Can we prevent preeclampsia?

Preeclampsia (PE), a specific complication of pregnancy, is one of the most frequent causes of maternal and fetal morbidity and mortality in the world. Recently, PE risk calculation algorithms allowing early detection of PE in the first trimester of pregnancy have been described. The aim of early detection would be to rapidly introduce an effective preventive treatment. The aim of our work is to study the different preventive treatments through the literature. Aspirin has some efficiency and reduces the risk of PE from 10 to 24%. It is most effective when the dose exceeds 75 mg and when introduced before 16 gestational age. Early introduction of aspirin mainly prevents severe and preterm PE. Low molecular weight heparin (LMWH) and vitamin D appear to be promising therapy for PE but further research is required. Calcium administered at 1 g/day reduces the risk of PE especially to patients with low baseline calcium intake. A low dose of calcium could also reduce the risk of PE but this must be confirmed. Other preventive measures (antioxidants, nitric oxide, progesterone, rest, exercise) do not reduce the incidence of PE.