Different types of complications, either physical, physiological, or, psychological can affect the expecting mother in the course of pregnancy. Preeclampsia is one such pregnancy complications.
Preeclampsia

What Is Preeclampsia?

Preeclampsia is a condition that happens only during pregnancy, which appears mostly after the 20th week of pregnancy. Very rarely, it is also reported before the 20th week of gestation. Preeclampsia is characterized by high blood pressure even if the expecting mother has no previous history of blood pressure (pregnancy-induced). Protein level in their urine also increases significantly. Women with preeclampsia also develop swelling in the feet, legs, and hands.
If preeclampsia is not recognized, it will develop into the next stage, called eclampsia, which can put the life of mother and child in jeopardy. Because there is no sure-shot way to treat preeclampsia, the only way to protect yourself is to learn about the symptoms and going for regular prenatal checkups so that the condition can be detected early and necessary steps can be taken. The earlier it is caught, the easier it is to manage.

What Causes Preeclampsia?

Though the exact cause of preeclampsia and eclampsia is not known, it is understood it results from a placenta that is not functioning properly. Reduced blood flow to the placenta is the primary cause of preeclampsia, though some experts believe that poor nutrition and high body fat can also be responsible for the condition. This can happen if:

  • The placenta is not properly embedded in the lining of the uterus
  • The blood vessels are less dilated decreasing the flow of the blood to the placenta
  • There is a problem with the mother’s immune system
  • Genetics also play a role
What Are The Signs And Symptoms Of Preeclampsia?

The signs and symptoms of preeclampsia include:

  • High blood pressure: After the 20th week of pregnancy, even a slight rise in blood pressure can be an indication of preeclampsia. High blood pressure is one of the major red flags of preeclampsia. Blood pressure that is 140/90mm Hg or greater, taken on two occasions on at least four hours difference is considered as abnormal(120/80mm Hg is normal reading)
  • Proteinuria: Presence of protein in the urine of the mother is another symbol of preeclampsia. Proteins are restricted in the blood stream because of the filtering process performed by the kidneys. Preeclampsia tampers with the filtering process, resulting in loosing different proteins like albumin through the urine
  • Nausea and vomiting: Being nauseous and frequent vomiting is an important sign of preeclampsia appearing around the midriff of the pregnancy period. As all the signs of morning sickness are disappearing, sudden appearing /reappearing of these signs indicates asudden onset of preeclampsia
  • Severe headache: Severe, throbbing, and persisting headache coupled with high blood pressure can be a sign of preeclampsia
  • Abdominal, shoulder, lower back pain: Shoulder pain radiating from the right ribs, acute and focused pain in lower back, and shoulder pain along the bra strap or neck can be an indication of liver issues associated with preeclampsia
  • Edema: Face eyes and limbs appearing excessively puffy, and if you press the thumb into the puff, the impression will remain for few seconds. This pitting edema can be an indication of preeclampsia
  • Changes in vision: Regular vision changes incorporate, vibes of aura, blazing lights, sensitivity to light, hazy vision, etc. can be an indication of swelling in the brain or irritation of central nervous system that are commonly associated with preeclampsia
  • Shortness of breath: Shortness of breath and increased heart rate can be a vital sign of preeclampsia
  • Thrombocytopenia: The deficiency of the blood platelets, thrombocytopenia, is an indication of the preeclampsia
  • Sudden weight gain: Sudden gain in weight within a week can be due to excess water trapped in the body tissue. This may be due to the damages happened to the blood vessels because of preeclampsia
  • Decreased urination: Decrease in the frequency and the quantity of urination can be an indication of preeclampsia

Preeclampsia risk factors

What Are The Risk Factors For Preeclampsia?

There are certain factors that increase the risk of preeclampsia.

  • Age: Teenage pregnancy or getting pregnant after 40 years increases the chances of preeclampsia
  • First pregnancy: Preeclampsia is more frequently found during the first pregnancy
  • Multiple pregnancies: Being pregnant with twins or more babies increase the risk of preeclampsia
  • History of mother: Possessing a certain condition before getting pregnant, like Chronic hypertension, diabetes, kidney disease, blood clotting diseases, rheumatoid arthritis, etc. increases the risk of preeclampsia
  • Autoimmune conditions: If the pregnant woman has autoimmune diseases like lupus, the chances of preeclampsia increases
  • If the pregnancy is not natural: If the pregnancy is due to artificial insemination or through egg donation, the chances of preeclampsia increases
  • Obesity: Being overweight before getting pregnant and in the course of pregnancy increases the risk of preeclampsia
  • Family history: A family history of preeclampsia (grandmother, mother, aunt or sister), increases the risk of preeclampsia
  • Previous history of preeclampsia: One out of six expecting mothers who had had preeclampsia during their previous pregnancy, increases their chances of experiencing it in the following pregnancy. In case, the preeclampsia experienced during the previous pregnancy was very severe and appears before the 30th week of pregnancy, the risk of having it in the following pregnancy will increase to 40%
  • The gap between pregnancies: If the gap between the pregnancies is more than 10 years or less than two years, the risk of preeclampsia increases
  • New partners: Having a baby with a new partner each time you are pregnant put you at a higher risk of developing preeclampsia
How Can Preeclampsia Affect The Mother And The Baby?

Preeclampsia can result in placental abruption, which is the sudden separation of the placenta from the uterus. It can also result in cardiovascular disease, eclampsia, and HELLP syndrome (Hemolysis- demolition of RBC; Elevated Liver enzymes; Low Platelet count)
Significantly decreased blood flow towards the placenta, will, in turn, decrease the availability of oxygen and nutrients for the fetus. This can cause:

  • Low birth weight
  • Growth retardation
  • Preterm birth
  • Slow growth
  • Learning disabilities
  • Hearing and vision problems
  • Epilepsy and cerebral palsy

It can also increase the probability of infection (maternal) after childbirth, sometimes causing rare but serious complications like strokes, seizure, heart failure, water in the lungs, and bleeding after the birth.

What Is The Death Rate Due To Preeclampsia?

Around one crore women are reported to develop preeclampsia around the world in a year. Out of this, around 76,000 mothers are reported to lose their life.

How Can Preeclampsia Be Managed?

As there is no treatment for preeclampsia other than delivering the baby, it is important to learn how to manage it. Once you are diagnosed with preeclampsia, your doctor will closely monitor you.
Taking rest, increasing the intake of fluids, decreasing the intake of salt, undergoing regular examination by the doctor are some of the measures that help to manage the preeclampsia.
You may have to stay in hospital and the doctor will:

  • Regularly take your blood pressure
  • Give you medication to lower the blood pressure
  • Perform a Doppler scan to measure the blood flow from the placenta to the baby

If your condition is severe, you will be admitted to the hospital for the rest of the gestation period, and an expert team will:

  • Conduct frequent blood test
  • Constantly monitor the blood pressure
  • Control fluid level
  • Regularly take cardiotocography (fetal heart beat)
  • Put you on a magnesium sulphate drip to lower the risk of eclampsia

Remember, the only cure for preeclampsia and eclampsia is the delivery of the baby, which depends on how far along you are in your pregnancy. If your baby has developed enough and you are around 37 weeks of gestation, and induced labor or a c-section may be done to combat the effects of preeclampsia. Incase the baby is not close to term, strict monitoring will be done until the baby develops enough to be delivered. Remember, the closer to due date your baby is born, the better it is for him.
As we already said delivery is the only way to get rid of preeclampsia, the doctor will induce labor (if needed) so that the risk of the delivery, the health of the baby, and the health of the mother is least affected.