Pre-eclampsia is a condition that affects some pregnant women, usually during the second half of pregnancy (from 20 weeks) or soon after their baby is delivered. Show
Symptoms of pre-eclampsiaEarly signs of pre-eclampsia include having high blood pressure (hypertension) and protein in your urine (proteinuria). It's unlikely that you'll notice these signs, but they should be picked up during your routine antenatal appointments. In some cases, further symptoms can develop, including:
If you notice any symptoms of pre-eclampsia, seek medical advice immediately by calling your midwife, GP surgery or NHS 111. Although many cases are mild, the condition can lead to serious complications for both mother and baby if it's not monitored and treated. The earlier pre-eclampsia is diagnosed and monitored, the better the outlook for mother and baby. Video: what is pre-eclampsia and what are the warning signs?In this video, a midwife explains the warning signs of pre-eclampsia. Media last reviewed: 1 September 2020 Who's affected?There are a number of things that can increase your chances of developing pre-eclampsia, such as:
Other things that can slightly increase your chances of developing pre-eclampsia include:
If you have 2 or more of these together, your chances are higher. If you're thought to be at a high risk of developing pre-eclampsia, you may be advised to take a 75 to 150mg daily dose of aspirin from the 12th week of pregnancy until your baby is born. What causes pre-eclampsia?Although the exact cause of pre-eclampsia is not known, it's thought to occur when there's a problem with the placenta, the organ that links the baby's blood supply to the mother's. Treating pre-eclampsiaIf you're diagnosed with pre-eclampsia, you should be referred for an assessment by a specialist, usually in hospital. While in hospital, you'll be monitored closely to determine how severe the condition is and whether a hospital stay is needed. The only way to cure pre-eclampsia is to deliver the baby, so you'll usually be monitored regularly until it's possible for your baby to be delivered. This will normally be at around 37 to 38 weeks of pregnancy, but it may be earlier in more severe cases. At this point, labour may be started artificially (induced) or you may have a caesarean section. You'll be offered medicine to lower your blood pressure while you wait for your baby to be delivered. ComplicationsAlthough most cases of pre-eclampsia cause no problems and improve soon after the baby is delivered, there's a risk of serious complications that can affect both the mother and her baby. There's a risk that the mother will develop fits called "eclampsia". These fits can be life threatening for the mother and baby, but they're rare. Imagine a condition that can happen suddenly and without warning during your pregnancy. Imagine if the only cure was to deliver your baby, regardless of how far along you were.And one more thing – signs that you may have this condition are similar to normal symptoms of pregnancy. Pretty scary, right? This is a real condition called preeclampsia. It actually is one of the more common pregnancy complications, affecting about 5 to 8 percent of all pregnancies in the United States. If you’ve been pregnant before, you may remember having your blood pressure and urine checked during every prenatal appointment. One of the main reasons we do this is to screen for preeclampsia. Although preeclampsia is scary to think about, we have a long history of caring for women with this and other high-risk complications. What is preeclampsia?Preeclampsia is a condition that only happens to women when they are pregnant or in the early postpartum period. Women who are diagnosed with preeclampsia have high blood pressure (hypertension), and at least one of the following:
Preeclampsia can affect any organ system in the body. The kidney and liver are the most at-risk for damage from preeclampsia. Bleeding also is a risk because preeclampsia can affect cells called platelets, which are needed for your blood to clot. Additionally, many women experience headaches and vision abnormalities due to changes in the brain. Once preeclampsia has been diagnosed, it can be “cured” only by delivery of the baby. You’ll notice that preeclampsia starts with “pre” – that’s because if it’s left untreated, the condition can develop into eclampsia: pregnancy-related seizures. We don’t know for sure what causes preeclampsia. But the general belief is that it happens when the placenta does not interface with the uterus appropriately. Preeclampsia risk factors and symptomsThere are several risk factors for preeclampsia. The most obvious is if you’ve experienced it before. If you’ve had preeclampsia with an earlier pregnancy, you are much more likely to develop it again, so we will be watching trends in your blood pressure closely during your prenatal appointments.In addition, preeclampsia most often affects women who:
‘Things were going well, until they weren’t’With my first pregnancy, things were going well, until they weren’t. All of a sudden, at 31 weeks and three days, I started “not feeling good.” I continued to work, thinking I would feel better in a couple of days. Two days later, I checked my blood pressure, and it was 163/94. I was admitted to the hospital, and I started having double vision. I was diagnosed with severe pre-eclampsia, and I had my baby at 31 weeks and six days.Two years later I was pregnant again, and this time I knew I was at increased risk for developing pre-eclampsia. At 29 weeks it happened again, the exact same way. I started “not feeling good,” and my blood pressure was elevated – I had mild pre-eclampsia. This time I was able to stay pregnant on bedrest, but at 34 weeks I developed severe pre-eclampsia and had to deliver my baby. How we help women with preeclampsiaThe first thing we do is classify the patient’s condition as mild or severe. Women with severe features have blood pressure levels higher than 160/110, low platelet counts, fluid in the lungs, or problems with their kidney or liver function.Based on the severity of the condition, we develop a game plan for each patient. Of course, the more time we can buy for the patient and her baby, the better. But there’s a balance. Waiting to improve the chances the baby will do well means risking the possibility that the mother may get sicker herself. If there are no severe features, we aim for at least 37 weeks for delivery. When a woman is diagnosed with preeclampsia, she will likely remain in the hospital until delivery. Even if severe features are not present, preeclampsia can worsen suddenly, so we monitor these women closely. No medications can treat preeclampsia. We recently had three patients who developed preeclampsia at 22 weeks. These patients all had pre-existing risk factors. Babies are unlikely to survive if they are born before 23 weeks, so there was a lot at stake. In two of the cases, we were able to delay delivery until 26 weeks, and the babies survived. In the third case, the mother was so sick her life was at risk. She delivered at 23 weeks, and unfortunately, the baby did not survive. These are very difficult conversations to have and decisions to make. Our overall goal is the health and safety of both the mother and the baby. After delivery, the patient’s blood pressure usually returns to safer levels within 24 to 48 hours. For some women, it can take longer, up to 12 weeks – we prescribe medication to treat these patients. The story isn’t over when pregnancy ends. Research has shown that developing preeclampsia or other pregnancy complications can predict a woman’s future heart disease risk. There is no way to prevent preeclampsia. Studies have been done where women used aspirin, calcium, or other blood thinners, but nothing has been shown to work. The best thing you can do is be aware of your risk and report any concerning symptoms to your doctor. If you are taking medication for high blood pressure, and you’re planning to get pregnant soon, request an appointment with us. Depending on your situation, it may be appropriate to change your medication. The best time to change medications is before you are pregnant. If you’re interested in receiving pregnancy trips and patient stories in your inbox, sign up for the Your Pregnancy Matters notification list. We’ll email you when new stories are published on our blog. Can I have preeclampsia without high blood pressure?Recent data suggest that in some women, preeclampsia and even eclampsia may develop in the absence of hypertension or proteinuria.
Does preeclampsia always show protein in urine?The first signs of preeclampsia are often detected during routine prenatal visits with a health care provider. Along with high blood pressure, preeclampsia signs and symptoms may include: Excess protein in urine (proteinuria) or other signs of kidney problems.
What can mimic preeclampsia?Angioedema.. Bronchitis.. Bulimia Nervosa.. Chronic Obstructive Pulmonary Disease.. Congestive Heart Failure.. Depression.. Hypothyroidism.. Menopause.. What are the 2 main symptoms of preeclampsia that cause all the other symptoms?Early signs of pre-eclampsia include having high blood pressure (hypertension) and protein in your urine (proteinuria). It's unlikely that you'll notice these signs, but they should be picked up during your routine antenatal appointments. In some cases, further symptoms can develop, including: severe headache.
|