Pre-eclampsia is elevated blood pressure (hypertension) during pregnancy. Early development of this condition may increase the risk of complications for both the mother and the baby. Generally, it occurs after 20 weeks of pregnancy, but it may also occur earlier. It is more common in first-time mothers and is typically characterized by high blood pressure (hypertension) and protein in the urine (proteinuria).
Most pregnant women with preeclampsia deliver healthy babies, but if not treated, it can lead to problems like preterm birth and, in rare cases, cause death.
Causes of Pre-eclampsia
There is no definitive cause of pre-eclampsia. However, it is believed that preeclampsia may come from problems with the health of the placenta (the connection between mother and baby through which nutrients and oxygen are supplied to the baby). The blood supply to the placenta may be reduced, causing complications for both mother and infant.
Some factors that may cause preeclampsia include:
- Insufficient blood flow to the uterus
- History of high blood pressure, kidney diseases, or other comorbidities
- Obesity
- Expecting multiples
- Family history of preeclampsia
- Autoimmune diseases such as lupus
Symptoms of Pre-eclampsia
Most mothers experiencing pre-eclampsia do not exhibit symptoms. However, a few first signs of pre-eclampsia may include high blood pressure (>140/90 mmHg), proteins in the urine, and retaining body water, causing swelling of body parts and weight gain.
Other symptoms of pre-eclampsia may include:
- Headaches
- Dark spots appear in the vision
- Pain in the right side of the abdomen
- Blurry vision
- Light sensitivity
- Swelling of hands and face (edema)
- Shortness of breath
It is essential to inform the healthcare provider of all pregnancy symptoms. Individuals are usually diagnosed with pre-eclampsia at prenatal check-ups when their blood pressure and urine proteins are checked.
If pre-eclampsia has gotten severe, it may be required that the individual be admitted to the hospital for close monitoring or that she deliver the baby as soon as possible.
Severe preeclampsia symptoms may include:
- Hypertensive emergency (BP 160/110 mmHg or more)
- Decreased kidney or liver function
- Low blood platelet levels
- Decreased urine production
- Fluid in the lungs
The healthcare provider may usually provide medications to help control high blood pressure or help the fetus’s lungs develop before delivery.
Complications of Preeclampsia
Preeclampsia, if left untreated, can be dangerous to both the mother and the developing fetus. Complications can occur both before and after a child’s birth.
- Before the infant is born: Complications could result in premature birth, low birth weight, or placental abruption.
- Following the child's birth: Following the child’s birth, the mother may be at increased risk of kidney diseases, heart attack, stroke, and developing preeclampsia in future pregnancies.
Diagnosis of preeclampsia
Preeclampsia is often diagnosed during prenatal check-ups when the healthcare professional checks for weight gain, blood pressure, and urine proteins.
If preeclampsia is suspected, the healthcare professional may order:
- Blood tests: In this, the blood samples from an individual are collected and analyzed in a lab to understand how well the kidneys and liver are functioning. These can also help measure blood platelets (cells that help in blood clotting).
- Urine analysis: In this, a 24-hour urine sample (urine collection is done over a full 24-hour period) or a single urine sample is collected from an individual and checked for the presence of any proteins in it. This test helps determine the proper functioning of an individual’s kidneys.
- Fetal ultrasound: Fetal ultrasound is advised for close monitoring of fetal growth. The images obtained from the ultrasound are helpful in estimating the baby’s size, weight, and amniotic fluid (fluid in the uterus).
- Penta marker test: It is a blood test recommended to all pregnant women, usually for screening any chromosomal abnormalities and neural tube defects in the growing fetus. Additionally, it may help in detecting preeclampsia (developing at <37 weeks) in the first trimester.
Interpretation of results
From the tests, results may suggest preeclampsia as mild or severe. The difference between the two can be understood as:
Mild preeclampsia: High blood pressure plus high protein levels in urine
Severe preeclampsia: Mild preeclampsia plus severe preeclampsia symptoms
Severe symptoms include a hypertensive emergency (blood pressure is 160/110 mmHg or higher), or decreased kidney or liver function.
Treatment of preeclampsia:
Treatment is usually based on how close an individual is to their due date.
- Delivery: If the individual is close to their due date and the baby is fully formed, the baby will be delivered early. Normal vaginal delivery is still possible; however, a C-section (cesarean) delivery is mostly suggested or selected.
- Management: The healthcare professional may administer drugs to aid with the development of fetal lungs or to maintain high blood pressure until the baby is born.
It is sometimes preferable to have the baby sooner rather than later in order to avoid complications during and after the delivery.
Prevention of preeclampsia:
Although there is no sure way to prevent preeclampsia, a few factors that may contribute to its prevention include:
- Limiting or avoiding salt intake in foods
- Drinking 6–8 glasses of water per day
- Avoiding junk foods and deep-fried items
- Avoiding alcohol intake
- Avoiding caffeinated beverages
- Getting enough rest
- Exercising regularly
- Consuming prescribed medications and additional supplements
Preeclampsia is a serious pregnancy condition that may go unnoticed even if it is present. Therefore, it is recommended to complete all prenatal check-ups and be open about all the symptoms one feels during their pregnancy to their healthcare professionals. Several diagnostic tests, including penta marker tests, urine analysis tests, and ultrasounds, may be useful in identifying preeclampsia in its early stages. When preeclampsia is detected early, it can be effectively treated and managed to keep both mother and baby safe and healthy. Most people with preeclampsia have healthy babies if they receive effective treatment and preventive measures at the right time.
