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Preeclampsia is characterized by high blood pressure & proteinuria induced by pregnancy (Advanced Prenatal Therapeutics [APT], n.d.).

It contributes to 15% of preterm deliveries and between 9-26% maternal deaths globally (Townsend, O'Brien, & Khalil, 2016).

The treatment options for preeclampsia are still very limited, mostly confined to hypertension medications, bed rest, and birthing the baby, which is essentially a cure for the disease (Medgadget, 2019).

For more information on preeclampsia, please see this short video by the  Preeclampsia Foundation (2017).

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7 Symptoms Every Pregnant Woman Should Know

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Apheresis is a common procedure similar to kidney dialysis in which the patient’s blood is passed through a device that separates and removes a particular substance from the blood and returns the cleaned blood back to the patient (APT, n.d.).
To see apheresis in action, please see this video by Blanco (2017).

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In preeclampsia, the placenta produces proteins that prevent the action of certain growth factors that regulate blood vessel growth and are believed to contribute to maternal high blood pressure (APT, n.d.).

To treat the patient:

Blood is pumped through an apheresis machine, which separates blood into plasma and blood cells.

The plasma is then circulated through the Targeted Apheresis Column for Preeclampsia (TAC-PE) device, which is an apheresis column that selectively removes certain factors from the mothers blood while leaving the rest of the blood components intact.

The cleaned plasma is then remixed with the blood cells and returned to the patient (APT, n.d.).

*No video available of TAC-PE in use with apheresis machine.

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May alleviate maternal high blood pressure and other symptoms of preeclampsia.

May possibly extend the duration of the pregnancy.

Offers another treatment option when treatment options are limited.

Pregnancy does not represent a contradiction to apheresis (Marson et al., 2015).

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FDA approved in May 2019: may need to overcome fears/bias of receiving blood products or performing procedures on pregnant women and babies that may be considered high risk.

Cost: apheresis is expensive especially if not reimbursed by insurance.

Some technical aspects of apheresis will need to be carefully considered due to physiological changes of gestation such as the increase of circulating blood volume  (Marson et al., 2015).

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As someone that travels to various hospitals to perform apheresis procedures, it is evident there is a lack of awareness regarding the clinical applications for apheresis as it treats a wide variety of diseases.  I was surprised to learn of yet another new apheresis application with the addition of the TAC-PE device.  My first reaction was that I would hesitate to treat a pregnant patient as noted in the disadvantages, but research shows that the procedure is safe for mother and baby in other apheresis treatments.  Initial studies showed that pregnancy was extended by eight days for patients receiving one treatment and up to fifteen days for women receiving multiple treatments ("Therapy May," 2015). Several Medgadget articles show estimated trends of a massive growth in the blood preparation market, and I believe that clinicians educated to apheresis treatments will help grow this market. I look forward to being able to apply this new treatment to my practice and appreciate how apheresis technology is offering new treatment options.

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Advanced Prenatal Therapeutics. (n.d.). Retrieved from https://www.advancedprenatal.com/

Blanco, Antonio. (2017, July 25). Therapeutic Apheresis [Video file]. Retrieved from https://www.youtube.com/watch?v=8lzdniwYAR4

Marson, P., Gervasi, M. T., Tison, T., Colpo, A., & Silvestro, G. D. (2015). Therapeutic apheresis in pregnancy: General considerations and current practice. Transfusion and Apheresis Science, 53(3), 256–261. doi: 10.1016/j.transci.2015.11.004

Medgadget. (2019, April 23). New Device Cleans Blood to Treat Preeclampsia. Retrieved from https://www.medgadget.com/2019/04/new-device-cleans-blood-to-treat-preeclampsia.html

Preeclampsia Foundation. (2017, April 26). 7 Symptoms Every Pregnant Woman Should Know [Video file]. Retrieved from https://www.youtube.com/watch?v=dqMXyDLiUqg&feature=youtu.be

SciTechTrend. (n.d.). [Red blood cells] [Photograph]. Creative Commons. https://search.creativecommons.org/photos/0154214c-fee9-4a26-843b-6524f3539cf6

Therapy May Cut Preterm Delivery from Preeclampsia. (2015). Retrieved from https://www.kidneynews.org/kidney-news/cover-story/therapy-may-cut-preterm-delivery-from-preeclampsia

Townsend, R., O'Brien, P., & Khalil, A. (2016). Current best practice in the management of hypertensive disorders in pregnancy. Integrated blood pressure control, 9, 79–94. https://doi.org/10.2147/IBPC.S77344

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My top strengths are futuristic, strategic, restorative, relator, and achiever.  Because of my strengths, I have selected the following for my team:

Analytical Angelica because analysis is a part of strategic thinking (numbers, figures, and charts) that I do not enjoy.

Context Carols because as a rule of thumb I try not live in the past. I would prefer to team with someone that enjoys thinking about the past and researching history.

Focus Fernando because as someone that is always multi-tasking things sometimes get lost. I need someone with good follow through and to keep me on track.

Maximizer Matthew because as someone that likes to stimulate excellence it is always great to have another set of eyes from someone that also does the same.

Responsibility Randall because honesty and loyalty are important values for me and will aide in successful execution.