Every pregnancy deserves a healthy outcome. Educate, advocate, eradicate.
Preeclampsia (PE) is a complication of pregnancy. Its main symptoms are high blood pressure, and high levels of protein in urine. If untreated, it can be fatal to mother and to baby.
In India, 5-15% pregnant women have preeclampsia. And 1.5% have eclampsia, which is new onset of seizures or coma not related to an existing brain condition.
Symptoms
Important to note that PE may not cause any noticeable symptoms.
Usually, the main symptom is high blood pressure. High level of protein in urine (proteinuria), a sign of kidney damage, or other signs of damage to the kidneys or other organs are other tell-tale signs.
Other symptoms may be:
- Severe headaches
- Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
- Increased liver enzymes that indicate liver problems
- Shortness of breath, caused by fluid in the lungs
- Pain in the upper belly, usually under the ribs on the right side
- Decreased levels of platelets in blood (thrombocytopenia)
- Nausea or vomiting
Other symptoms may be sudden swelling mainly in the legs and feet but also in face and hands, and sudden weight gain.
The swelling is caused by too much fluid trapped in the body’s tissues (Edema). Weight gain and some swellings are normal during pregnancy. But sudden and excess of these signals problems that should be investigated.
Causes
Early in pregnancy, new blood vessels develop in the placenta to supply oxygen and nutrients to the fetus. In some pregnant women these vessels may not develop or may not work properly, and blood may not circulate well in the placenta. This may cause poor regulation of blood pressure in the mother.
Risk factors
Women with these conditions are at a higher risk of preeclampsia:
- Chronic high blood pressure (hypertension)
- Being pregnant with more than one baby
- Preeclampsia in a previous pregnancy
- Type 1 or type 2 diabetes before pregnancy
- Autoimmune disorders
- Kidney disease
- Use of in vitro fertilization
Women with these conditions are at a moderate risk of preeclampsia:
- Family history of preeclampsia
- Obesity
- Complications in a previous pregnancy
- First pregnancy with current partner
- Maternal age of 35 or older
- More than 10 years since previous pregnancy
Detection
Preeclampsia is detected by blood pressure checks, and urine tests to check if it contains protein, at every antenatal visit.
Treatment
Delivery of the baby is the only treatment for PE.
An experienced gynecologist will monitor the pregnancy and deliver the baby as soon as possible.
Complications
Possible complications of PEare:
- Slow growth of the fetus. Also called fetal growth restriction. It is caused because the fetus receives inadequate blood and oxygen and less nutrients because the placenta does not get enough blood.
- An unplanned or planned birth before 37 weeks of pregnancy. The premature baby is at a higher risk of developmental delays, vision or hearing problems, breathing, and feeding problems, and cerebral palsy.
- Separation of placenta from the inner wall of the uterus before delivery, called Placental abruption. Severe abruption can be life-threatening for both the mother and the baby because of heavy bleeding and blood loss it may cause.
- Seizures or coma called eclampsia. It can happen without any signs or symptoms of preeclampsia.
Difficult to predict if a patient with preeclampsia will suffer eclampsia. Signs and symptoms that may appear before seizures include mental confusion or altered behaviors, vision problems, and severe headaches. But often seizure may happen without any symptoms or warning signs. Eclampsia may occur before, during or after delivery.
- HELLP syndrome. HELLPstands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count. This affects several organ systems. HELLP syndrome is life-threatening to the mother and baby, and it may cause lifelong health problems for the mother. Headache, upper right belly pain, nausea and vomiting, and a general feeling of illness or being unwell are the symptoms. But HELLP may develops suddenly, without any symptoms, and even before high blood pressure is detected.
- Preeclampsia may result in damage to the lung, eyes, liver, kidneys, heart, and may cause a stroke or other brain injury. The amount of injury to other organs depends on how severe the preeclampsia is.
- Preeclampsia increases the risk of future heart and blood vessels (cardiovascular) diseases. The risk is higher if preeclampsia happened more than once, or in the case of preterm delivery.
Prevention and medication
Low-dose aspirin (81-milligram aspirin tablet) after 12 weeks of pregnancy may reduce the risk of preeclampsia. Diuretics, progesterone, nitric oxide, calcium supplementation may also be used to reduce the risk. Do not take any medicines without your gynecologist’s advice.
To reduce the risk of PE, be as healthy as you can be before pregnancy. And go for preconception consultations.
Lifestyle and healthy choices
Diets high in vegetables, olive oil, fruits, and poultry, and avoiding processed meat, white bread, French fries, salty snacks, and fizzy drinks may reduce the risk of PE.
Regular exercise, proper rest, vitamins C and E, garlic, marine oil, may also reduce the risk.
Conclusion
Prevention is better than cure is especially true for PE which has no cure. Awareness of the problem and the possible solutions is the first step towards prevention. Early detection and timely intervention can ameliorate the PE problem to some extent. Healthy lifestyle and healthy eating can go sone way in facing the challenge of PE.