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American Morning

'House Call'

Aired February 06, 2004 - 09:44   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


HEIDI COLLINS, CNN ANCHOR: There has been a dramatic rise during the past decade in premature births and other pregnancy complications. A new study looks at some early-warning signs that could help treat high-risk pregnancies.
Dr. Sanjay Gupta has been looking at it. He joins us now to tell us more.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning.

COLLINS: Good morning.

GUPTA: This is a big deal. This is out of the National Institutes of Health, a study published in "The New England Journal of Medicine." Looking at a pretty significant complication of pregnancy that can occur sometimes. It's known as preeclampsia. Women who've ever had this certainly know what it is, but essentially what is, is pregnancy-induced hypertension. It occurs about 5 to 8 percent of the time. The exact cause is not known, and it's more likely in first pregnancies, older mothers, multiple pregnancies. It can be very serious. It can result in maternal or fetal death both.

The trickiest part about this, it's hard to figure out exactly who is going to develop it, which is why there's so much excitement about a new study that actually looks at two markers in the blood that can be tested in pregnant women before they deliver their babies to try and figure out whether or not they're going to get higher risk for this.

Specifically, these are the markers, soluble FMS tyracene kinais (ph), big word; you don't need to remember it. Big word. You don't need to remember it. Essentially if you have an elevated level of that or you have a lower level of a platelet growth factor which is the second line there, you're at more risk of developing this preeclampsia condition. So this is a pretty big deal. Maybe the first time that there's actually a marker to try and determine whether or not someone's going to develop this complication.

COLLINS: As far as -- is there any way to look at someone? You got this test and everything, and you see that they may be high risk, then what do you do from there? I mean, what are the treatments?

GUPTA: You get the hypertension. And sometimes preeclampsia can actually progress to something known as eclampsia, and that's actually when you have the seizures as well. And certainly you can treat both those things. You can treat hypertension, you can treat seizures. The real key for preeclampsia is to really deliver the baby, which is why you have so many premature babies.

What happens -- take a look at this animation. What happens in this situation, very dramatic. That's a woman who's pregnant. Those are the placental blood vessels, the blood vessels that are actually feeding the fetus. When you get hypertension, they start to get contracted down, and you actually don't get enough blood supply to the fetus. That can lead to a pretty significant problem. You can treat those symptoms, but the key really, and what they really maybe stumbled on to here, is to try and figure out who's going to develop it early, to try and prevent it from ever happening in the first place.

COLLINS: In lots of cases, maybe not just this particular preeclampsia, but you hear often about bedrest for high-risk pregnancies. Is this really something that helps, or is it the only thing sometimes that doctors can think of to really tone down the activity?

GUPTA: That's an excellent question. And certainly, it's become a very controversial, to some extent topic, because there are a lot of doctors who swear by prescribing bedrest in certain conditions, and other doctors, very good ones, who say it's just an old wive's tale. We actually talked to several doctor's about this. The former head of the Society for Obstetrics and Gynecology says there's only two situations where bedrest is absolutely mandatory. Here they are. When you have cervical changes during midpregnancy, your cervix starts to open up, it's opened up too early. It put the women at bedrest, just simple gravity may prevent that baby from being born too early. Or if you get blood reduction to the uterus or the placenta, again, both those things probably really the only true indications for bedrest. A lot of women go on bedrest because of multiple pregnancies, because of other sorts of situations, but according to a lot of doctors, those are the absolutes.

COLLINS: All right, Dr. Sanjay Gupta, some great advice. Very interesting. Always interesting to hear about new developments in pregnancies like that. All right, thanks very much, Sanjay.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com






Aired February 6, 2004 - 09:44   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
HEIDI COLLINS, CNN ANCHOR: There has been a dramatic rise during the past decade in premature births and other pregnancy complications. A new study looks at some early-warning signs that could help treat high-risk pregnancies.
Dr. Sanjay Gupta has been looking at it. He joins us now to tell us more.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Good morning.

COLLINS: Good morning.

GUPTA: This is a big deal. This is out of the National Institutes of Health, a study published in "The New England Journal of Medicine." Looking at a pretty significant complication of pregnancy that can occur sometimes. It's known as preeclampsia. Women who've ever had this certainly know what it is, but essentially what is, is pregnancy-induced hypertension. It occurs about 5 to 8 percent of the time. The exact cause is not known, and it's more likely in first pregnancies, older mothers, multiple pregnancies. It can be very serious. It can result in maternal or fetal death both.

The trickiest part about this, it's hard to figure out exactly who is going to develop it, which is why there's so much excitement about a new study that actually looks at two markers in the blood that can be tested in pregnant women before they deliver their babies to try and figure out whether or not they're going to get higher risk for this.

Specifically, these are the markers, soluble FMS tyracene kinais (ph), big word; you don't need to remember it. Big word. You don't need to remember it. Essentially if you have an elevated level of that or you have a lower level of a platelet growth factor which is the second line there, you're at more risk of developing this preeclampsia condition. So this is a pretty big deal. Maybe the first time that there's actually a marker to try and determine whether or not someone's going to develop this complication.

COLLINS: As far as -- is there any way to look at someone? You got this test and everything, and you see that they may be high risk, then what do you do from there? I mean, what are the treatments?

GUPTA: You get the hypertension. And sometimes preeclampsia can actually progress to something known as eclampsia, and that's actually when you have the seizures as well. And certainly you can treat both those things. You can treat hypertension, you can treat seizures. The real key for preeclampsia is to really deliver the baby, which is why you have so many premature babies.

What happens -- take a look at this animation. What happens in this situation, very dramatic. That's a woman who's pregnant. Those are the placental blood vessels, the blood vessels that are actually feeding the fetus. When you get hypertension, they start to get contracted down, and you actually don't get enough blood supply to the fetus. That can lead to a pretty significant problem. You can treat those symptoms, but the key really, and what they really maybe stumbled on to here, is to try and figure out who's going to develop it early, to try and prevent it from ever happening in the first place.

COLLINS: In lots of cases, maybe not just this particular preeclampsia, but you hear often about bedrest for high-risk pregnancies. Is this really something that helps, or is it the only thing sometimes that doctors can think of to really tone down the activity?

GUPTA: That's an excellent question. And certainly, it's become a very controversial, to some extent topic, because there are a lot of doctors who swear by prescribing bedrest in certain conditions, and other doctors, very good ones, who say it's just an old wive's tale. We actually talked to several doctor's about this. The former head of the Society for Obstetrics and Gynecology says there's only two situations where bedrest is absolutely mandatory. Here they are. When you have cervical changes during midpregnancy, your cervix starts to open up, it's opened up too early. It put the women at bedrest, just simple gravity may prevent that baby from being born too early. Or if you get blood reduction to the uterus or the placenta, again, both those things probably really the only true indications for bedrest. A lot of women go on bedrest because of multiple pregnancies, because of other sorts of situations, but according to a lot of doctors, those are the absolutes.

COLLINS: All right, Dr. Sanjay Gupta, some great advice. Very interesting. Always interesting to hear about new developments in pregnancies like that. All right, thanks very much, Sanjay.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com