Pregnancy – preeclampsia – Better Health Channel

What is preeclampsia?

Preeclampsia is a disorder of pregnancy characterised by high maternal blood pressure, and protein in the urine. It is the most common serious medical complication of pregnancy, affecting around 5 to 8 per cent of all pregnancies in Australia. 1 to 2 per cent of cases are severe enough to threaten the lives of both the mother and her unborn child.

The causes of this condition are not fully understood, but genetic factors and the placenta seem to play significant roles. Preeclampsia tends to be more common in first, rather than subsequent, pregnancies.

The woman’s blood pressure usually returns to normal after the baby is born and the placenta is delivered.

Effects of preeclampsia on the mother

Preeclampsia may develop at any time during the second half of pregnancy, but commonly develops during the later stages of pregnancy.

Preeclampsia most commonly causes high blood pressure and protein in the urine. The seriousness of the disease is decided by the level of the blood pressure.

In its mildest form, protein will show in a urine test and blood pressure may be only slightly raised. However, preeclampsia can become very serious.

At its most serious, blood pressure can be very high and other body organs are affected such as the kidneys, liver, brain and blood (in particular, the blood clotting system).

If left untreated, preeclampsia can lead to serious problems such as: fitting or convulsions, kidney failure, liver failure, clotting problems or death.

All forms of preeclampsia need to be treated.

Who is at risk of preeclampsia?

It is difficult to predict who will be affected, but certain women appear to be more at risk than others, including women who:

• are having their first pregnancy
• have pre-existing high blood pressure
• have a family history of the condition
• have diabetes
• are pregnant with more than one baby in the womb.

What are the symptoms of preeclampsia?

Preeclampsia initially has no obvious symptoms and most women with the condition feel well. That’s why regular antenatal checks of your blood pressure are so important.

Early symptoms of preeclampsia include:

• a sudden rise in blood pressure (above levels at the start of pregnancy)
• proteinuria (protein in your urine).

Over time, you may also develop fluid retention (oedema). Oedema is a common pregnancy symptom, usually causing swelling of the feet and ankles. However, sudden swelling of the face, hands and feet can be a sign of preeclampsia.

Some of the advanced symptoms of preeclampsia include:

• dizziness
• headache
• visual disturbances, such as flashing lights
• abdominal pain just below the ribs
• nausea and vomiting.

If left untreated, preeclampsia can lead to serious problems such as:

• fitting or convulsions
• kidney failure
• liver failure
• blood clotting problems
• death.

Effects of preeclampsia on the unborn baby

Around 5 to 8 per cent of pre-term deliveries in Australia are due to preeclampsia or its associated complications.

In the womb, the baby is attached to a special organ of pregnancy called the placenta. It is the placenta that provides the baby with oxygen and nutrients from the mother’s blood and gets rid of waste products (such as carbon dioxide) by passing them back to the mother’s blood.

If the mother has preeclampsia, high blood pressure can slow down the amount of oxygen and nutrients that are able to get through to the baby. In severe cases, the baby can be gradually starved of oxygen and nutrients, which may affect growth. This growth restriction threatens the life of the baby and it is then necessary for the baby to be born early, even prematurely.

Another serious complication of preeclampsia is placental abruption, where the placenta separates from the uterine wall and the woman experiences vaginal bleeding and abdominal pain. This is a medical emergency.

Diagnosis of preeclampsia

Some symptoms of preeclampsia, such as fluid retention, are also typical of normal pregnancy, so women may dismiss the early warning signs. This is why regular antenatal blood pressure checks are vital to detecting and diagnosing preeclampsia.

Preeclampsia is diagnosed when high blood pressure (140/90 mm Hg or higher) occurs together with one or more of the following after 20 weeks pregnancy:

• protein in the urine – determined by analysis of a urine sample
• swelling and fluid in the feet hands and face
• liver function abnormalities – determined by a blood test for liver function
• kidney function abnormalities – determined by a blood test for kidney function
• blood clotting abnormalities – determined by a blood test for platelet count
• onset of headaches or visual disturbances
• fetal growth restriction – determined by fetal ultrasound.

Treatment of preeclampsia

If you are diagnosed with mild preeclampsia your GP (doctor) will advise you as to how often you need to have antenatal check-ups. Your blood pressure and urine will be tested regularly, and you will be asked about any symptoms you may have.

If you are diagnosed with severe preeclampsia you may need to be admitted to hospital for monitoring and treatment – this may be until your baby is born. Treatment may include:

• rest
• blood pressure medication
• anticonvulsant medication.

At present, the only cure for preeclampsia is for the baby to be born and the placenta to be delivered. In some cases this may mean that your labour is induced.

Current preeclampsia research

Maternal deaths in Australia are very rare; however, preeclampsia and its associated complications are responsible for around 15 per cent of maternal deaths.

Medical researchers are looking for ways to predict preeclampsia, in order to reduce the risks for mothers and their babies. Since preeclampsia tends to run in families, scientists are currently looking for the specific gene(s) which might be responsible for preeclampsia. If discovered, it is hoped there will eventually be a prepregnancy test for the condition.

Where to get help

• Your GP (doctor)
• Midwife
• Obstetrician

Preeclampsia: Causes, symptoms, and treatments

Preeclampsia is a condition that causes a sudden rise in blood pressure during pregnancy. It can also lead to clotting issues that may affect organs, such as the liver and kidneys.

Preeclampsia is the most common complication to occur during pregnancy. It generally develops during the third trimester and affects about 1 in 25 pregnancies.

It can progress into eclampsia in some people, where they can experience seizures and enter a coma. It can also be fatal. Prenatal appointments are an important component of managing health, preeclampsia, and potential conditions such as eclampsia.

Preeclampsia may present no initial symptoms, but common signs include:

• protein in the urine
• high blood pressure
• blurry vision, sometimes seeing flashing lights
• headaches, often severe
• feeling ill
• shortness of breath
• pain just below the ribs on the right side
• rapid weight gain, caused by excess fluid
• nausea and vomiting during the second half of pregnancy
• urinating less often
• lower platelet count
• impaired liver function

Pregnant people should seek immediate medical attention if they experience any of these signs or symptoms.

Although some people may develop high blood pressure during pregnancy, it does not necessarily mean they have preeclampsia. The criteria for diagnosing preeclampsia include elevated blood pressure and at least one correlating sign from above.

As preeclampsia progresses, people may experience fluid retention, with swelling in the hands, feet, ankles, and face.

Swelling, or edema, can be a common part of pregnancy, especially during the third trimester. It tends to occur in the lower parts of the body, such as the ankles and feet. Symptoms are typically milder first thing in the morning and build up during the day. This is not preeclampsia, in which edema occurs suddenly and tends to be much more severe.

Preeclampsia can also restrict the baby’s growth because of decreased blood supply to the placenta.

Experts are not sure why preeclampsia occurs. Most say there is a problem with the placenta’s development because the blood vessels that supply it respond differently to hormonal signals and are narrower than normal, limiting blood flow.

Experts also do not fully understand why the blood vessels develop differently, but several factors may play a role. These include:

• damage to the blood vessels
• insufficient blood flow to the uterus
• immune system problems
• genetic factors

Preeclampsia is not cured until the baby is delivered.

Until the pregnant person’s blood pressure reduces, they are at a greater risk of stroke, severe bleeding, separation of the placenta from the uterus, and seizures. In some cases, especially if preeclampsia develops earlier in pregnancy, early delivery may not be the best option for the baby.

People who have had preeclampsia in previous pregnancies are advised to attend prenatal visits more often. The doctor may recommend the following medications:

• Antihypertensives: These help to lower blood pressure.
• Anticonvulsants: In severe cases, doctors may use these drugs to prevent a first seizure. They may prescribe magnesium sulfate.
• Corticosteroids: If the person has preeclampsia or HELLP syndrome – see below – these drugs can help induce fetal lung maturity to prepare for premature delivery. This can prolong the pregnancy.

Rest

If the person is far from the end of their pregnancy and has mild symptoms, the doctor may advise bed rest. Resting helps bring the blood pressure down, increasing blood flow to the placenta and benefiting the baby.

Doctors may advise some people to lie down in bed and only sit up or stand when needed. Others may be allowed to sit in an armchair or on the sofa or bed, but their physical activities will be strictly limited. There will be regular blood pressure and urine tests, and doctors will also monitor the baby closely.

In severe cases, the pregnant person may be hospitalized for continuous bed rest and monitored closely.

Inducing labor

With a diagnosis of preeclampsia close to the end of pregnancy, doctors may advise delivering the baby early.

There may be no choice in very severe cases, and doctors will induce the labor or perform a cesarean delivery as soon as possible. The doctor may give the parent magnesium sulfate to improve uterine blood flow and prevent seizures during childbirth.

Symptoms of preeclampsia should go away within a few weeks of delivery.

For a doctor to diagnose preeclampsia, the pregnant person must have a diagnosis of high blood pressure and at least one additional associated sign, such as decreased blood platelets or impaired liver function.

Hypertension

This is the term for high blood pressure. A blood pressure reading of 140/90 mm Hg or higher is abnormal in pregnancy.

The doctor may also order diagnostic tests:

• Blood tests: This checks kidney and liver function and whether the blood is clotting properly.
• Fetal ultrasound: Doctors will closely monitor the baby’s progress to make sure they are growing properly.
• Non-stress test: The doctor checks how the baby’s heartbeat reacts when they move. If the heartbeat increases 15 beats or more a minute for at least 15 seconds twice every 20 minutes, it is an indication that everything is normal.

Risk factors associated with preeclampsia include:

• First pregnancies: The chances of preeclampsia during a first pregnancy are considerably higher than subsequent ones.
• Family history: A person whose parent or sibling had preeclampsia has a higher risk of developing it.
• Personal history of preeclampsia: A person who had preeclampsia in their first pregnancy can have a much greater risk of having the same condition in subsequent pregnancies.
• Certain conditions and illnesses: People with diabetes, chronic high blood pressure, autoimmune conditions, and kidney disease are more likely to develop preeclampsia.
• Obesity: Preeclampsia rates are much higher among obese people.
• Multiple pregnancies: If a person is expecting two or more babies, the risk is higher.

While the prevalence of preeclampsia is 3–5%, its impact is not equal across all populations. The rates of occurrence and outcomes are disproportionate among groups such as non-Hispanic Black women and American Indian or Alaskan Native women.

Furthermore, most of the currently available data that examines disparities primarily compare the differences between non-Hispanic Black and white women.

Additionally, only a small number of studies examine outcomes for mixed-race, Asian, American Indian, or Alaskan Native women.

A 2017 report examined the prevalence of preeclampsia in 2014. It included data from nearly 177,000 deliveries in women with preeclampsia or eclampsia.

The total rates of preeclampsia and eclampsia based on race and ethnicity:

• 69.8 per 1,000 deliveries for Black women
• 46.8 per 1,000 deliveries for Hispanic women
• 43. 3 per 1,000 deliveries for white women
• 28.8 per 1,000 deliveries for Asian/Pacific Islander women

However, studies discussing preeclampsia and using race and ethnic differences for clarity do not often consider contributing factors. Further research is warranted that considers behavioral, environmental, genetic, and socioeconomic factors as well as access to healthcare.

Preeclampsia is not fully preventable, but there are several steps a pregnant person can take to moderate some factors that contribute to high blood pressure.

These can include:

• drinking between 6 and 8 glasses of water every day
• avoiding fried or highly processed foods
• excluding added salt
• avoiding alcohol and caffeine
• taking regular exercise under their doctor’s guidance
• keeping feet elevated a few times per day
• resting

These steps can help maintain healthy blood pressure and may reduce the risk of preeclampsia. Pregnant people should follow their doctor’s advice on diet and exercise.

In rare cases, a person may experience high blood pressure after giving birth. This is known as postpartum preeclampsia and can occur between a few days and a few weeks after delivery. The main symptoms are high blood pressure and protein in the urine. The typical accompanying symptoms of preeclampsia, such as severe headaches and a swollen face, can also occur.

Postpartum preeclampsia is easily treated with blood pressure medications that reduce and prevent seizures. Doctors will prescribe drugs that will not affect the ability to breastfeed.

There is a risk of serious complications with untreated preeclampsia. Complications may be prevented if the signs of preeclampsia are detected sooner, which is possible by attending routine prenatal visits. However, if the condition is not diagnosed for some reason, the risks are considerably greater.

The following complications may develop from preeclampsia:

Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome: HELLP can very quickly become life threatening for both the pregnant person and the baby. It stands for hemolysis, elevated liver enzymes, and low platelet count. It is a combined liver and blood clotting disorder that most commonly occurs right after giving birth but can appear at any time after the 20th week of pregnancy. Very rarely, it may occur beforehand. The only way to treat HELLP syndrome effectively is to deliver the baby as soon as possible.

Poor blood flow to the placenta: If blood flow to the placenta is restricted, the baby might not be getting oxygen and nutrients, which may lead to slower growth, breathing difficulties, and premature birth.

Placental abruption: The placenta separates from the inner wall of the uterus. In severe cases, there may be heavy bleeding, which can damage the placenta. Any damage to the placenta may place the baby’s and pregnant person’s life at risk.

Eclampsia: This is a combination of preeclampsia and seizures. The pregnant person may experience pain under the ribs on the right side of their body, intense headache, blurry vision, confusion, and decreased alertness. If left untreated, they are at risk of coma, permanent brain damage, and death. The condition is also life threatening for the baby.

Preeclampsia can have some long-term consequences for the developing baby. Research shows that high blood pressure in pregnant people may affect the baby’s cognitive skills, which can carry through into later life.

Preeclampsia is a complication of pregnancy where there is a sudden rise in blood pressure. It usually develops during the third trimester.

Preeclampsia is not entirely preventable, but visiting a doctor for regular prenatal visits may lead to early detection. Limiting highly processed foods and choosing fruits and vegetables — frozen and canned are great options — can also help to keep people and their babies healthier during pregnancy.

It is advisable for pregnant people to speak with a healthcare professional about their risk of developing preeclampsia and its warning signs.

Preeclampsia and pregnancy | Ida-Tallinna Keskaigla

Preeclampsia and pregnancy

The purpose of this information leaflet is to provide the patient with information about the nature, occurrence, risk factors, symptoms and treatment of preeclampsia.

What is preeclampsia?

Pre-eclampsia is a disease that occurs during pregnancy and is characterized by high blood pressure and protein in the urine. Preeclampsia is one of the most common complications of pregnancy. Epilepsy-like seizures occur in severe preeclampsia and are life-threatening.

What symptoms may indicate the development of preeclampsia?

High blood pressure – blood pressure values ​​are 140/90 mmHg. Art. or higher. If systolic (upper) or diastolic (lower) blood pressure rises by 30 mm Hg. Art. or more, then such an increase cannot be ignored.

Protein in urine – 300 mg in urine collected over 24 hours, or +1 value on a rapid test.

Swelling of the arms, legs or face , especially under the eyes or if the skin is pitted when pressed. Edema can occur in all pregnant women and is generally harmless, but rapidly developing edema should be taken into account.

Headache that does not improve after taking pain medication.

Visual disturbances – double vision or blurred vision, dots or flashes before the eyes, auras.

Nausea or pain in the upper abdomen – These symptoms are often mistaken for indigestion or gallbladder pain. Nausea in the second half of pregnancy is not normal.

Sudden weight gain – 2 kg or more per week.

As a rule, there is a mild course of the disease that occurs at the end of pregnancy and has a good prognosis. Sometimes, preeclampsia can worsen quickly and be dangerous to both mother and fetus. In such cases, rapid diagnosis and careful monitoring of the mother and child are of paramount importance.

Unfortunately, most women develop symptoms in the final stages of the disease. If you experience any of the above symptoms, you should contact your midwife, gynecologist, or the Women’s Clinic emergency department.

Is preeclampsia called toxemia of pregnancy?

Previously, pre-eclampsia was really called toxicosis, or toxemia, since it was believed that the cause of the disease was toxins, that is, poisons in the blood of a pregnant woman.

What is the difference between preeclampsia and gestational hypertension?

Pregnancy hypertension is an increase in blood pressure above normal after the 20th week of pregnancy. With hypertension of pregnant women, protein in the urine is not observed.

What is HELLP syndrome?

HELLP syndrome is one of the most severe forms of preeclampsia. HELLP syndrome is rare and sometimes develops before symptoms of preeclampsia appear. Sometimes the syndrome is difficult to diagnose, as the symptoms resemble gallbladder colic or a cold.

When does preeclampsia occur?

Preeclampsia usually occurs after the 20th week of pregnancy. As a rule, preeclampsia goes away after delivery, but complications can occur up to six weeks after delivery, during which careful monitoring of the condition is necessary. If by the sixth week after birth, blood pressure does not return to normal, then you need to contact a cardiologist, who will begin treatment against hypertension.

What is the cause of preeclampsia?

The causes of the disease are still not clear, there are only unproven hypotheses.

How does the disease affect pregnant women and pregnancy?

Most preeclamptic pregnancies have a favorable outcome and a healthy baby is born. However, the disease is very serious and is one of the most common causes of death of the child and mother. Preeclampsia affects a woman’s kidneys, liver, and other vital organs, and if left untreated, it can cause seizures (eclampsia), cerebral hemorrhage, multiple organ failure, and death.

How does the disease affect the fetus?

In preeclampsia, the fetus does not receive enough oxygen and nutrients to grow, and intrauterine growth retardation may occur. In addition, the placenta may separate from the uterine wall before the baby is born. Since the only treatment for preeclampsia is childbirth, sometimes a pregnancy has to be terminated prematurely. Until the 34th week of pregnancy, the lungs of the fetus have not yet matured, and steroid hormones are injected intramuscularly into the pregnant woman to prepare his lungs. In addition to the immaturity of the lungs, the health of a premature baby is threatened by many other diseases.

Who is at risk of developing preeclampsia?

Preeclampsia occurs in approximately 8% of pregnant women, many of whom have no known risk factors.

What are the risk factors for preeclampsia?

Patient-related risk factors

• First pregnancy
• Pre-eclampsia during a previous pregnancy
• Age over 40 or under 18
• High blood pressure before pregnancy
• Diabetes before or during pregnancy
• Multiple pregnancy
• Overweight (BMI> 30)
• Systemic lupus erythematosus or other autoimmune disease
• Polycystic ovary syndrome
• Long interval between two pregnancies

Risk factors associated with the patient’s family

• Pre-eclampsia in the mother’s or father’s family
• Parental high blood pressure or heart disease
• Diabetes mellitus

What is the prevention and treatment of preeclampsia

The first trimester screening or Oscar test also calculates the risk of preeclampsia in addition to the most common chromosomal disorders. In case of high risk, pregnant women are advised to take aspirin (acetylsalicylic acid) at a dose of 150 mg in the evenings until the 36th week of pregnancy. This helps reduce the chance of preeclampsia by the 34th week of pregnancy by up to 80%.

Childbirth is the only treatment for preeclampsia. Sometimes a child can be born naturally, but sometimes, if the disease is very acute, an emergency caesarean section is necessary. The best time to have a baby is after the 37th week of pregnancy. Bed rest, medications, and, if necessary, hospitalization can sometimes help bring the condition under control and prolong the pregnancy. Often, a doctor will refer a woman with preeclampsia to the hospital for observation, as the condition of the fetus and pregnant woman may suddenly worsen.

Does bed rest help?

Sometimes bed rest is enough to control mild preeclampsia. In this case, the patient often visits a doctor who measures blood pressure, does blood and urine tests, and monitors the course of the disease. The condition of the fetus is also often examined using a cardiotocogram (CTG) and ultrasound.

Are drugs used to treat preeclampsia?

High blood pressure sometimes requires medication. The medications used have few side effects, the drugs prescribed do not have much effect on the fetus, but are very important in the treatment of maternal high blood pressure.

Seizures are a rare but very serious complication of preeclampsia. Magnesium sulfate is sometimes given intravenously to prevent seizures in a pregnant woman with preeclampsia both during and after childbirth. It is safe for the fetus, but the mother may experience side effects such as hot flashes, sweating, thirst, visual disturbances, mild confusion, muscle weakness, and shortness of breath. All these side effects disappear when the drug is discontinued.

Can preeclampsia recur?

Preeclampsia does not necessarily recur in the next pregnancy, but the main risk factor for preeclampsia is the presence of preeclampsia in a previous pregnancy(s). Risk factors for relapse include the severity of the previous case and the woman’s overall health during pregnancy. A woman who has previously had preeclampsia should consult a gynecologist during a new pregnancy or when planning a pregnancy.

ITK1013

The information material was approved by the Health Care Quality Committee of East-Tallinn Central Hospital on 11/30/2022 (Minutes No. 18-22).

Preeclampsia during pregnancy

Pre-eclampsia in pregnancy

What is preeclampsia?

Preeclampsia is a serious blood pressure disorder that can occur after the 20th week of pregnancy or after childbirth (called postpartum preeclampsia). This is when a woman has high blood pressure and signs that some of her organs, such as her kidneys and liver, are malfunctioning.

Blood pressure is the force with which blood presses against the walls of the arteries. Arteries are blood vessels that carry blood from the heart to other parts of the body. High blood pressure (also called hypertension) occurs when the pressure of blood against the walls of blood vessels is too high. This can be stressful for your heart and cause problems during pregnancy.

Pre-eclampsia is a serious health problem for pregnant women. It affects 2 to 8 percent of pregnant women worldwide. It is also the cause of 15% of preterm births. A preterm birth is a birth that occurs too early, before 37 weeks of gestation.

Diagnosis of preeclampsia during pregnancy

Most women with preeclampsia give birth to healthy children. But if left untreated, it can cause serious health problems for you and your baby.

Causes of preeclampsia

The exact cause of preeclampsia is likely related to several factors. Experts believe it begins in the placenta, the organ that nourishes the fetus throughout pregnancy. During early pregnancy, new blood vessels form and develop to supply the placenta with oxygen and nutrients.

Make an appointment with a gynecologist ►

In women with preeclampsia, these blood vessels do not develop and function properly. Problems with blood circulation in the placenta can lead to irregular regulation of blood pressure in the mother.

Risk factors for preeclampsia

Conditions that are associated with a higher risk of preeclampsia include:

• Preeclampsia in a previous pregnancy

• Pregnancy with more than one child

• Chronic high blood pressure (hypertension)

• Type 1 or 2 diabetes before pregnancy

• Kidney disease

• Autoimmune diseases

• Use of in vitro fertilization (IVF)

that are associated with a moderate risk of preeclampsia include:

• First pregnancy with current partner

• Obesity

• Family history of preeclampsia

• Maternal age 35 years or older

• Complications in previous pregnancy

• More than 10 years since previous pregnancy

Symptoms of pre-eclampsia during pregnancy

What are the signs and symptoms of preeclampsia?

Signs of illness are things that someone else might notice about you, such as having a rash or coughing. Symptoms are things you feel yourself that others don’t see, such as a sore throat or dizziness.

Signs and symptoms of pre-eclampsia include:

• Changes in vision such as blurring, flashing lights and spots, or sensitivity to light.

• Headache that does not go away

• Nausea (feeling of nausea in the stomach), vomiting or dizziness

• Pain in the upper right side of the abdomen

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Sudden weight gain

• Swelling of legs, arms or persons

• Difficulty breathing

• Severe vomiting and nausea

Many of these signs and symptoms are a common discomfort during pregnancy. If you have even one sign or symptom, call your doctor right away.

How can preeclampsia affect you and your baby?

Without treatment, preeclampsia can cause serious health problems for you and your baby, including death. You can have preeclampsia even if you don’t know it, so be sure to attend all prenatal checkups, even if you feel well. Tell your doctor if you have any signs or symptoms of preeclampsia.

• Fetal growth restriction
  Preeclampsia affects the arteries that carry blood to the placenta. If the placenta does not receive enough blood, the baby may not receive enough blood and oxygen and fewer nutrients. This can lead to growth retardation, known as fetal growth retardation.

• Preterm birth
  Preeclampsia can lead to unplanned preterm birth – delivery before 37 weeks. In addition, planned preterm birth is the main treatment for preeclampsia. A premature baby is at increased risk of breathing and feeding difficulties, vision or hearing problems, developmental delays, and cerebral palsy. Treatment before preterm labor may reduce some of the risks.

• Placental abruption
  Preeclampsia increases the risk of placental abruption. In this condition, the placenta separates from the inner wall of the uterus before delivery. A severe detachment can cause severe bleeding, which can be life-threatening for both mother and baby.

• HELLP syndrome
  HELLP stands for hemolysis (destruction of red blood cells), elevated liver enzymes and low platelets. This severe form of preeclampsia affects multiple organ systems. HELLP syndrome is life threatening for mother and baby and can cause lifelong health problems for the mother. Signs and symptoms include nausea and vomiting, headache, pain in the upper right side of the abdomen, and general malaise or feeling unwell. Sometimes it develops suddenly, even before high blood pressure is detected. It can also develop without any symptoms.

Treatment of preeclampsia

• Eclampsia
  Eclampsia is the onset of seizures or coma with signs or symptoms of preeclampsia. It is very difficult to predict whether a patient with preeclampsia will develop eclampsia. Eclampsia can occur without any previously observed signs or symptoms of preeclampsia. Signs and symptoms that may occur before seizures include severe headaches, vision problems, confusion, or altered behavior. But often there are no symptoms or warning signs. Eclampsia can occur before, during, or after childbirth.

• Other organ damage
  Preeclampsia can cause damage to the kidneys, liver, lungs, heart, or eyes, as well as stroke or other brain damage. The extent of damage to other organs depends on how severe the preeclampsia is.

• Cardiovascular disease
  Having preeclampsia can increase your risk of future heart and blood vessel disease (cardiovascular disease). The risk is even higher if you have had preeclampsia more than once or have had a preterm birth.

Treatment of preeclampsia

The only cure for preeclampsia and eclampsia is to give birth. Your doctor will discuss with you when to give birth, depending on how your baby has developed, how well your baby is doing in your womb, and the severity of your preeclampsia.

If your baby is growing well, usually by 37 weeks or later, your doctor may order induction of labor or a caesarean section. This will prevent preeclampsia from worsening.

If your baby is not yet due, you and your doctor can treat mild preeclampsia until your baby is mature enough to deliver safely. The closer your due date is, the better for your baby.

If you have mild preeclampsia, also known as preeclampsia without severe symptoms, your doctor may prescribe:

• Bed rest at home or in the hospital; rest mainly on left side

• Careful monitoring of fetal heart rate and frequent ultrasounds

• Blood pressure medicines

• Blood and urine tests

Your doctor may also recommend that you stay in the hospital so they can monitor you closely. At the hospital you can get:

• Medicine to help prevent seizures, lower blood pressure, and prevent other problems.

• Steroid injections to speed up your child’s lung development

Other treatments include:

If you have severe preeclampsia, your doctor may need to deliver you immediately, even if you are not close to your due date. Thereafter, symptoms of preeclampsia should resolve within 1 to 6 weeks, but may persist for longer.

Diagnosis of preeclampsia in pregnant women

Diagnosis of preeclampsia

You have preeclampsia if you have high blood pressure and at least one of the following:

• Too much protein in the urine

• Not enough platelets in the blood

• High levels of kidney-related chemicals in the blood blood levels of liver-related chemicals

• Fluid in the lungs

• New headache that doesn’t get better with medication

Your doctor may order tests to confirm your diagnosis, including:

• Blood tests to check platelets and look for chemicals in the kidneys or liver.

• Urinalysis to measure proteins

• Ultrasounds, non-stress tests or biophysical profiles to see how your baby is growing

Prevention of preeclampsia

If you are more likely to get preeclampsia, talk to your doctor about changes lifestyle that will help keep you healthy. You may need:

• Lose weight if you are overweight

• Stop smoking

• Exercise regularly

• Keep your blood pressure under control or blood sugar level

Your doctor may also recommend that you take a small dose (81 milligrams) of aspirin every day. But do not take any medications, vitamins, or nutritional supplements without first talking to them.

Can low-dose aspirin help reduce the risk of preeclampsia and preterm birth?

For some women, yes. If your healthcare provider thinks you are at risk for preeclampsia, they may ask you to take low doses of aspirin to help prevent it. Low-dose aspirin is also called baby aspirin or 81 mg (milligram) aspirin. Talk to your doctor to see if low-dose aspirin treatment is right for you.

If your doctor wants you to take low-dose aspirin to prevent preeclampsia, take it exactly as he tells you to. Do not take more or more often than your doctor tells you to.

If you have preeclampsia, can you give birth naturally?

Yes. If you have preeclampsia, a vaginal delivery may be better than a caesarean section (also called a caesarean section). A caesarean section is an operation in which your baby is delivered through an incision the doctor makes in the abdomen and uterus. With vaginal delivery, there is no stress from the operation. For most women with preeclampsia, epidural anesthesia is safe to relieve the pain of childbirth. An epidural is a pain medication given through a tube in the lower back to help relieve pain in the lower body during childbirth. This is the most common type of pain relief during childbirth.

Prevention of pre-eclampsia

What is postpartum preeclampsia?

Postpartum preeclampsia is a rare condition. This is when you have preeclampsia after giving birth. It most often occurs within 48 hours (2 days) after the baby is born, but can develop up to 6 weeks after the baby is born. It is as dangerous as preeclampsia during pregnancy and requires immediate treatment. If left untreated, it can cause life-threatening problems, including death.

The signs and symptoms of postpartum preeclampsia are the same as those of preeclampsia. It may be difficult for you to know if you have signs and symptoms after pregnancy because you are focused on caring for your baby. If you have signs or symptoms, tell your doctor right away.

We don’t know exactly what causes postpartum preeclampsia, but these could be possible risk factors:

• You had gestational hypertension or preeclampsia during pregnancy. Gestational hypertension is high blood pressure that starts after 20 weeks of pregnancy and resolves after childbirth

• Obesity

• You had a caesarean section

Complications of postpartum preeclampsia include the following life-threatening conditions: 0002 HELLP syndrome

Your doctor uses blood and urine tests to diagnose postpartum preeclampsia. Treatment may include magnesium sulfate to prevent seizures and medications to lower blood pressure. A medicine to prevent seizures is also called an anticonvulsant medicine. If you are breastfeeding, talk to your doctor to make sure these medications are safe for your baby.