Pre-eclampsia: What You Should Know

Pre-eclampsia or toxemia in pregnancy is a potentially severe complication of pregnancy.

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It occurs after 20 weeks of pregnancy and is characterized by increased blood pressure (above 140/90 mmHg) and protein in the urine.

Signs and symptoms.

Sometimes, symptoms may not be obvious except on examination in the hospital during routine antenatal clinic days.

Symptoms include;

– High blood pressure above 140/90mmHg checked at three intervals or 160/100mmHg on first check.

– Protein in urine.

– Change in vision: Blurred vision, light sensitivity, or temporary loss of vision.

– Headaches; with no relief after medication.

– Significant weight gain.

– Oedema: Swelling of the ankles, and feet (with pitting), puffy face, larger abdomen than gestational age.

– Shortness of breath.

– Pain in the upper abdomen.

– Nausea and vomiting.

Pre-eclampsia is classified as early pre-eclampsia (before 34 weeks of pregnancy) and late pre-eclampsia (after 34 weeks of pregnancy).

Types.

Pre-eclampsia is either mild or severe.

Mild preeclampsia: Pre-eclampsia is termed mild when the blood pressure is above 140/90mmHg checked 3 times, 6 hours apart, and protein in the urine of about 300 milligrams per 24-hour sample.

Severe preeclampsia: Pre-eclampsia is termed severe when blood pressure is 160/100mmHg or more, protein in urine of about 5 grams per 24-hour sample, and signs of other organ compromise (mainly liver or kidneys) on blood tests.

Causes.

The exact cause of pre-eclampsia is unclear but has been linked to certain abnormalities with the placenta and the blood vessels supplying it.

However, there are risk factors that predispose an individual to the disease. They include:

Higher risk conditions;

– Previous history of pre-eclampsia.

– Multiple pregnancy.

– Chronic Hypertension.

– Type 1 diabetes mellitus before pregnancy.

– Kidney disease.

– In vitro fertilization (IVF).

– Autoimmune disorders.

Lesser risk factors;

– First pregnancy with current partner.

– Obesity.

– Family history of pre-eclampsia.

– Maternal age of 35 years or older.

– Complications in previous pregnancies.

– More than 10 years since last pregnancy.

Complications.

– Intrauterine growth restriction (baby’s growth in the womb is limited).

– Eclampsia; onset of seizures or coma with pre-eclampsia.

– HELLP syndrome; H – Haemolysis (abnormal breakdown of blood cells), EL – Elevated liver enzymes, LP – Low platelets (blood clotting cells that reduce or prevent bleeding).

– Other organ damage; Kidneys, liver, heart, lungs, etc.

– Future risk of heart diseases.

– Rarely, death of the baby or mother.

Prevention.

– Medication such as low-dose aspirin may be prescribed by a doctor for women with higher risk factors.

– Healthy lifestyle choices: Adequate nutrition, exercise, and regular antenatal clinic visits.

Pre-eclampsia is diagnosed in the hospital usually on antenatal care after symptoms are observed and further tests are done to confirm the condition. Such tests include:

– Blood tests.

– Blood pressure checks.

– Urine analysis.

– Fetal ultrasound.

– Non stress test.

Treatment is primarily by managing the condition until the best time to deliver the baby. This decision with your healthcare provider will depend on the severity of pre-eclampsia.

– Blood pressure control with prescribed medications and daily blood pressure monitoring.

– In severe conditions, anti-convulsing drugs are given to prevent seizures.

– A steroid drug may be given to promote the development of the baby’s lungs in preparation for delivery.

– Delivery: The health care provider will usually wait till 37 weeks to deliver the baby, but in very severe cases, the baby is delivered pre-term. Delivery of the baby typically stops pre-eclampsia.

– Close monitoring after delivery for high blood pressure and other symptoms before discharge. Some women may still show signs of pre-eclampsia a few days after delivery, this is called post-partum pre-eclampsia or eclampsia.