Preeclampsia: Everything you need to know

Preeclampsia is a disease during pregnancy in which blood pressure and swelling rapidly increase, often in the face, hands and feet.

The most common complication that occurs during pregnancy is freeclampsia. This occurs usually during the third trimester and affects around 1 in 20 pregnancies.

When the preeclampsia remains untreated, it may develop into eclampsia, where the mother may undergo seizures, coma and may even die. However, preeclampsia problems are exceedingly unlikely if the mom is attending her prenatal appointments.

Fast facts on preeclampsia

Here are a few key points about preeclampsia. The main article provides more descriptions and supporting material.

  • Preeclampsia affects roughly 5 percent of pregnancies.
  • If preeclampsia is untreated, it can develop into eclampsia, a potentially life-threatening condition.
  • The exact causes of preeclampsia are not known but are likely to involve blood vessels in the placenta.
  • Some research implies that there is a genetic component to preeclampsia.
  • According to one study, traffic pollution might be connected to preeclampsia.
A pregnant woman receiving check up
Preeclampsia affects roughly 1 in 20 pregnancies.

Initially, preeclampsia may present no symptoms; however, early signs, include:

The woman will not be conscious of these two symptoms in the majority of cases, and can find out only when a doctor examines her during an antenatal visit.

Even though 6 to 8 percent of all pregnant women experience high blood pressure, this does not necessarily mean preeclampsia is present. The most telling indication of this is the urine production of protein.

When the preeclampsia progresses, the woman may experience fluid retention (edema), with swelling in her hands, feet, ankles and neck.

Swelling, particularly during the third trimester, is a common part of pregnancy and appears to occur in the lower parts of the body, such as the ankles and feet. Usually, symptoms are milder in the morning, and build up throughout the day. It is not preeclampsia, where edema occurs all of a sudden and appears to be even more serious.

Then can show the following signs and symptoms:

  • blurry vision, sometimes seeing flashing lights
  • headaches, often severe
  • malaise
  • shortness of breath
  • pain just below the ribs on the right side
  • rapid weight gain (caused by fluid retention)
  • vomiting
  • decrease in urine output
  • decrease in platelets in the blood
  • impaired liver function

The main sign of preeclampsia in the fetus is growth restriction due to decreased blood supply to the placenta.

Causes

Preeclampsia is thought to be due to insufficiently formed placental blood vessels.
Preeclampsia is thought to be due to insufficiently formed placental blood vessels.

Experts aren’t exactly what causes preeclampsia. Most claim there is a problem with placenta production because the blood vessels supplying it are narrower than normal and respond differently to hormonal signals.

Since the blood vessels are narrower than average, the flow of blood is restricted.

It is not completely understood why the blood vessels grow differently but a variety of factors can play a role; including:

  • damage to the blood vessels
  • insufficient blood flow to the uterus
  • immune system problems
  • genetic factors

Treatment

Preeclampsia is not cured until the baby is delivered.

If the blood pressure drops from the patient, she is at a greater risk of stroke, serious bleeding, separation of the placenta from the uterus and seizures. In certain situations, particularly if the preeclampsia started early, the fetus may not be given the best choice.

Women who have had preeclampsia during prior pregnancies are recommended to attend more regular prenatal sessions. Please prescribe the following medications:

  • Antihypertensives: These are used to lower blood pressure.
  • Anticonvulsants: In severe cases, these drugs are used to prevent a first seizure. The doctor may prescribe magnesium sulfate.
  • Corticosteroids: If the mother has preeclampsia or HELLP syndrome (see below) these drugs can improve platelet and liver functioning. This can prolong the pregnancy.

We also speed up the growth of the baby’s lungs, which is vital if premature birth is to occur. HELLP syndrome is typically best treated with delivery as soon as possible.

Rest

If the woman is far from ending her pregnancy and her symptoms are mild, she can be advised by the doctor to rest in bed. Resting helps bring down blood pressure, which in effect increases blood flow to the placenta, helping the infant.

This is recommended that certain women only lay down in bed and just sit up or stand up when they have to. Others will be permitted to sit on an armchair, couch or bed so they would have strictly limited physical activity. Blood pressure and urine tests are routinely administered. The baby is being closely watched, too.

The woman may need to be hospitalized in extreme situations, and given constant bed rest where she will be closely monitored.

Inducing labor

When preeclampsia is diagnosed near the end of pregnancy, the doctors may prescribe that the baby should be born as soon as possible.

There may be no alternative in very serious situations, so either labor is triggered or a cesarean delivery is made as soon as possible. Mom may be given magnesium sulfate during childbirth to increase uterine blood flow and avoid seizures.

After a few weeks of childbirth the signs of preeclampsia will go away.

Diagnosis

A blood test and urine test are both necessary to diagnose preeclampsia.
A blood test and urine test are both necessary to diagnose preeclampsia.

For a diagnosis of preeclampsia to be made, both of the following tests must come back positive:

Hypertension

Blood pressure is too high for the woman. A measurement of blood pressure above 140/90 millimeters of mercury is anomalous during pregnancy.

Proteinuria

Protein is contained in urine. Urine samples are obtained over 12 hours or more, and the protein content is measured. That may suggest the seriousness of the disease.

The doctor may also order further diagnostic tests:

  • Blood tests – to see how well the kidneys and the liver are functioning and whether the blood is clotting properly.
  • Fetal ultrasound – the baby’s progress will be closely monitored to make sure they are growing properly.
  • Non-stress test – the doctor checks how the baby’s heartbeat reacts when they move. If the heartbeat increases 15 beats or more a minute for at least 15 seconds twice every 20 minutes, it is an indication that everything is normal.

Risk factors

Risk factors associated with preeclampsia include:

  • First pregnancies: The chances of preeclampsia during a first pregnancy are considerably higher than the subsequent ones.
  • Pregnancy gap: If the second pregnancy occurs at least 10 years after the first, the second pregnancy has an increased risk of preeclampsia.
  • New paternity: Each pregnancy with a new partner raises the risk of preeclampsia when compared with a second or third pregnancy with the same partner.
  • Family history: A woman whose mother or sister had preeclampsia has a higher risk of developing it herself.
  • Personal history of preeclampsia: A woman who had preeclampsia in her first pregnancy has a much greater risk of having the same condition in her subsequent pregnancies.
  • Age: Women over 40 and teenagers are more likely to develop preeclampsia compared with women of other ages.
  • Certain conditions and illnesses: Women with diabetes, high blood pressure, migraines, and kidney disease are more likely to develop preeclampsia.
  • Obesity: Preeclampsia rates are much higher among obese women.
  • Multiple pregnancies: If a woman is expecting two or more babies, the risk is higher.

Prevention

This will help keep the blood pressure stable and reduce the risk of preeclampsia.

These can include:

  • drinking between 6 and 8 glasses of water every day
  • avoiding fried or processed food
  • excluding added salt from the diet
  • regular exercise
  • avoiding alcohol and caffeine intake
  • keeping the feet elevated a few times per day
  • resting
  • supplements and medications as prescribed by your doctor

This will help keep the blood pressure stable and reduce the risk of preeclampsia.

After birth

In rare cases, a woman after giving birth can experience high blood pressure. It is known as Preeclampsia Postpartum.

It can happen from a couple of days to a few weeks after getting the baby. High blood pressure and cholesterol are the primary signs in the urine. There may also be the usual underlying preeclampsia symptoms, such as extreme headaches and a swollen face.

Blood pressure drugs and medicines that minimize and avoid seizures are easy to manage. Doctors are likely to prescribe medicine which does not impair breast-feeding capacity.

Complications

If preeclampsia is not treated, the possibility of severe complications occurs. If the woman goes to antenatal appointments complications are unlikely. However, if for whatever reason the disease isn’t treated, the chances are far greater.

Complications from preeclampsia can grow as follows:

HELLP syndrome: HELLP can very easily become life-threatening, both for mother and child. It stands for hemolysis, high liver enzymes and low count of platelets. This is a combination liver and blood clotting condition that most often occurs right after giving birth but may appear after the 20th week of pregnancy at any given time. Quite rarely, this can happen in advance. The only way to successfully handle HELLP’s syndrome is to deliver the baby as early as possible.

Low blood flow to the placenta: When blood flow to the placenta is limited, the baby does not get oxygen and nutrients, which can result in slower development, trouble breathing and premature birth.

Placental abruption: The placenta divides the uterus from its inner wall. In extreme cases, heavy bleeding can occur which could damage the placenta. Some damage to the placenta could endanger the life of the baby and the mother.

Eclampsia: It is a mixture of seizures and preeclampsia. The woman on the right side of her body can feel pain underneath the ribs, extreme headache, blurred vision, confusion, and diminished alertness. If left untreated the woman can go into a coma, suffer irreversible brain damage and die. The baby also has a life-threatening illness.

Cardiovascular disease: People with preeclampsia are more likely to develop cardiovascular diseases later in life.

Preeclampsia can have some long-term effects for the developing baby. Research has shown that high blood pressure in pregnant women can have an effect on the cognitive ability of the infant, which can be carried into later life.

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