Preeclampsia

Preeclampsia is a condition that occurs only during pregnancy. Some symptoms may include high blood pressure and protein in the urine, usually occurring after week 20 of pregnancy. Preeclampsia is often precluded by gestational hypertension. While high blood pressure during pregnancy does not necessarily indicate preeclampsia, it may be a sign of another problem. The condition affects at least 5-8% of pregnancies.

Preeclampsia Causes, Treatment and Prevention

Who is at risk for preeclampsia?

  • A first-time mom
  • Previous experience with gestational hypertension or preeclampsia
  • Women whose sisters and mothers had preeclampsia
  • Women carrying multiple babies
  • Women younger than 20 years and older than age 40
  • Women who had high blood pressure or kidney disease prior to pregnancy
  • Women who are obese or have a BMI of 30 or greater

What are the symptoms?

Preeclampsia sometimes develops without any symptoms. High blood pressure may develop slowly, or it may have a sudden onset. Monitoring your blood pressure is an important part of prenatal care because the first sign of preeclampsia is commonly a rise in blood pressure. Blood pressure that exceeds 140/90 millimeters of mercury (mm Hg) or greater — documented on two occasions, at least four hours apart — is abnormal.

Mild preeclampsia: high blood pressure, water retention, and protein in the urine.

Severe preeclampsia: headaches, blurred vision, inability to tolerate bright light, fatigue, nausea/vomiting, urinating small amounts, pain in the upper right abdomen, shortness of breath, and tendency to bruise easily.

Other signs and symptoms of preeclampsia may include:

  • Excess protein in your urine (proteinuria) or additional signs of kidney problems
  • Severe headaches
  • Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
  • Upper abdominal pain, usually under your ribs on the right side
  • Nausea or vomiting
  • Decreased urine output
  • Decreased levels of platelets in your blood (thrombocytopenia)
  • Impaired liver function
  • Shortness of breath, caused by fluid in your lungs

Contact your doctor immediately if you experience blurred vision, severe headaches, abdominal pain, and/or urinating very infrequently.

How do I know if I have preeclampsia?

At each prenatal checkup, it’s important that your healthcare provider checks your blood pressure because an early symptom of preeclampsia is a rise in blood pressure. Blood pressure that exceeds 140/90 millimeters of mercury (mm Hg) or greater, documented on two occasions, at least four hours apart is abnormal.

Your physician may also perform other tests that include: checking your urine levels, kidney and blood-clotting functions; an ultrasound scan to check your baby’s growth; and Doppler scan to measure the efficiency of blood flow to the placenta.

What is the treatment?

Treatment depends on how close you are to your due date. If you are close to your due date, and the baby is developed enough, your health care provider will probably want to deliver your baby as soon as possible.

If you have a mild case and your baby has not reached full development, your doctor will probably recommend you do the following:

  • Rest, lying on your left side to take the weight of the baby off your major blood vessels.
  • Increase prenatal checkups.
  • Consume less salt
  • Drink at least 8 glasses of water a day
  • Change your diet to include more protein

If you have a severe case, your doctor may try to treat you with blood pressure medication until you are far enough along to deliver safely, along with possibly bed rest, dietary changes, and supplements.

How can preeclampsia affect the mother?

If preeclampsia is not treated quickly and properly, it can lead to serious complications for the mother such as liver or renal failure and future cardiovascular issues.

It may also lead to the following life-threatening conditions:

  • Eclampsia– This is a severe form of preeclampsia that leads to seizures in the mother.
  • HELLP Syndrome (hemolysis, elevated liver enzymes, and low platelet count)- This is a condition usually occurring late in pregnancy that affects the breakdown of red blood cells, how the blood clots, and liver function for the pregnant woman.

How does preeclampsia affect my baby?

Preeclampsia can prevent the placenta from getting enough blood. If the placenta doesn’t get enough blood, your baby gets less oxygen and food. This can result in low birth weight. Most women still can deliver a healthy baby if preeclampsia is detected early and treated with regular prenatal care.

How can I prevent preeclampsia:

The exact cause of preeclampsia is not known. It’s thought to be improper functioning of the placenta including insufficient blood flow to the placenta. Other factors that may increase risk include: high fat and poor nutrition; immune function disorders; genetic issues or a family history.

Currently, there is no sure way to prevent preeclampsia. Some contributing factors to high blood pressure can be controlled and some can’t. Follow your doctor’s instruction about diet and exercise.

What are the Causes of Preeclampsia?

According to the Mayo Clinic, the exact cause of preeclampsia involves several factors. Experts believe it begins in the placenta — the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta.

In women with preeclampsia, these blood vessels don’t seem to develop or function properly. They’re narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them.

Causes of this abnormal development may include:

  • Insufficient blood flow to the uterus
  • Damage to the blood vessels
  • A problem with the immune system
  • Certain genes

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Compiled using information from the following sources:

1. Medscape; Hypertension and Pregnancy

2. Preeclampsia Foundation

3. Mayo Clinic