Academic journal article Journal of Prenatal & Perinatal Psychology & Health

On the Psychodynamics of Preeclampsia and HELLP Syndrome: Recent Advances in Treatment

Academic journal article Journal of Prenatal & Perinatal Psychology & Health

On the Psychodynamics of Preeclampsia and HELLP Syndrome: Recent Advances in Treatment

Article excerpt

Abstract: In medical science it is well known that the uterine conditions during the time of implantation are crucial. The "mother embryo crosstalk," or the communication between embryo and mother, lays the foundation for the later health of both, on a basic biological and psychological level. A new and unique synopsis of current knowledge about implantation with psychological findings of patients affected by preeclampsia or HELLP (hypertension, elevated liver enzymes, and low platelets) syndrome shows striking interrelations. For the first time a psycho-dynamic understanding of these life-threatening conditions comes into reach. This gives rise to new prevention and treatment modalities.

Keywords: Mother embryo crosstalk, Preeclampsia, HELLP Syndrome

Preeclampsia and the HELLP Syndrome are important clinical conditions because they are of great significance in health policies and the health of mothers of babies. For decades, a close link with conditions in early stages of pregnancy (i.e. bad placentation hypothesis) has been suspected by medical science as causal. The aim of this paper is to clarify the psychological relationships related to these conditions.

There are three parts:

* Knowledge about the manifold physiological processes during early pregnancy;

* Findings from bodily therapeutic courses about mental processes during exactly this period; and

* Examples that give an impression of the early imprinting from this period in the lives of adults with appropriate case histories.

Knowledge of Early Pregnancy

In scientific literature, the medical conditions preeclampsia and the more severe forms of eclampsia and HELLP Syndrome are combined under the generic term pregnancy induced hypertension (PIH). Preeclampsia is characterized by increased blood pressure of the pregnant woman, proteinuria and the formation of oedema. The HELLP Syndrome gets its name from H: hypertension, EL: elevated liver enzymes and LP: low platelets. Despite its being life threatening (bleeding disorder, liver failure), it is often only expressed clinically only by light upper stomach pains. The diagnosis is made by means of characteristic blood values. The significance for health policies is very high: worldwide over 50,000 women die of PIH every year. In industrial countries it occurs in 2 - 5% of pregnancies and is the second highest cause of maternal mortality in 12 - 18%. It is responsible for 25% of perinatal mortality in children. When occurring up to the 24th week of pregnancy it is responsible for 65% of maternal complications and 82% of child mortality (Rath & Fischer, 2009).

Is it possible that such a serious illness can be related to psychological factors? I well remember a discussion with my esteemed colleague Susanne Bässler in a gynaecological working group in Karlsruhe in the mid-1990s. She replied at the time to my psychosomatic speculations, "That is impossible because medical science has just established that PIH is related to early placentation. It therefore can't be caused psychologically." On the other hand, medical science has increasingly accepted that early imprinting of people in many aspects (fetal programming) through the circumstances of the children before birth (Gluckman, Hanson, Cooper, & Thornburg, 2008; Nathanielsz, 2006; Van den Bergh, 2011). Fetal programming states that the roots of physical illness may be in the prenatal period, and has increasingly included psychological attitudes and behaviours (Räikkönen, Seckl, Personen, Simons, & Van den Bertg, 2011; Van den Bergh, 2005; 2011).

Burkard Schauf (2008), previously senior physician of obstetrics at the University Gynaecological Clinic in Tübingen, now chief physician of the Gynaecological Clinic of the Sozialstiftung Bamberg, gave an unforgettable lecture on the topic, "Fetal programming, diabetes, hypertension, preeclampsia: What influence does the uterine environment have on later life?" Schaufs noticeable empathy with the unborn child was remarkable. …

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