increase available calcium to the body and it balances the sodium/potassium ratio of your blood. Plus the salad tastes really good, especially with walnuts added -- no dressing required!
She only recommends valerian root for elevated bp IN THE CONTEXT OF BEING IN LABOR (along with hops and skullcap -- she recommends a handful of each valerian root, hops and skullcap in a quart jar, steeped for two hours to temporarily lower bp).
Of course there's also taking an extra b complex vitamin in
addition to your regular prenatal vitamins, high protein, NOT
limiting salt, etc. for preeclampsia.
I have seen a study where EPO was shown to reduce the incidence of PIH. The study was conducted on the Farm, and it was a double-blind, placebo controlled study. I'm so sorry that I don't have the reference for it. Maybe someone else has seen it?
The researchers attributed the decreased incidence of PIH to the
essential fatty acids in EPO, however, instead of to the
I have personally used the cream of tartar recipe in Susan Weed's
book. Once a day put 2 t of cream of tartar in the juice of half a
lemon (reallemon works too) with a little water. Drink that for
three days skip a day and repeat for three days. It drops my bp
about 15/10 after one day.
Hazards of Diuretics in Pregnancy - some additional
information about the dynamics of blood volume and blood pressure
during pregnancy, and some cautions about herbal diuretics.
Gemmotherapy (from plant buds) for Hypertension, from Dolisos
English Hawthorne (Crataegus Oxycantha) Young Shoots 1DH: 50 drops in the morning
European Olive (Olea Europea) Young Shoots 1DH: 50 drops in the afternoon
Black Poplar (Populus Nigra) Buds 1DH: 50 drops in the evening
The acronym stands for: H - hemolysis: breakdown of red cells in
vessels in vasospasm from high blood pressure; EL - elevated liver
enzymes, SGOT and LDH; think liver congestion and symptom of
epigastric pain; LP - low platelets; used up in damaged vascular
endothelium; risks for bleeding and DIC.
Syndrome - Here's a great handout for parents from the
Perinatal Education Associates, Inc.
Syndrome: Recognition and Perinatal Management from the AAFP
Effects of Mag. Sulfate on
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