Preeclampsia In Pregnancy

Preeclampsia is a pregnancy disease, which can be very dangerous for both mother and baby. If it is not diagnosed soon enough or left untreated, it can lead to severe, even life-threatening complications.

What is preeclampsia in pregnancy?

Preeclampsia is a severe condition, which can occur only in pregnancy. It generally starts after the twentieth week of pregnancy and affects up to 10 percent of pregnant women.

Pregnant women with preeclampsia have high blood pressure (hypertension) and protein in the urine, but the condition can be accompanied by other signs and symptoms too.

Preeclampsia can occur rapidly or as a silent disease, meaning a pregnant woman may not feel the early symptoms and does not recognize her condition.

Attend all regular prenatal checkups during pregnancy! Your health care provider can diagnose preeclampsia in its early stages and provide you with proper care and monitoring until your delivery date.

Among women who receive regular prenatal care, preeclampsia is almost always caught soon enough and managed successfully. For them, the chance of having a positive pregnancy outcome is virtually the same as for women with normal blood pressure.

Signs and symptoms of preeclampsia

A pregnant woman with mild preeclampsia may not have any symptoms. However, most of them have them, among which the first signs of the disease are usually high blood pressure and proteins in the urine.

Regular blood pressure monitoring throughout the whole pregnancy is the best indicator of developing preeclampsia. But, if the blood pressure suddenly rises, only additional urine and blood tests may confirm or rule out the disease.

Measuring blood pressure and finding protein in the urine are some of the most important parts of prenatal care.

Preeclampsia, however, can also be manifested by other signs. But the problem is that most of them are hard to distinguish from common pregnancy problems.

So, if you have one of the following symptoms, that does not necessarily mean you have developed the condition. Any of them can be either a sign of preeclampsia, a symptom of other diseases, or only a common pregnancy problem.

If you notice any of them, or you are just worried, consult with your health care provider if further actions are needed.

Early signs of preeclampsia:

High blood pressure (hypertension): Blood pressure 140/90 or more is an indicator of preeclampsia or some other condition that requires medical assessment.
Proteins in the urine are a sign of preeclampsia. Preeclampsia affects kidneys, inducing protein accumulation in the urine.

Other early signs of preeclampsia may include:

Severe headaches, which do not subside after taking over-the-counter pain medications
Visual disturbances such as blinking or sparking in front of the eyes, blurred vision, or light sensitivity
Pain in the spleen and upper abdomen, under the right ribs
A sudden swelling (edema) and consequential rapid weight gain, especially if it is accompanied by high blood pressure or breath shortness
Unusually active reflexes
Nausea or vomiting, of course, in case your morning sickness has already ended, and vomiting suddenly reappears in the third trimester

Severe symptoms of preeclampsia in pregnancy:

Pregnant women suffering from preeclampsia may experience one or more following symptoms:

Confusion
Heavy breath
Decreased urine output or other signs of kidney problems
Noticeable petechiae on the skin (tiny spotted bleeding from capillaries), which indicates a reduced platelet count in the blood, and a greater tendency to bleed
Impaired liver function
Temporary vision loss

When to see a doctor?

The best way to detect preeclampsia in its early stages is by regular attendance on prenatal care. Your health care provider will monitor your blood pressure and notice changes that may indicate the development of preeclampsia. Rapid detection of the condition will enable the prevention of severe complications.

However, in some cases, high blood pressure may have a sudden onset. If your blood pressure suddenly rises, or you have any of the severe symptoms listed above, go to an emergency room or immediately contact your doctor.

Signs and symptoms, such as headaches, nausea, aches, and pains, are common in pregnancy. That can confuse pregnant women by not knowing if they indicate a serious problem. So, talk to your health care provider if you are concerned about milder symptoms as well.

RELATED: First Signs of Preeclampsia

What causes preeclampsia in pregnancy?

The exact cause of preeclampsia is not yet fully known, but it is related to several factors. Based on the facts known so far, scientists believe there is a problem with the placenta formation.

The placenta doesn’t develop properly because of the blood vessel defect. In women with preeclampsia, blood vessels constrict instead of widening, causing lower blood circulation in a pregnant woman’s body and a rise in blood pressure.

The same applies to the placenta and uterus, which also do not get enough blood, leading to improper function and development. Such a placenta provides less oxygen and nutrients to your growing baby, which may cause a lag in the fetus’s growth.

The improper blood vessel growth that leads to preeclampsia may be the cause of:

The inflammatory response to the pregnancy
Genes
Preexisting diseases

An immune response to the baby: The woman’s body recognizes the baby and the placenta as intruders who eats up its nutrients. The mother’s body reacts to the part of the fetus with the father’s genes. An excessive immune response may damage her blood vessels and blood circulation.

Preeclampsia may be genetically determined. Pregnant women whose mothers and spouse’s mothers had preeclampsia during their pregnancies are considered at a higher risk of developing preeclampsia.

Some other factors that may cause blood vessel defects include hormonal imbalance, blood vessel injuries, nutritional and environmental factors.

Risk factors for developing preeclampsia

The following risk factors increase the chance of developing preeclampsia:

Pregnant women who are pregnant for the first time are more likely to develop preeclampsia.
Pregnant women older than 35, or teen moms, are considered at a higher risk of developing preeclampsia.
Those who are pregnant with twins or more.
Women with autoimmune disorders, including lupus, rheumatoid arthritis, antiphospholipid antibody syndrome, or scleroderma, are also at higher risk.
Those with pre-existing diseases, such as high blood pressure, obesity, diabetes, kidney disorder, are at potential risk for developing preeclampsia in pregnancy.
Women who have had preeclampsia or complications in previous pregnancies are at greater risk.
Poor nutrition during pregnancy, leading to a deficiency of certain minerals (calcium and magnesium) and vitamins (E and C), is also linked to a higher risk for preeclampsia.
Environmental risk factors, such as air pollution, may also contribute to a higher risk for developing preeclampsia.

How is preeclampsia diagnosed?

Health care providers suspect preeclampsia on regular prenatal care appointments, where pregnant women have their blood pressure measured each time.

A rise in blood pressure is a sign for doctors to make a further examination of the pregnant woman. They are looking for other symptoms, more precisely a pattern of them, and conduct additional tests.

Additional tests to confirm or rule out preeclampsia could be:

Urine test: Most health care providers confirm preeclampsia by urinalysis, where they are looking at the presence of proteins in the pregnant woman’s urine. She is diagnosed with preeclampsia if she has high blood pressure and protein in the urine.
Blood tests: A Pregnant woman is diagnosed with preeclampsia if she has high blood pressure, along with a low platelet count (less than 100,000) and/or abnormally high liver enzymes in the blood.

Potential complications of preeclampsia

Preeclampsia may lead to severe complications for both the pregnant woman and the fetus. An unrecognized or untreated condition can even lead to the death of one or both of them.

Possible complications for the mom:

If not treated correctly and fast enough, it can lead to severe complications. Preeclampsia can affect the pregnant woman’s organs. Kidney damage or damage to the liver, brain, and lungs may occur. These problems are usually transient, but in severe forms can be long-lasting as well.

In very severe cases, preeclampsia may lead to life-threatening conditions such as eclampsia and HELLP syndrome, which are both medical emergencies.

Eclampsia is a severe form of preeclampsia, which includes seizures similar to epilepsy.

HELLP syndrome is a rare pregnancy complication that affects the blood and liver of pregnant women. It can happen during pregnancy or right after birth.

HELLP stands for the different conditions, which may happen to a pregnant woman affected by this syndrome.

Hemolysis: is a breakdown of red blood cells that carry oxygen throughout the body.
Elevated Liver Enzymes: which is a sign of liver disease.
Low Platelet Count: which causes poor blood clotting and can lead to severe bleeding.

How can preeclampsia affect the baby?

Preeclampsia inhibits the blood flow to the placenta. If the placenta doesn’t get enough blood, the baby doesn’t receive enough oxygen and nutrients for proper development. That may result in slower growth (fetal growth restriction), low birth weight, or preterm birth.

If preeclampsia is detected early enough and treated appropriately, most women give birth to a perfectly healthy baby.

What is the difference between preeclampsia and eclampsia?

Both preeclampsia and eclampsia are high blood pressure disorders that can occur only in pregnancy. Preeclampsia is the initial condition, and eclampsia is its complication.

Pre-eclampsia =the initial stage, which can lead to eclampsia

Eclampsia is a severe disorder, which manifests by seizures similar to epileptic. If preeclampsia is not detected and managed, it can lead to the stage where it affects a woman’s brain function causing seizures or coma.

This stage is called eclampsia, which is a life-treating condition. The pregnant woman loses consciousness or gets seizures that are not generalized by epilepsy or brain tumor, but by extremely high blood pressure in pregnancy.

Due to prenatal care, the incidence of eclampsia has hugely decreased in recent years. However, if it occurs, it is a medical emergency and requires immediate treatment in a hospital and delivering the fetus.

Treatment of preeclampsia

The only cure for preeclampsia is delivery. So, if preeclampsia occurs in the 37+ week of pregnancy, doctors may decide to induce labor. The baby is already fully developed, and if they expect complications, it doesn’t make sense to wait until the end of the pregnancy.

But for those who are still in early pregnancy, there are several treatments for managing preeclampsia. Doctors decide on the most appropriate approach based on the severity of the condition and the gestational age of the baby.

All treatments of preeclampsia have the same goal, which is preventing complications in pregnant women and prolonging the pregnancy until the fetus is mature enough to give birth.

Pregnant women with high blood pressure, who do not show kidney or liver disease, and have no protein in their urine, must firstly reduce salt and fat intake, avoid stress, and rest as much as they can. Most of them can usually stay at home, monitor their condition, and attend more frequent prenatal care appointments.

If these measures are not enough, they might get medication to lower blood pressure and/or stay in the hospital.

In severe forms of preeclampsia, which can lead to eclampsia, seizures, and organ failure in pregnant women, childbirth is the only option for saving the mother – regardless of the length of the pregnancy.

When a woman gives birth, her health usually improves, and the signs of preeclampsia disappear.