Preeclampsia is a pregnancy complication that is characterized by high blood pressure, swelling, and, on a more serious note, possible system damage. Preeclampsia usually develops after the 20th week of pregnancy and occurs in approximately 5-8% of pregnancies.
Who is at risk?
History of preeclampsia – Women who have experienced preeclampsia in a previous pregnancy, or who have a family history of preeclampsia.
Age – Women over the age of 40.
Multiples – Women carrying twins, triplets, or multiple babies.
The time between pregnancies – Women who have pregnancies less than two years apart or more than ten years apart.
History of certain conditions – Women with high blood pressure, migraines, type 1 or 2 diabetes, kidney disease, lupus, or blood clots.
First-time moms are also at a higher risk of developing preeclampsia. In addition, women who have more than one pregnancy with different fathers are at a greater risk of developing preeclampsia.
What causes preeclampsia?
Unfortunately, the exact cause of preeclampsia is unknown. Medical experts believe that it originates in the placenta. Early in pregnancy, blood vessels develop to help blood circulate through the placenta. In mothers who develop preeclampsia, these blood vessels don’t quite form the way they should. They are more narrow and react differently to hormones, which can limit the amount of blood that flows through them.
Can preeclampsia be prevented?
Doctors are continuing to study possible ways to prevent preeclampsia, but at this time, there are no consistently proven treatment plans. There are theories that eating less salt and watching your calories can help reduce the risk of developing preeclampsia, but they haven’t been proven. The same goes for taking garlic or fish oil supplements, or increasing your intake of vitamins C and E. They just don’t seem to be effective.
There are some situations in which the risk of preeclampsia may possibly be reduced.
If a woman had preeclampsia in a previous pregnancy that resulted in a premature delivery (before 34 weeks) a doctor may suggest taking a daily low dose aspirin. Some women may also benefit from taking a calcium supplement to help prevent preeclampsia. Before starting any vitamin or supplement regimens, it’s best to talk to your doctor first.
If you are considering becoming pregnant, it’s a good idea to be as healthy as possible – especially if you’ve been pregnant and had preeclampsia before. Eat right, exercise, and maintain a healthy weight. Once you become pregnant, it’s important to take care of yourself (and the baby) through routine prenatal care. If preeclampsia is diagnosed early, you will have a better chance of avoiding complications and making healthy choices for you and your baby.
What are the signs and symptoms of preeclampsia?
Preeclampsia is most often associated with high blood pressure. It can develop slowly, but more often it will come on suddenly. Other signs and symptoms of preeclampsia can include:
- Severe headaches
- Changes in vision (temporary loss of sight, blurred vision, sensitivity to light)
- Upper abdominal pain (under the ribs)
- Nausea or vomiting
- Shortness of breath
- Sudden weight gain
- Swelling in the face and hands, known as edema
- Decreased urination
- Excess protein in the urine, or additional symptoms of kidney problems
- Decreased levels of platelets in the blood
- Impaired liver function
Headaches, nausea, aches and pains, and even shortness of breath are all common pregnancy complaints, so it’s hard to tell if new symptoms are just part of being pregnant or if they are an indicator of something more serious. If you’re concerned about your symptoms, contact your doctor right away.
How is preeclampsia diagnosed?
To be diagnosed with preeclampsia, a woman has to have high blood pressure and one of the following complications after the 20th week of pregnancy:
- Protein in the urine
- Low platelet count
- Impaired liver function
- Signs of kidney trouble other than protein in the urine
- Fluid in the lungs
- Frequent headaches
- Problems with vision
If your doctor is concerned about preeclampsia, you may need certain tests. Blood tests can determine how well your liver and kidneys are functioning. They can also indicate whether or not your blood has a normal number of platelets. A urinalysis can measure how much protein is lost in urine, which can indicate the severity of preeclampsia.
The doctor may also recommend close monitoring of your baby’s growth, usually through a series of ultrasounds. The ultrasounds allow your doctor to estimate the baby’s size, weight, and the amount of amniotic fluid in the uterus. In addition, you may be required to undergo nonstress testing. A nonstress test is monitoring the baby’s heart rate when the baby moves.
What pregnancy complications can be caused by preeclampsia?
Preeclampsia may cause several pregnancy complications, which can be dangerous and even life threatening for both mother and baby. Preeclampsia can reduce blood flow to the placenta. If the placenta doesn’t receive enough blood, the baby receives less oxygen and fewer nutrients. This can lead to slow growth, low birth weight, and/or premature birth. Preeclampsia also raises the risk of placental abruption, which means the placenta detaches from the inner lining of the uterus before delivery. Severe placental abruption can cause heavy bleeding.
If preeclampsia isn’t controlled, eclampsia can set in. Eclampsia is basically preeclampsia, plus seizures. Symptoms of eclampsia include abdominal pain, severe headache, vision problems, and decreased mental awareness. With eclampsia, delivery becomes medically necessary, no matter how far along the pregnancy is.
HELLP syndrome is another complication of preeclampsia. HELLP stands for hemolysis, (red blood cells are destroyed) elevated liver enzymes, and low platelet count. Symptoms of HELLP are, again, nausea and vomiting, headache, and abdominal pain; however, HELLP can develop suddenly, even before high blood pressure is detected. HELLP is especially dangerous for mother and baby because it indicates damage to several organ systems. Between 10-20% of women with preeclampsia develop HELLP syndrome.
What treatment options are available for preeclampsia?
Left untreated, preeclampsia can lead to serious, even fatal, complications for both you and your baby. If you have preeclampsia, the only real cure is delivering the baby. Depending on your situation, your doctor may recommend medications available to lower blood pressure, improve liver function, prevent seizures, or boost the development of the baby’s lungs in case of an early delivery. Getting your symptoms under control can help the pregnancy go closer to full term, which is better for the baby.
If your preeclampsia diagnosis comes near the end of your pregnancy, your doctor may suggest inducing labor. In more severe cases, it may not be possible to consider your baby’s age and the doctor may induce labor or schedule a caesarean section. If you are 30 weeks along or less, the cervix may not be able to dilate, so a caesarean section would be your only option.
After delivery, your blood pressure should return to normal within 12 weeks or less. It should be noted that women who have preeclampsia during pregnancy are at a greater risk for high blood pressure, heart disease, and stroke later on in life, making it all the more vital for women to monitor and manage these conditions with their primary care doctor