Pre-eclampsia

What is it?

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Pre-eclampsia is hypertension which starts from about the 20th week of pregnancy. It is not very clear what causes pre-eclampsia, but it is thought to be due to an abnormally growing placenta. The placenta (after-birth) is the mass of tissue through which the baby is fed during pregnancy. The placenta can also send harmful chemicals into the blood which raise the blood pressure.

 

However, it has been found that a number of conditions increase the likelihood of having pre-eclampsia. They include:

  • Maternal personal factors: First pregnancy; age younger than 18 years or older than 35 years; previous pre-eclampsia; family history of pre-eclampsia in a first degree relative; black race, and obesity.
  • Maternal medical factors: Long standing hypertension, diabetes, kidney disease, obesity.
  • Foetal factors: Multiple pregnancy and genetic abnormalities.

 

What are the symptoms?

Mild pre-eclampsia usually doesn’t cause any symptoms (asymptomatic). When it starts getting severe, the following may be noticed:

  • Visual disturbances or blurring of vision
  • Headache of new onset; usually in the forehead, and throbbing in nature
  • Moderate or severe pain in the upper abdomen; usually starting suddenly and is constant.
  • Rapidly increasing body swelling
  • Rapid weight gain.

 

What can be done?

If someone has a high risk of having pre-eclampsia, some treatments may be given to prevent it from occurring.

 

The doctor may recommend low dose aspirin daily. This reduces the risk. Calcium supplements can also reduce the risk of pre-eclampsia. They're helpful if dietary calcium (i.e. from the food consumed) is not sufficient.

 

If the woman has already developed pre-eclampsia, some drugs can also be given to lower the blood pressure. They are some of the drugs used to treat hypertension but are safe in pregnancy. The doctor should decide the best ones to use. They will also give advice on what one can do on their own to manage the hypertension.

 

If the pre-eclampsia is severe, admission in a hospital is required. Treatment will be given there until it is safe to deliver the baby. Drugs will be given to lower the blood pressure. A drug called magnesium sulphate may also be given to prevent seizures from occurring.

 

When delivery is safe, drugs may either be given to start labour (induction of labour), or a surgery (caesarean section) is done to deliver the baby. The decision is guided by the specialist’s assessment.

 

What will happen to me?

Pre-eclampsia doesn't get better until after the baby is born. If it happens near the end of pregnancy, normal vaginal delivery may be tried. Otherwise, the baby may need to be delivered as early as possible to avoid complications.

 

Some women get serious health problems because of pre-eclampsia. These include Seizures (eclampsia), or problems with their liver, kidneys, heart, or lungs. Regular antenatal care visits can help prevent these from happening.

 

Most women who've had pre-eclampsia get back to normal health after they have their baby. Some need to recover in hospital for a few days.

 

A woman who has had pre-eclampsia is more likely to have it again than one who hasn’t had it before. However, majority of women who have had pre-eclampsia don’t have it again.