The World of Pregnancy

What Is Preeclampsia? Symptoms, Risk Factors & Complications!

Have you heard of preeclampsia? Are you interested in knowing what causes this medical condition and how you can treat it?

What Is Preeclampsia

What Is Preeclampsia?

Preeclampsia (also known in the past as pregnancy toxemia) is defined as a blood pressure higher than 140 mm Hg for the systolic one and 90 mm Hg for the diastolic one (meaning 140/90) after the week 20 of pregnancy. Another characteristic of preeclampsia is the protein level in urine higher than 0.3 g in 24 hours.
Most women who suffer of this medical condition experience a mild form of this affection around their due date and with proper medical care, they don`t encounter too big problems.

Symptoms

This condition can develop gradually, but it often has a sudden onset after 20 weeks of pregnancy and can vary from mild to severe. In case that the blood pressure was in normal limits before pregnancy, symptoms of preeclampsia may include:

  • Increased blood pressure (hypertension) – 140/90 mm Hg or higher – documented twice in at least 6 hours, but no more than 7 days apart.
  • Excess of proteins in urine (proteinuria).
  • Severe headache.
  • Changes in sight, including temporary sight loss, cloudy vision or sensitivity to light.
  • Pain in the upper abdomen, usually under the ribs on the right side.
  • Nausea and vomiting.
  • Decreased urine volume.
  • Most of the times, swelling of hands or face comes with this condition. Swelling isn`t considered as a sign of confidence (pathognomic) for preeclampsia because can also appear during a normal pregnancy.

Get in touch with your doctor if you experience severe headache, cloudy vision or severe upper abdominal pain. Because headaches or nausea are frequent symptoms of pregnancy, it`s difficult to know when these signs are part of a normal pregnancy or they indicate a more serious health problem, especially if it`s the first pregnancy.

Who Gets Preeclampsia?

Preeclampsia as well as other hypertensive disorders related to pregnancy takes place in 5% to 8% of pregnancies of women who doesn`t present any risk factors. There are higher chances for this to happen in the first pregnancy. The most important risk factors for this condition include:

  • Previous history of this condition.
  • Family history of this affection.
  • Multiple pregnancies.
  • History of organ transplant, kidney disease, high blood pressure or diabetes.
  • Sickle-cell disease.
  • First attempt to have a child.
  • Obesity, especially BMI of 30 or greater.
  • The pregnant woman is under 18 years or over 40.
  • POS (Polycystic ovarian syndrome).
  • Autoimmune diseases – lupus, sarcoidosis, multiple sclerosis, rheumatoid arthritis.
  • IVF.

Causes

This condition has also been named pregnancy toxemia because the cause was considered the toxin in the blood of pregnant women. This theory has proven to be false, but experts aren`t yet able to explain the cause of this medical complication. Possible causes may by:

  • Insufficient blood flow to the uterus.
  • Damage to blood vessels.
  • An immune system problem.
  • Unhealthy diet.

Other Disorders of Blood Pressure during Pregnancy

This condition is classified as being one of the 4 disorders which cause high blood pressure during pregnancy. The other 3 are:

  • Gestational hypertensionWomen with gestational hypertension have high blood pressure, but don`t have an excess of proteins in urine. Some women with gestational hypertension eventually develop preeclampsia.
  • Chronic hypertension – This is characterized by high blood pressure, which appears before the week 20 of pregnancy or lasts for more than 12 weeks after birth. Usually, chronic hypertension was present (but not diagnosed) before pregnancy.
  • Superimposed preeclampsia – This condition appears in women who have chronic hypertension before pregnancy and who then develop a worst hypertension and proteinuria during pregnancy.

Risk Factors

This medical condition appears only during pregnancy and the risk factors are:

  • History of preeclampsia – A personal or familial history of this complication increases the risk of developing this condition.
  • First pregnancy – The risk of developing preeclampsia during pregnancy is slightly higher if you are at your first pregnancy.
  • Age – The risk of this condition is higher for pregnant women who are younger than 20 years old or older than 40 years old.
  • Obesity – The risk of this condition is higher if you suffer from obesity.
  • Multiple pregnancies – This complication is more frequent in women who have twins or triplets.
  • Prolonged interval between pregnancies – This may appear to increase the risk of preeclampsia.
  • Diabetes & gestation diabetes – Women who develop gestational diabetes are at higher risk of developing this condition while the pregnancy develops.
  • Pathological history – chronic hypertension, migraines – headache, diabetes, kidney diseases, rheumatoid arthritis or lupus increase the risk of experiencing this complication.

Other Possible Factors

  • There is some evidence that urinary infection and periodontal disease during pregnancy are associated with an increased risk of preeclampsia, which may indicate the fact that antibiotics may play an important role in preventing this condition. There`s also some evidence that the insufficient intake of vitamin D increases the risk of preeclampsia and that supplements with vitamin D at the beginning of pregnancy may play an essential role in preventing this complication.
  • High levels of certain found proteins. Pregnant women who had an increased level of certain proteins in blood or urine have developed preeclampsia. These proteins interfere with the growth and function of blood vessels – strengthening the theory regarding the cause of this condition – abnormalities of blood vessels which feed the placenta.

Note: Get in touch with your doctor immediately if you experience severe headache, severe abdominal pain or blurred vision.

Complications

Most women who have this medical condition give birth to healthy babies. The risks are higher for both the mother and baby if the condition is more severe and if it appears earlier in pregnancy. This complication may require artificially induced labor, but a C-section isn`t always necessary in these cases. Your doctor may recommend it though if the induction of labor becomes difficult due to the gestational age of your baby.

Complications of this condition may include:

  • Lack of blood flow to the placenta – This complication affects arteries which transport blood to the placenta. In case that isn`t enough blood reaching the placenta, the fetus may receive less oxygen and nutrients. This may lead to a slow development, low birth weight, premature birth and breathing difficulties for your baby.
  • Placental abruption – This condition increases the risk of placental abruption, in which the placenta separates from the uterine wall before birth. The separation may lead to abundant bleeding and placental lesions, which can put your life in jeopardy as well as the baby`s life.
  • HELLP syndrome –comes from hemolysis (destruction of red cells in blood), elevated liver enzymes and low platelet number. Symptoms of this syndrome include nausea, vomiting, headache and abdominal pains on the right side. This syndrome is extremely dangerous because it can appear before symptoms of preeclampsia.
  • Eclampsia – When preeclampsia isn`t controlled, eclapmpsia – which is basically preeclampsia with convulsions, may appear. Symptoms include abdominal pains on the right side, severe headache, sight problems or change in mental status (decreased alertness). Eclampsia can affect vital organs permanently, such as brain, liver or kidneys. If left untreated, eclampsia leads to coma, brain damage or cerebral lesions.
  • Cardiovascular diseases – preeclampsia can increase the risk of cardiovascular diseases.

Treatment

The only way to treat this condition is to give birth to your baby, whether is premature or not. However, if the baby`s life is put in jeopardy, there are a few methods to staging the illness until the baby is born by C-section.

First of all, bed rest is very important and that`s why sometimes hospitalization is even used sometimes, so that the doctor can have the pregnant woman under his supervision. Moreover, intravenous magnesium and antihypertensive medications relieve the condition`s manifestations quite significantly and prevent the crisis caused by preeclampsia.

Prevention

For now, there isn`t anything that a pregnant woman can do to prevent preeclampsia. According to WHO, reducing the amount of salt, calories or changing the daily activities doesn`t help too much. Also, the consumption of fish oil or vitamins A, E or D doesn`t help either. Moreover, WHO claims that supplements of vitamin C and E aren`t recommended (taken separately or combined).

Still, in some cases, it was noticed that the risk of preeclampsia can be reduced if the pregnant woman takes small doses of aspirin. But this is mostly true when it comes to mothers who suffered of preeclampsia in a previous pregnancy and were supposed to give birth due to this cause before the week 34 of pregnancy.

Also, WHO takes into account studies that proven that the intake of food supplements with calcium may prevent preeclampsia, especially in the case of pregnant women with a major deficiency. However, more studies are required for the recommendations to be applied to all pregnant women.

Therefore, the only option remains prenatal medical surveillance. This is because when discovered in an initial phase, preeclampsia can be controlled, and this is the best chance for a mother and child to stay healthy.

Image courtesy of birthinjuryadvocate.com
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