Understanding preeclampsia: what you should know
Preeclampsia (pre-eclampsia) is a condition that occurs when there’s a clinically dangerous spike in a pregnant woman’s blood pressure as well as protein in her urine. It is often coupled with a sudden increase in fluid retention. This condition affects about five percent of all pregnant women.
Women with preeclampsia who have seizures are considered to have eclampsia – a grave condition that will put both mother and foetus at serious risk, and can even result in death.
What causes preeclampsia?
Though scientists and health professionals have been trying to figure out exactly what causes preeclampsia, there is not yet one single defined, verified cause of it. Various theories have been proposed, and the most popular one has to do with the growth and functioning of the placenta.
As the placenta grows and develops, blood vessels grow from the uterine wall, helping the placenta to fully attach to the uterus while providing oxygen and food to the baby. As the pregnancy progresses, so blood volume increases. Sometimes the blood vessels don’t widen and grow accordingly to accommodate the increase, and this constriction results in raised blood pressure in mom.
Other common theories include poor nutrition, genetic predisposition, certain auto immune diseases, obesity, and insufficient blood flow to the uterus.
Who is at risk for preeclampsia?
There is not one definite risk factor that will determine the development preeclampsia, but there are certain factors that could indicate the possibility of it occurring. These include:
- First-time pregnancy
- Teenage pregnancy
- Pregnancy over the age of 40
- History of preeclampsia
- History of high blood pressure prior to pregnancy
- Carrying more than one baby
- History of obesity
- History of lupus, diabetes, kidney disease or rheumatoid arthritis
- Having a sister or mother who has had preeclampsia
When is it likely to develop?
Preeclampsia most commonly occurs after the 37th week of pregnancy, but can occur any time from 20 weeks onward. Sometimes it may even occur earlier on in the pregnancy or it can develop during labour or even after labour, and can stay up to six weeks after the delivery.
Preeclampsia can range from mild to severe, and progress slowly or quickly.
The first signs and symptoms
Apart from the better known symptoms of high blood pressure, swelling, and protein in the urine, preeclampsia can (but not always) include the following:
- Changes in vision
- Severe headaches
- Upper abdominal pain
- Nausea and vomiting
As you can see from these symptoms, you’d be forgiven for assuming that these are normal pregnancy ailments. Because of this, you may not even know that you have the condition until it’s discovered at your antenatal appointments. This is one of the reasons why you are asked to pee on a stick at each appointment and have your blood pressure tested. It’s therefore very important to attend your prenatal visits regularly.
How is preeclampsia diagnosed?
As mentioned above, every time you see your primary care provider, be it your midwife, gynaecologist or GP, you will be given a stick to pee on. This stick measures the amount of protein (among other things) in your urine. You will also have your blood pressure tested each time you have an appointment.
Even if the protein levels in your urine are not elevated, but your blood pressure is higher than it should be (systolic above 140, diastolic above 90), your care provider will more than likely order more lab tests and repeat your blood pressure tests more frequently.
How does preeclampsia affect baby and the pregnancy?
The dangers of preeclampsia are very high, not only for the mom-to-be but for baby as well. High blood pressure is not good for anyone at the best of times, but even more so during pregnancy.
Baby can be affected by possibly being born earlier than expected, either through induction or an emergency Caesarean, and coupled with that, she could be born with a low birth weight due to not receiving sufficient nutrient-rich, well oxygenated blood in utero.
Preeclampsia can also lead to cerebral palsy, blindness, deafness, learning disabilities, epilepsy, and even death in babies.
In moms, preeclampsia can lead to seizures, heart failure, strokes, water in the lungs, bleeding from the liver, bleeding after delivery, and sadly, even death.
What can be done to manage it?
Ultimately the only cure for preeclampsia is for baby to be delivered. Depending on the severity of the condition, this would be held off until baby is ready for birth or if the condition becomes very dangerous. Apart from this, and depending on the degree of the condition, the following steps could be advised:
- Bed rest
- Frequent ultrasounds
- Blood and urine tests
- Blood pressure medication
- Induction or emergency Caesarean
If you have any concerns regarding your pregnancy, previous medical history and preeclampsia, speak to your healthcare provider. With the correct monitoring and care from your primary caregiver, preeclampsia can be successfully managed and it need not be a frightening experience.