Pre-eclampsia: What every pregnant woman should know

PRE-ECLAMPSIA is a medical condition that usually develops in the second half of pregnancy. It is characterised by high blood pressure and protein in the urine or one of the organs such as the liver, kidney or brain being affected. It may also develop in labour or even after the baby is born.

What causes pre-eclampsia?

It is thought to arise from abnormal development of the placenta (the organ that develops in the pregnancy which is responsible for transporting oxygen and nutrients to, and waste from the baby). This abnormal development of the placenta potentially leads to poor blood flow to the baby. Additionally, there is an abnormal production of substances in the blood that leads to high blood pressure in the expectant mother.

What is the danger of pre-eclampsia?

It can affect the mother's organs including the liver, kidneys, brain and eyes. It can also cause the baby to be smaller than normal. Additionally, if it is very severe and develops early in the pregnancy, there is a high risk of having the baby too early (preterm birth), stillbirth (baby born with no signs of life) or neonatal death (death of a baby in the first four weeks of life).

What are the symptoms of pre-eclampsia?

Many patients do not experience symptoms and only find out after their blood pressure and proteins are checked at a prenatal visit. The symptoms include headaches (usually at the front of the head), sudden swelling in the face and hands, visual changes including blurred vision or flashes of light, as well as pain in the upper belly. Quite often, these symptoms occur when the condition is severe.

What should a pregnant woman do if she has these symptoms?

It's best to tell your doctor or nurse about your symptoms so that they can examine you, check your blood pressure and proteins in the urine. The symptoms and signs can be put in context as some of these symptoms can be experienced in normal pregnancy. The doctor will decide if further testing is needed. Blood tests can be done to determine if the organs are affected. Sometimes the doctor may even recommend admission to hospital depending on the level of blood pressure elevation and the clinical scenario.

What is the treatment for pre-eclampsia?

The only definitive treatment for pre-eclampsia is delivery of the baby. If pre-eclampsia develops earlier in your pregnancy, for example, before 34 weeks and it is not severe, your doctor may choose to prolong the pregnancy to achieve further maturity of the baby while monitoring you for complications. It is often a delicate balance between trying to give the baby the best chance of survival and ensuring the safety of the mother. Many patients can have a successful vaginal birth which may be achieved by inducing labour; however, a Caesarean section may be indicated depending on the clinical picture.

Can pre-eclampsia be prevented?

Once a pregnancy is established and gone beyond 20 weeks, there is generally no intervention to prevent it. The best thing for women to do is keep up with the pregnancy visits so the condition can be picked up early if it is present. If the woman has risk factors such as pre-eclampsia in a previous pregnancy or chronic high blood pressure, the doctor may choose to start low-dose aspirin to reduce the risk.

Can pre-eclampsia affect my long-term health?

The answer is yes. Associations have been found between pre-eclampsia and cardiovascular disease (including high blood pressure and heart disease) later in life. The risk can be reduced by maintaining a healthy diet, exercising, refraining from smoking, and keeping up with your health checks regularly.

Dr Hunter is a lecturer/consultant ObGyn and maternal foetal medicine specialist. Check her out on Instagram @drthunterobgyn.

Dr Tiffany Hunter

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