Preeclampsia

Preeclampsia is a serious complication during pregnancy which can affect approximately 5-8% of pregnant women. It can begin with high blood pressure and proceed to become more severe that it can be life-threatening in some cases.

Last Updated: Oct 22, 2020 11:29 GMT

Preeclampsia
Preeclampsia
What is preeclampsia?

One of the important routine checks your doctor will do during your prenatal visits is measuring your blood pressure. If your blood pressure shows a reading equal to or greater than 140/90 consistently, your doctor may likely suspect preeclampsia. Preeclampsia develops generally during the last trimester but there are chances that it can also happen in the earlier stages of pregnancy in which case it carries higher risks to the mother and the baby. In rare cases, it preeclampsia can affect the mother post delivery.

What are the symptoms of preeclampsia?

Preeclampsia may not always show signs. It can happen silently or warn with one or more of the following symptoms:

High blood pressure (over 140/90 mm Hg) measured at two time periods with an interval of at least four hours is the most commonly the first sign of preeclampsia. However, high blood pressure may not always indicate preeclampsia. It can point to other conditions including chronic hypertension, HELLP syndrome or gestational hypertension.

Normal pregnancy signs which are a part of most pregnancies can overlap with the symptoms of preeclampsia as well. They include:

·         Swelling of feet and ankles

·         Nausea

·         Weight gain

·         Shortness of breathe

Unusual swelling on the face and hands, however, is abnormal and can be a sign of preeclampsia. Said that, it must also be noted that preeclampsia may be present without noticeable swelling.

If identified with high blood pressure, a urine test for protein accumulation is a must. Excess of protein in the urine is symptomatic of preeclampsia.

Severe cases of preeclampsia include the following signs:

·         Persistent headache

·         Changes in vision such as blurred vision, seeing spots, sensitivity to light or even temporary loss of vision

·         Pain on the upper right abdomen, just below the ribs

What causes preeclampsia?

Preeclampsia cannot be traced down to one single cause. The root of the problem is believed to be the way the placenta develops during the very early stages of pregnancy. Placenta is a vital organ which supplies the nutrition that is required for the growing baby throughout pregnancy. Development of a strong network of blood vessels to supply blood to placenta is crucial. A decreased blood flow to the placenta can lead to preeclampsia. It may be caused by:

·         An abnormality in the implantation of placenta

·         Constricted blood vessels

·         Physical damage to the walls of the arteries that connect to the placenta

·         A disorder of the mother’s immune system

·         Not enough blood circulation

What are the complications of preeclampsia?

Preeclampsia if not treated early can pose serious risks to the mother and the baby. The complications may vary with the severity of the condition, the stage of pregnancy during its onset and how early it is diagnosed and treated. Here are the most common complications of preeclampsia:

Fetal growth restriction: When the blood supply to the placenta is restricted in preeclampsia, it directly results in decreased nutrition and oxygen supply to the fetus, thus restricting the normal development of the baby.

Premature delivery: As soon as preeclampsia is diagnosed, taking the baby out is the most preferred treatment in order to save the mother and the baby. This may often result in premature arrival of the baby which may require intensive post natal care.

HELLP syndrome: Preeclampsia can lead to another serious condition called the HELLP syndrome. HELLP is an abbreviation of the triad signs that are characteristic of the condition, namely, Hemolysis, ELevated liver enzymes, Low Platelet count. Major complications for pregnant mothers with HELLP syndrome are:

·         Placental Abruption – breaking apart of the placenta from the uterine wall during pregnancy

·         Blood clotting disorder leading to bleeding problems

·         Kidney failure

·         Accumulation of fluid in lungs, abdomen or brain

·         Liver injury, damage or rupture

·         Retinal detachment – retina detaches from the tissue layer underneath

Babies born to mothers affected with HELLP syndrome are at higher risk of premature birth (before 28 weeks) resulting in

·         Intrauterine growth restriction (IUGR)

·         Low birth weight

·         Neonatal respiratory distress syndrome (Neonatal RDS) – complications in newborn breathing because of under developed lungs.

Eclampsia: An untreated preeclampsia may result in eclampsia, in which the pregnant mother suffers from seizures in addition to preeclampsia symptoms.

Other complications include damage to the functioning of kidneys, liver, lungs, or eyes and increased risk for cardiovascular diseases in the future.

How is preeclampsia treated?

In the case of mild preeclampsia and the mother is at least 37 weeks, labor will be induced or a C-section will be carried out to deliver the baby. If less than 37 weeks, the mother will have to be closely monitored in the hospital and often resting will be advised to maintain a stable blood pressure.

 

If pregnancy is in a much earlier stage, medications to induce the maturation of the fetal lungs will be administered in order to speed up the process of delivering the baby at the earliest. 

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