What is pre-eclampsia?
Preeclampsia is a serious medical condition that develops during pregnancy. Women with preeclampsia often have high blood pressure (hypertension) and high levels of protein in their urine (proteinuria). Preeclampsia usually develops after the 20th week of pregnancy. It can also affect other organs in the body and be dangerous for both the mother and the developing fetus. Because of these risks, preeclampsia must be treated promptly by a health care provider.
What happens in preeclampsia?
When you have pre-eclampsia, your blood pressure rises (above 140/90 mmHg) and you may have high levels of protein in your urine. Preeclampsia puts pressure on the heart and other organs and can cause serious complications. It can also affect the blood supply to the placenta, affect liver and kidney function, or cause fluid to build up in the lungs. Protein in the urine is a sign of kidney dysfunction.
How common is preeclampsia?
Preeclampsia is a condition that occurs during pregnancy and complicates up to 8% of all deliveries worldwide.
Who can get preeclampsia?
Preeclampsia tends to be more common in early pregnancies. However, it is not clear why some women develop preeclampsia. Some factors that may put you at higher risk are:
- History of high blood pressure, kidney disease or diabetes
- Multiple Pregnancy
- Family history of preeclampsia
- Autoimmune Diseases
- Obesity
What are the symptoms?
Many women with preeclampsia have no symptoms. For those who do, some of the first signs of preeclampsia are high blood pressure, protein in the urine, and fluid retention (this can cause weight gain and swelling). Other signs of preeclampsia include:
- Headaches
- Blurred vision or sensitivity to light
- Appearance of dark spots in your vision
- Abdominal pain on the right side
- Swelling of the hands and face (edema)
- Breathing difficulty
It is essential to share all your pregnancy symptoms with your gynecologist. Many women don't know they have preeclampsia until they have their blood pressure and/or urine checked at an antenatal appointment. Severe preeclampsia can include symptoms such as:
- Hypertensive emergency (blood pressure is 160/110 mmHg or higher)
- Reduced kidney or liver function
- Fluid in the lungs
- Low levels of platelets in the blood (thrombocytopenia)
- Decreased urine output
If your preeclampsia is severe, you may be admitted to hospital for closer monitoring or you may need to deliver your baby as soon as possible. Your obstetrician may give you medicine for high blood pressure or to help the fetus's lungs develop before delivery.
What causes preeclampsia?
As mentioned, there is currently no official cause for the development of preeclampsia. It is believed, however, to come from a problem with the placenta (the organ that develops in the womb during pregnancy and is responsible for delivering oxygen and nutrients to the fetus). The blood supply to the placenta can be reduced in preeclampsia and this can lead to problems for both the pregnant woman and the fetus.
Can stress cause pre-eclampsia?
While stress can affect blood pressure, it is not one of the direct causes of preeclampsia. While some stress is inevitable during pregnancy, it's a good idea to avoid high-stress situations or develop stress management techniques.
What week of pregnancy does preeclampsia start?
Preeclampsia usually occurs after 20 weeks of pregnancy, but can occur earlier. Most preeclampsia occurs near 37 weeks of gestation. Preeclampsia can also occur after giving birth (postpartum preeclampsia), which usually occurs between the first few days and one week after delivery. In rare cases, it starts weeks after giving birth.
Will preeclampsia affect my baby?
Preeclampsia can cause premature labor. Premature babies are at increased risk for health complications such as low birth weight and breathing problems.
How is the diagnosis made?
Preeclampsia is often diagnosed during routine prenatal appointments when the gynecologist checks weight gain, blood pressure and urine. If preeclampsia is suspected, your healthcare provider may: → Write additional blood tests to check kidney and liver function. → Suggest a 24-hour urine collection to monitor proteinuria. → Perform ultrasound and other monitoring of the fetus to see the size of the fetus and assess the volume of amniotic fluid. Preeclampsia can be categorized as mild or severe. You may be diagnosed with mild preeclampsia if you have high blood pressure plus high levels of protein in your urine. You are diagnosed with severe preeclampsia if you have symptoms of mild preeclampsia plus:
- Signs of kidney or liver damage (shown in blood test)
- Low platelet count
- Fluid in the lungs
- Headaches and dizziness
- Impairment of vision or appearance of spots
How is preeclampsia treated?
Your gynecologist will advise you on the best way to treat preeclampsia. Treatment generally depends on how severe the preeclampsia is and how far along you are in the pregnancy. If you are close to full (37 weeks pregnant or more), your baby will likely be born early. You can still have a vaginal birth, but sometimes a C-section is recommended. Your health care provider may give you medicine to help the fetus's lungs grow and to manage your blood pressure until the baby is born. Sometimes it is safer to deliver the baby early than to risk prolonging the pregnancy. When preeclampsia develops earlier in pregnancy, you will be closely monitored in an attempt to prolong the pregnancy and allow the fetus to grow. You will have more prenatal appointments, including ultrasounds, urine tests, and blood tests. You may be asked to check your blood pressure at home. If you are diagnosed with severe preeclampsia, you could stay in hospital until you deliver your baby. If preeclampsia worsens or becomes more severe, your baby will need to be delivered. During labor and after birth, people with preeclampsia are often given magnesium intravenously to prevent the development of eclampsia (seizures from preeclampsia).
Is there a cure for preeclampsia?
No, there is no official treatment for preeclampsia. Pre-eclampsia can only be treated by delivery. Your healthcare provider will still want to monitor you for several weeks after delivery to make sure your symptoms go away.
Prevention- How can I reduce my risk of getting preeclampsia?
For people with risk factors, there are some steps that can be taken before and during pregnancy to reduce the chance of developing preeclampsia. These steps may include:
- Weight loss if you are overweight/obese (before pregnancy-related weight gain)
- Checking your blood pressure and blood sugar (if you had high blood pressure or diabetes before pregnancy).
- Maintaining a regular exercise routine
- Adequate sleep
- Eating healthy foods with low salt content and avoiding caffeine
What are the most common complications of preeclampsia?
If left untreated, preeclampsia can be potentially fatal to both you and the fetus. Before delivery, the most common complications are premature delivery, low birth weight or placental abruption. Pre-eclampsia can cause HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). This happens when preeclampsia damages the liver and red blood cells and interferes with blood clotting. Other signs of HELLP syndrome are blurred vision, chest pain, headaches and nosebleeds. After you give birth to your baby, you may be at increased risk for:
- Kidney disease
- Heart attack
- Stroke
- Development of preeclampsia in future pregnancies
Does pre-eclampsia go away after delivery?
Preeclampsia usually resolves within days to weeks after delivery. Sometimes, your blood pressure may remain high for a few weeks after giving birth, requiring drug treatment. Your healthcare provider will work with you after your pregnancy to manage your blood pressure. People with preeclampsia – particularly those who develop the condition early in pregnancy – are at greater risk for high blood pressure (hypertension) and heart disease later in life. Knowing this information, these individuals can work with their primary care provider to take steps to reduce these risks.
What is postpartum preeclampsia?
Postpartum preeclampsia is when you develop preeclampsia after your baby is born. It usually occurs within two days of giving birth, but it can also develop several weeks later. The signs of postpartum preeclampsia are similar to preeclampsia and include swelling in the extremities, headaches, spotting, stomach pain, and nausea. It is a serious condition that can cause seizures, stroke and organ damage.
What is the difference between preeclampsia and eclampsia?
Eclampsia is severe pre-eclampsia that causes seizures. It is considered a complication of preeclampsia, but can occur without signs of preeclampsia. In rare cases, it can lead to coma, stroke or death.
summarizing
Pre-eclampsia is a serious condition that you may not even know you have. It's important to be consistent with all your prenatal appointments and be open about any symptoms you feel during pregnancy. When preeclampsia is diagnosed early, it can be treated and keep both you and the fetus safe and healthy. Most women with preeclampsia go on to have healthy babies.
