For most of human history, we've had no choice but to be reactive about preeclampsia. Wait for it to strike, try to detect it as early as possible, and then deliver the baby. Which is why about 70,000 women die from preeclampsia every year globally (in fact that number is probably higher, because in many parts of the world, cases just aren't reported accurately).

But things are changing.

And the story of what’s changing, and why it’s important, comes from my guest on the show this week, Dr Neel Shah, OBGYN and Chief Medical Officer at Maven Clinic. ​

I appreciated his candor when he told me “As a clinician, preeclampsia can be scary” - and this opens the episode. He goes on to explain what exactly preeclampsia is, and why we’ve been on the back foot with this condition all along.

I found this exchange particularly insightful - here's an excerpt from the episode script.

That led us to a really interesting conversation about the very simple, unobtrusive devices we have today which are powerful tools for health - the Apple watch for example, which can check blood pressure …. And which not everyone can afford. And Dr Shah laid out a really interesting framework for thinking about the cost of health, and healthcare.

He also outlined the story of how the science evolved for this condition, through the work of Dr Ananth Karumanchi and Dr Sarosh Rana. The discovery of a protein associated with preeclampsia has now led to the development of blood tests that can predict it.

After years of being on the back foot with preeclampsia, we’re finally figuring out how to see it coming. And with a maternal mortality crisis on our hands here in the US, this is a big step forward.

A couple more resources to go deeper on this:

-I knew I wanted to do this topic on the show when I read Dr Shah’s newsletter on preeclampsia. ​

-Making sense of preeclampsia tests, from the Preeclampsia Foundation.

-More on Dr Sarosh Rana.​

-More on Dr Ananth Karumanchi.​

Do you have a preeclampsia story to tell, or an overlooked condition you want me to look into for an episode? Leave a voice memo here.​

If you’re catching up, newsletters from past episodes are here.​

What else is going on with me right now:

Wishing you the best of health,

Golda