Talk:Pre-eclampsia/Archive 1

Reference to Vitamin D Deficiency
Data suggests that the link between preeclampsia and vitamin D deficiency might be more substantive than this article would lead the reader to believe (this connection is given essentially one line in the whole complicated review, and the average reader would quickly conclude that this is a minor issue). The one study that they reference that shows "no effect from calcium and vitamin D supplementation" used what was probably an insufficient dose of Vitamin D. See http://www.youtube.com/watch?v=Cq1t9WqOD-0 for a very compelling treatment of these issues. Vitamin D3 is really a hormone that functions like a transcription factor, and has wider ranging effects than virtually any other vitamin. It may nfluence as many as 2000 genes, including genes regulating inflammatory cascades, which clearly impact preeclampsia. Someone should update this article to include a more substantial reference to the work on vitamin D and preeclampsia, particularly by Dr. Holick. 207.180.129.233 (talk) DFW Harvard Medical School

Where is the reference for this statement
"Pre-eclampsia may also occur in the immediate post-partum period or up to 6-8 weeks post-partum." The citation at the end of the paragraph to the 2005 BMJ article on late postpartum eclampsia does not reference any reported cases of eclampsia 6-8 weeks after delivery, and I am unable to find any reference beyond 23 days. -- Drjasonmd (talk) 10:49, 5 March 2009 (UTC)

Clone
What did you mean when you said "cloned" in your edit summary, User:Karada? Is this a clone of an already-existing article? If that is the case, you should use a redirect instead. -- Timwi 20:16, 27 Dec 2003 (UTC)

'''It's taking a fragment of an existing article (in this case obstetrics), and beginning to spin it out into a bigger article. Like taking a cutting from a plant. -- Karada 20:17, 27 Dec 2003 (UTC)'''

Some guy think this is a genetic desease. Quote "t is down to a gene passed down to a daughter by their mother"


 * Possibly worth mentioning. If Gus Dekker is behind it, it must be good. There is no comment about the 33%, nor the way in which STOX1 influences the disease. The Pubmed abstract is not available yet. JFW | T@lk  21:46, 4 Apr 2005 (UTC)

Why was this reverted?
I'm not sure about this reversion. It seems to be reasonably well supported. --Arcadian 17:54, 16 September 2005 (UTC)


 * Not everything with a PubMed abstract should need to be in Wikipedia. This is a hypothesis (fellatio decreases risk of toxemia) which is in the process of being investigated, and it has enormous urban legend potential. That itself is not enough. Does anyone suggest fellatio on prescription? Has it found its way into the common media? These are all factors of notability. There are many theories on the exact mechanism and etiology of (pre)eclampsia and HELLP - all give clues but none is conclusive. I strongly disapprove of citing the fellatio example just because it sounds weird. JFW | T@lk  17:29, 19 September 2005 (UTC)

Fellatio and its ability to reduce preeclampsia risk:

There is no need to leave it out as a means of prevention! What can be done is merely to report on the studies' conclusions rather than presenting them as medical facts. The truth of the matter is that the studies were done by highly regarded researchers, and were published in medical journals. We shouldn't have to leave the information out because of all the political correctness crap spun by radical feminists.

The truth is the truth. If immunological tolerance to semen is very likely induced most effectively via oral ingestion, then it should be reported. Although some women may find the idea offensive, there are many women that actually enjoy performing oral sex, and the question of whether or not it is safe to swallow semen during pregnancy keeps coming up in public forums. So why not give them medical science's best answer? I think it's certainly OK to report that studies have shown it is likely not only safe, but helpful.

Anyone opposed to allowing wikipedia to merely report on the studies is obviously trying to skew the facts in favor of some ideology.

If Wikipedia is "merely report[ing] on the studies" then surely my revisions to the immunological tolerance section, which were backed up by a citation of a study published in the top journal on this subject, need not be reverted. It is in fact the case that the hypothesis that sperm tolerance is relevant to preeclampsia is still being investigated and is not confirmed. As the revisions in question are not actually politically motivated (and had they been, surely rather than modifying the claims in the article to reflect current understanding I'd simply have removed all reference to the potential relevance of sexual behavior), I'll restore my edits. Can someone repair the citation to this article for me (I've just inserted it at the relevant bit because I'm not sure, yet, how to create the footnotes): http://www.ncbi.nlm.nih.gov/pubmed/15617622 CarynRogers (talk) 10:20, 25 March 2009 (UTC)

CarynRogers, I incorporated your citation for you. You are partially correct that the theory is still not "confirmed," but there aren't any other theories that have as much evidence behind them as does the theory of immune intolerance. There have been numerous published studies supporting the theory. It has shown up in print, in articles, books, and videos. There are even physicians that prescribe sexual activity in advance of pregnancy. There are very few, possibly NO reproductive biologists that will claim that immune tolerance (or the lack of it) is not relevant to a safe pregnancy. Also, if you read the details on the study you cited, there was a lot of subjective analysis that went into their conclusions, and even then, there WAS an association, but it was just no longer as significant as other studies show. In any case, I added your citation to this article.

Thanks for contributing. It helps keep wikipedia up to date!

I'm well aware of that, which is precisely why I didn't rewrite the entire section. Since the placenta is a foreign organ of *course* maternal tolerance induction is relevant. But maternal tolerance doesn't rely solely on exposure to sperm; as the HLA-C/KIR data from Cambridge makes clear, the trophoblasts of some men produce proteins that can't be detected by their partners regardless of duration of intercourse or use of barrier contraception. (This is aside from the fact that many women will have underlying conditions that make it irrelevant.) The combination of maternal and paternal genes acting in any given pregnancy is perhaps more important, as well as the extent of spiral artery remodelling from prior pregnancies. I'll take a look at your revisions. CarynRogers (talk) 15:38, 25 March 2009 (UTC)

I tweaked it slightly -- see previous explanation and citation 7, the full-text, to see why. CarynRogers (talk) 15:51, 25 March 2009 (UTC)

Induced premature delivery
User:TalkAbout queried my prior revertion of added material, and while I thought the phrasing was unencyclopaedic and duplicated information already given in the article, there is indeed important consequences to the fetus for having an induced delivery occuring pre-term. User:TalkAbout seeks consideration of alternative information/phrasing that might be added... so first copied from my talk page: David Ruben Talk 02:48, 26 August 2006 (UTC) Dear Dave,

I did not state that the steroids were for the treatment of pre-eclampsia but for the benefit of the fetus. The “fetus” is in utero in the mother, treating post delivery does not provide for the possibility of a positive patient outcome (patient being the fetus which at 24 to 34 weeks is viable). If you ask any mother, they would surely like to have the option to know about this treatment.

Also, a series is indicative of more than one; if you like you can edit and state that they are given every 12 hours along with any additional information. It’s your call there. My point is from a patient’s right to know, a patients access to information. Post pre-mature delivery this information is of no of value.

I also note that the article does not state that this condition can be fatal to both mother and fetus. “It is the most common dangerous complication of pregnancy--impacting both the mother and the fetus.”

Davidruben wrote: (rv as link clearly describes, steroids are used in premature delivery "usually 24 to 34 weeks", not specifically needed for pre-eclampsia. Also link discusses giving just one vs several injections)

Removed edit: Steroid injections (Betametasane and Decadron) may have to be requested by the mother or family as doctors may feel that delivery will come quickly and the steroid injections are given in a ‘’’ series over a 24 hour period.’’’ These injections will help the development and maturity of the fetal lungs.

So Doc, can you develop an edit that will meet your standards, that you can approve of or should I get a second opinion in my family of Docs? PEACE 01:47, 26 August 2006 (UTC) User:TalkAbout


 * Limited space in edit summary - what I was trying to indicate was that the steroids are given for imminent premature delivery, not specifically because of the underlying reason for the premature delivery. Similarly the article makes no mention of the requirement for SCBU monitoring of babies born prematurely or increased risks intracerebral haemorrhages - its not directly relevant to the article on pre-eclampsia (but vital in premature birth article).
 * Wikipedia is neither a how-to-guide nor gives medical advice - so the bit about "have to be requested by the mother or family as doctors may feel that" just seemed awkward English, unless that is doctors specifically forget about steroids in cases of pre-eclampsia, in which case one would need to WP:Cite to WP:Verify (the Obstetric Unit I worked at had, like all such UK units, very clear guidelines for the management of cases of pre-eclampsia which included details of when steroids should be given to cover the possibility of urgent delivery being required – so unless there is evidence that such protocols are not followed, it was always my experience that the use of steroids was always initiated by the doctors or midwives on the unit following the protocols). Likewise the article does not give advice that mother/family similarly need supervise/instruct/request that their doctors monitor state of the foetus, blood pressure, urine output, urine protein leakage, urate/D-Dimer/Coagulation levels or check for hyper-reflexia.
 * Finally the text removed was duplication of information already in the article - "In some cases women with preeclampsia or eclampsia can be stabilized temporarily with magnesium sulfate intravenously to forestall seizures while steroid injections are administered to promote fetal lung maturation"
 * Do you think the article needs instead more a mention that when induced delivery becomes required, then in cases under 37 weeks this is done despite (?irrespective of) the additional risks to the foetus/neonate for being delivered prematurely ? i.e.something added after the existing mention of use of steroids, along lines of:
 * "... to promote fetal lung maturation. When induced delivery needs to take place before 37 weeks gestation, it is accepted that there are additional risks to the baby from premature births that will require additional monitoring and care." ? David Ruben Talk 02:48, 26 August 2006 (UTC)
 * Dear Dave,
 * This:"... to promote fetal lung maturation. When induced delivery needs to take place before 37 weeks gestation, it is accepted that there are additional risks to the baby from premature births that will require additional monitoring and care." The addition is a good. Regards TalkAbout 19:48, 26 August 2006 (UTC)

sFlt1:PIGF
Watch. JFW | T@lk  07:08, 7 September 2006 (UTC)

COPYRIGHT VIOLATIONS: ALMOST ENTIRE ARTICLE IS LIFTED
Much of this article has been lifted from "Clinical Obstetrics and Gynaecology" by James Drife and Brian Magowan. I don't have time to remove it at the moment but I thought I should let moderators know. Of particular note, the section mentioning the increase in diameter of maternal arteries five-fold, lifted from page 368 onwards.


 * Please tell us which sections are copyright violations. I will remove the stolen content and replace it with something original. JFW | T@lk  13:41, 4 October 2006 (UTC)

Most of the article is copied wholesale. I have put the copied sections in chevrons below:


 * Now that this issue has been resolved, I have removed the offending content from this talk page too!PsychoticSock 18:34, 22 November 2006 (UTC)

Obviously this takes out most of the article! Good luck replacing it...


 * Hi there, before you make any alterations to this article, I must ask you to follow correct copyright violation process at WP:COPYVIO. If you believe this article in indeed a copyright violation, please return here with a link to the source text in order that I or another user make confirm whether or not your claim is valid. In the meantime you should refrain from making any alterations to this article. If you remove any part of this article without following correct WP:COPYVIO procedure, your edits may be reverted (as page blanking vandalism) and potentially your access to this article or to Wikipedia could be blocked. It is, as you may gather, rather unusual for an unregistered user to come forward claiming copyright violations without providing any evidence to backup their claims. I apologise in advance if this seems unduly harsh, this is not my intention. I don't want to see you or Wikipedia suffer over this article. Kind Regards -  Heligoland   |   Talk  |   Contribs  21:02, 8 November 2006 (UTC)

As I stated earlier, the material has been directly lifted from a book (which I own) "Clinical Obstetrics and Gynaecology" by James Drife and Brian Magowan. ISBN:0-7020-1775-2 Chapter 39, Pregnancy-induced hypertension, Pages 367-370. I came to Wikipedia to cement my knowledge and what I found on this page seemed all too familiar...

I just realised that I did register after all, thus I shall sign for the above. PsychoticSock 19:44, 11 November 2006 (UTC)

Treatment
Wouldn't terminating the pregnancy also be a valid treatment for this? Svenna 23:13, 26 June 2007 (UTC)
 * It is not always the first choice, i.e. insufficiently matured foetus. Nomen Nescio Gnothi seauton 00:10, 27 June 2007 (UTC)

The sense has gone awol here
"Some women will experience pre-eclampsia, though this is rare. It is much more common in women who are pregnant for the first time.[2]" A word or phrase has gone missing here. The context demands "in subsequent pregnancies" or something. I am not a medic, I don't know. Can someone insert the necessary? 134.2.147.82 17:32, 6 August 2007 (UTC)

Cardiac markers
suggests that preeclampsia is not normally associated with raised cardiac markers. This finding should prompt further cardiological investigations. JFW | T@lk  14:35, 30 August 2007 (UTC)

Plugs for university
This article unnecessarily mentions the University of Adelaide multiple times, especially in the context of ongoing research. If we were to start listing all of the universities that are currently researching diseases, or that have in the past, every disease article would be mostly insignificant information. Mauvila 05:13, 2 December 2007 (UTC)

verification
I cannot pull up the article cited for the following claim... Can someone please try to verify it?

"Consistent with the fact that human immune systems tolerate things better when they enter the body via the mouth, the Dutch researchers conducted a series of studies that confirmed a surprisingly strong correlation between a diminished incidence of pre-eclampsia and a woman's practice of oral sex, and noted that the protective effects were strongest if she swallowed her partner's semen."

71.234.109.192 (talk) 01:07, 15 January 2008 (UTC)

New Pre-eclampsia test allows earlier detection
Researchers state they have discovered identifying symptoms of pre-eclampsia that can be detected earlier than 20 weeks, and that they "plan to develop a user-friendly diagnostic kit within five years which could be used in hospitals all over the world to safely and speedily test all pregnant women." (press release)

Press Release

Journal Article:

It sounds to me as if this could be pertinent to know that new information has been identified and that a simple test could be available in about 5 years.

Thoughts welcome

- JasonSpradlin82 (talk) 15:59, 12 February 2008 (UTC)

Immunological tolerance: unreliable source for the Dutch research
As New Scientist is not peer-reviewed I'd ask for a more appropriate source to be added to back up the description of research by the Dutch scientists in regard to oral sex and semen ingestion if it is to stay in the article. Per RS: "Material that has been vetted by the scholarly community is regarded as reliable; this means published in peer-reviewed sources, and reviewed and judged acceptable scholarship by the academic journals." --Eleassar my talk 10:51, 15 May 2008 (UTC)

Please see the citations. There is a definite link, as is demonstrated by the many peer-reviewed studies discussing the topic. -2009

Complications
This article would be more complete if specific complications due to preeclampsia (such as an increased risk of abruption, increased risk of pre-term labour etc.) were included in its contents. 121.210.98.66 (talk) 00:12, 11 February 2011 (UTC)

Magnesium sulfate
...only in recent years did (Magnesium sulfate's) use in the UK replace the use of diazepam or phenytoin. Amazing. Magnesium sulfate was the only medication I used for pre-eclampsia in Viet Nam in 1970. Mirrordor 06:50, 14 November 2011 (UTC) — Preceding unsigned comment added by Mirrordor (talk • contribs)

Anti-concision
In April there was a "concision" edit and I suspect that it removed more than it should have, because the reference-tag, categories and all inter-wiki links fell as well, together with a Cochrane review reference. I've now reinserted removed segments from the bottom and up to the previous level, and reinserted that Cochrane reference, but I didn't revert the minor reformulations. Mikael Häggström (talk) 15:22, 14 June 2012 (UTC)

Does this source state this?
From the abstract, the source of the statement below doesn't seem to reflect what the entry is claiming. Would someone with access to the entire paper like to confirm? Mikael Häggström (talk) 15:36, 14 June 2012 (UTC)

Copyright claim
And the "other symptoms" section has at least one paragraph lifted verbatim from page 183 of Medical Disorders in Obstetric Practice by Michael De Swiet and is used without permission from the copyright holder (1984, 1989, 1995, and 2002 by Blackwell Science LTD).

Many other sites are unknowingly violating the copyright because they think that Wikipedia holds the license to the content. http://www.news-medical.net/health/What-is-Pre-eclampsia.aspx writes: "This article is licensed under the Creative Commons Attribution-ShareAlike License. It uses material from the Wikipedia article on "Pre-eclampsia" All material adapted used from Wikipedia is available under the terms of the Creative Commons Attribution-ShareAlike License. Wikipedia® itself is a registered trademark of the Wikimedia Foundation, Inc." — Preceding unsigned comment added by 71.115.108.214 (talk) 14:46, 16 August 2012 (UTC)
 * Mirrors/copiers of Wikipedia content are outside of our jurisdiction and not something that we need to worry about. violet/riga [talk] 08:57, 17 August 2012 (UTC)

On closer inspection, it appears as though nearly the entire article is lifted, word for word, from a Princeton University publication, copyrighted in 2006. Princeton bought the copyright for some of the content from Blackwell Science LTD, who had an original copyright from 1984, 1989, 1995, and 2002. Footnotes are stolen directly from the original content. Almost no original research has been done.

Original copyright holder: http://www.websters-online-dictionary.org/definitions/pre-eclampsia 2006

Original original copyright holder: Michael De Swiet, Medical Disorders in Obstetric Practice. 1984-2002.

Another copyright holder made a complaint of lifted content, apparently three pages of his work from Clinical Obstetrics and Gynaecology by James Drife and Brian Magowan (c2006) on pregnancy-induced hypertension. This section has been drastically reduced and now contains a "fake" footnote, #4, which links to information on a blood pressure monitor, having no relevance to and providing no support for the information presented. When I figure out how to report it, I will. This article needs a nomination for speedy deletion, I think. — Preceding unsigned comment added by 71.115.108.214 (talk) 15:24, 16 August 2012 (UTC)

Oh, well, I tried to follow the directions for speedy deletion nomination and ended up putting the page itself as the original source. The directions for reporting copyright violations read like an alien language! Please see above notes for original source for this article, and the original copyright holders.
 * The "Original copyright holder" as you put it gets their content from us. As for the "original original" it's difficult to check but I will have a go at looking into it. violet/riga [talk] 08:57, 17 August 2012 (UTC)
 * Right, so looking through that book with the help of Google (here) I can't even find anything I would consider close paraphrasing. Could you please give me a more detailed example of the copied content? violet/riga [talk] 09:05, 17 August 2012 (UTC)

http://books.google.com/books?id=dvtEBZaBOe0C&pg=PA173&lpg=PA173&dq=The+epigastric+pain,+which+reflects+hepatic+involvement+and&source=bl&ots=OjuVK16DcO&sig=XTE5RB5ZhNuhV81dX71nuyOJSDc&hl=en&sa=X&ei=55EuUI3MN6q9ywHM14DgBg&ved=0CGUQ6AEwBQ#v=onepage&q=The%20epigastric%20pain%2C%20which%20reflects%20hepatic%20involvement%20and&f=false

Page 173 paragraph 7, for example, (linked above) has been just copied and pasted into this article. If you google any number of phrases, you will find they have been lifted from these medical books, and the information is still under copyright. — Preceding unsigned comment added by 71.115.108.214 (talk) 18:53, 17 August 2012 (UTC)
 * That sentence was introduced nearly six years ago by a user who has since left Wikipedia. This does still need further investigation, certainly. violet/riga [talk] 23:45, 19 August 2012 (UTC)

Missing text
At the bottom of the section titled "Causes", there is a partial sentence. — Preceding unsigned comment added by 75.87.103.29 (talk) 01:53, 20 April 2013 (UTC)