Preeclampsia

Preeclampsia

This blog post gives you information on preeclampsia – a pregnancy complication caused by high blood pressure. This condition is also called as Pregnancy Induced Hypertension (PIH). If you have high blood pressure or have a history of high blood pressure in the family, bring it to the notice of your gynaecologist as soon as you learn about your pregnancy. An early detection would help you and your doctor make the best choices for you and your baby.

What is preeclampsia?

Preeclampsia is a pregnancy complication characterized by high blood pressure, excessive odema (fluid accumulation in hands and legs), albuminuria (protein in urine) and seizures. These extend to signs of damage to another organ functions. It usually occurs after 20 weeks of pregnancy. It can also occur in the post partum period. If left untreated, preeclampsia can pose serious – sometimes even fatal – complications for the mother and baby.

Who is more likely to be at risk for preeclampsia?

Pregnant women may be at an increased risk for preeclampsia if they:

  • are pregnant for the first time
  • have had preeclampsia in a previous pregnancy or have a family history of preeclampsia
  • have a history of chronic hypertension, kidney disease, or both
  • are 40 years or older
  • are carrying more than one baby
  • having babies less than two years apart or more than 10 years apart
  • have certain medical conditions such as diabetes mellitus, thrombophilia, or lupus, obesity, tendency to develop blood clots
How is it diagnosed?

High blood pressure and increased levels of protein in the urine are warning signs of preeclampsia in pregnant women. However, recent studies show that preeclampsia can develop even without any signs of protein in the urine.

What are the other signs and symptoms?
  • High blood pressure
  • Persistent headache
  • Swelling of face or hands (oedema)
  • Blurry vision
  • Breathing difficulties
  • Rapid weight gain
  • Nausea and vomiting (in the second half of pregnancy)
  • Pain in the upper abdomen or shoulder
  • Decreased urine output
  • Decreased levels of platelets in the blood
  • Impaired liver function
What risks does it pose to the pregnancy?

Limits foetal growth: High blood pressure can decrease the flow of nutrients to the baby through the placenta. This could lead to slow growth, low birth weight, or preterm delivery.

Preterm delivery: If the placenta receives less blood due to high blood pressure, it will not be able to provide enough oxygen and nutrients to the baby. In such cases, keeping the health of the baby in mind, it will be advisable to have a preterm delivery rather than continue with the pregnancy.

Placental abruption: The placenta could prematurely detach from the uterus walls. This is a medical emergency, which results in heavy bleeding and damage to the placenta. Immediate treatment is required.

HELLP syndrome: HELLP — which stands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count — syndrome can rapidly become life-threatening for both you and your baby. Symptoms of HELLP syndrome include nausea and vomiting, headache, and upper right abdominal pain. This syndrome is dangerous because it indicates damage to the organ systems. It may develop suddenly, even before high blood pressure is detected.

Eclampsia: When preeclampsia isn't controlled, eclampsia — which is essentially preeclampsia plus seizures — can develop. Symptoms that suggest imminent eclampsia include upper right abdominal pain, severe headache, vision problems and change in mental status, such as decreased alertness. Because eclampsia can have serious consequences for both mom and baby, delivery becomes necessary.

Increased risk of cardiovascular disease for the mother in the future: To minimize future complications, mothers are advised to maintain an ideal weight by eating healthy and exercising regularly post delivery.

Can preeclampsia be prevented?

Research so far has found no sure-fire way to prevent preeclampsia. However, it is advisable to consult a doctor before you become pregnant if you have high blood pressure or have a history of high blood pressure in the family. Also, if you are overweight, you would be advised to lose weight before you conceive.

Once pregnant, you would need to keep up with your prenatal appointments, eat healthy, quit smoking in case you do. Cut down salty food intake. Do not add table salt to food and stay away from salted snacks. Sodium in salt (sodium chloride) is known to raise blood pressure and in those with diagnosed hypertension, excessive intake may only exacerbate. Do not take any medications without consulting your doctor.