Preeclampsia

Description

Preeclampsia is a complication of pregnancy. With pre-eclampsia, you can have high blood pressure, high levels of protein in the urine indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range.

Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and the baby.

At the beginning of the delivery of the baby is often recommended. The delivery time depends on the severity of the preeclampsia is, and how many weeks of gestation. Before the delivery, pre-eclampsia treatment includes careful monitoring and medications to lower blood pressure and manage complications.

Pre-Eclampsia can develop after delivery of a baby, a condition known as postpartum preeclampsia.

Symptoms

The defining characteristic of pre-eclampsia is hypertension, proteinuria, or other signs of damage to the kidneys or other organs. There may be no noticeable symptoms. The first signs of pre-eclampsia are often detected during routine prenatal visits with a health care provider.

Along with the high blood pressure, pre-eclampsia signs and symptoms may include:

  • The excess protein in the urine (proteinuria) or other signs of kidney problems
  • Decreased levels of platelets in the blood (thrombocytopenia)
  • Increased liver enzymes that indicate liver problems
  • Severe headaches
  • Changes in vision, including temporary loss of vision, blurred vision, or sensitivity to light
  • Shortness of breath, caused by fluid in the lungs
  • Pain in the upper part of the abdomen, usually under the ribs on the right side
  • Nausea or vomiting

The weight gain and swelling (edema) are typical during healthy pregnancies. However, the sudden weight gain or a sudden onset of edema — especially on the face and the hands — can be a sign of preeclampsia.

When to see a doctor

Be sure to attend your prenatal visits so that your health care provider may monitor your blood pressure. Contact your doctor immediately or go to an emergency room if you have severe headache, blurred vision or other visual disturbances, severe abdominal pain or severe shortness of breath.

Due to headaches, nausea, aches and pains are common discomforts of pregnancy, it is difficult to know when new symptoms are simply just part of being pregnant and when they can indicate a serious problem, especially if it is your first pregnancy. If you are worried about your symptoms, contact your doctor.

Causes

The exact cause of preeclampsia likely involves multiple factors. The experts believe that it begins in the placenta, the organ that nourishes the fetus during the entire pregnancy. At the beginning of the pregnancy, new blood vessels develop and evolve for the supply of oxygen and nutrients from the placenta.

In women with pre-eclampsia, these blood vessels do not seem to develop or work correctly. Problems with the way blood flows in the placenta may lead to the irregularity of the regulation of blood pressure in the mother.

Another of high blood pressure disorders during pregnancy

Preeclampsia is a high blood pressure (hypertension) disorder that can occur during pregnancy. Other disorders can occur, and also:

  • Gestational hypertension is high blood pressure that begins after 20 weeks without any problems in the kidneys or other organs. Some women with gestational hypertension may develop pre-eclampsia.
  • Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy. The high blood pressure that lasts more than three months after the pregnancy is also called chronic hypertension.
  • Chronic hypertension with preeclampsia superimposed occurs in women diagnosed with chronic hypertension before pregnancy, which then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy.

Risk factors

Conditions that are linked to an increased risk of pre-eclampsia include:

  • The pre-Eclampsia in a previous pregnancy
  • Being pregnant with more than one baby
  • Chronic high blood pressure (hypertension)
  • Type 1 or type 2 diabetes before pregnancy
  • Kidney disease
  • Autoimmune disorders
  • The use of in vitro fertilization

The diseases that are associated with a moderate risk of developing pre-eclampsia include:

  • First pregnancy with the current partner
  • Obesity
  • The family history of pre-eclampsia
  • The maternal age of 35 years or more
  • Complications in a previous pregnancy
  • More than 10 years since the previous pregnancy

Other risk factors

Several studies have shown an increased risk of pre-eclampsia in Black women compared with other women. There is also some evidence of an increased risk among indigenous women in North America.

A growing body of evidence suggests that these differences in risk may not necessarily be based on biology. An increased risk may be related to inequalities in access to antenatal care and health care in general, as well as social inequalities and chronic stress factors that affect the health and well-being.

Low-income is also associated with an increased risk of preeclampsia, probably because of access to health care and the social factors that affect health.

For the purposes of making decisions about the strategies of prevention, a Black woman, or a woman with a low level of income has a moderate increased risk of developing pre-eclampsia.

Complications

Complications of preeclampsia may include:

  • The Fetal growth restriction. Preeclampsia affects the arteries that carry blood to the placenta. If the placenta doesn't get enough blood, your baby may receive inadequate blood and oxygen and fewer nutrients. This can lead to a slow growth of the well-known as fetal growth restriction.
  • The preterm birth. Pre-Eclampsia can lead to an unplanned birth premature delivery before 37 weeks. Also, anticipated preterm birth is the main treatment for pre-eclampsia. A baby that was born prematurely has increased the risk of breathing and feeding difficulties, vision or hearing problems, developmental delay, and cerebral palsy. Treatments prior to preterm birth may reduce some of the risks.
  • Abruption of the placenta. Preeclampsia increases the risk of detachment of the placenta. With this condition, the placenta separates from the inner wall of the uterus before delivery. Severe abruption can cause heavy bleeding, which can be life threatening for the mother and the baby.
  • the hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome.HELLPstands by hemolysis (destruction of red blood cells), elevated liver enzymes and low platelet count. This severe form of preeclampsia affects several organs and systems.HELLPsyndrome threatens the life of the mother and the baby, and may cause health problems for the life of the mother. Signs and symptoms include nausea and vomiting, headache, upper right stomach pain, pain and a general feeling of illness or discomfort. Sometimes, it develops suddenly, even before the high blood pressure is detected. It can also develop without any symptoms.
  • Eclampsia.Eclampsia is the onset of seizures, or coma with signs or symptoms of pre-eclampsia. It is very difficult to predict whether a patient with pre-eclampsia develop pre-eclampsia. Eclampsia can occur without any previously observed signs or symptoms of pre-eclampsia. The signs and symptoms that may appear before the attacks include headaches, vision problems, mental confusion or altered behaviors. But, there are often no symptoms or warning signs. Eclampsia can occur before, during, or after delivery.
  • Other organ damage. Pre-Eclampsia can result in damage to the kidneys, the liver, lung, heart, or eyes, and may cause a stroke or other brain injury. The number of lesions in other organs depends on the severity of the preeclampsia.
  • Cardiovascular disease. Have preeclampsia may increase your risk of future heart and blood vessel (cardiovascular) disease. The risk is even greater if you have had pre-eclampsia more than once or have ever had a premature delivery.

the hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome. Hellp stands for hemolysis (destruction of red blood cells), elevated liver enzymes and low platelet count. This severe form of preeclampsia affects several organs and systems. The HELLP syndrome is a threat to the life of the mother and the baby, and may cause health problems for the life of the mother.

Signs and symptoms include nausea and vomiting, headache, upper right stomach pain, pain and a general feeling of illness or discomfort. Sometimes, it develops suddenly, even before the high blood pressure is detected. It can also develop without any symptoms.

Eclampsia. Eclampsia is the onset of seizures, or coma with signs or symptoms of pre-eclampsia. It is very difficult to predict whether a patient with pre-eclampsia develop pre-eclampsia. Eclampsia can occur without any previously observed signs or symptoms of pre-eclampsia.

The signs and symptoms that may appear before the attacks include headaches, vision problems, mental confusion or altered behaviors. But, there are often no symptoms or warning signs. Eclampsia can occur before, during, or after delivery.

Prevention

Medicine

The best available clinical evidence for the prevention of pre-eclampsia is the use of low-dose aspirin. Your primary care provider may recommend that you take a 81 mg aspirin tablet daily after 12 weeks of pregnancy, if you have a high-risk factor for pre-eclampsia, or more than one moderate risk factor.

It is important that you speak with your doctor before taking any medication, vitamins or supplements to make sure that it is safe for you.

Lifestyle and healthy choices

Before you get pregnant, especially if you've had preeclampsia before, it is a good idea to be as healthy as can be. Talk with your provider about the administration of any of the conditions that increase the risk of pre-eclampsia.

Preeclampsia

Diagnosis

A diagnosis of pre-eclampsia occurs if you have high blood pressure after 20 weeks of pregnancy and at least one of the following findings:

  • Protein in the urine (proteinuria), which indicates an impairment of the kidneys
  • Other signs of kidney problems
  • A low platelet count in the blood
  • Elevation of liver enzymes, showing a deterioration of liver
  • Fluid in the lungs (pulmonary edema)
  • New headaches that will not go away after taking drugs for pain
  • New vision disorders

High blood pressure

A blood pressure reading has two numbers. The first number is the systolic pressure, which is a measure of the blood pressure when the heart contracts. The second number is the diastolic pressure, which is a measure of the blood pressure when the heart is relaxed.

In pregnancy, high blood pressure, is diagnosed if the systolic pressure of 140 millimeters of mercury (mm Hg) or more, or if the diastolic pressure is 90 millimeters of mercury (mm Hg) or higher.

A number of factors can affect your blood pressure. If you have a high blood pressure reading during an appointment, your doctor will probably have a second reading, four hours later to confirm a diagnosis of high blood pressure.

Additional tests

If you have high blood pressure, your doctor will order additional tests to check if there are other signs of pre-eclampsia:

  • Blood tests. A blood sample is analyzed in a laboratory can show how well the liver and kidneys are working. Blood tests can also measure the amount of blood platelets, the cells that help the blood to clot.
  • Analysis of urine. Your health care provider will ask for 24-hour urine sample or a single urine sample to determine how well the kidneys are working.
  • The Fetal ultrasound. Your primary care provider will likely recommend close monitoring of your baby's growth, usually through the ultrasound. The pictures of your baby's created during the ultrasound examination to allow estimates of the baby's weight and the amount of fluid in the uterus (amniotic fluid).
  • Nonstress test or biophysical profile. A nonstress test is a simple procedure that checks to see how your baby's heart rate reacts when your baby moves. A biophysical profile uses ultrasound to measure your baby's breathing, muscle tone, movement, and the volume of amniotic fluid in the uterus.

Treatment

The main treatment for preeclampsia is delivery or treat the disease until the best time to deliver the baby. This decision with your health care provider will depend on the severity of the preeclampsia, gestational age of your baby, and the general state of health and the health of your baby.

If pre-eclampsia is not severe, you may have frequent provider visits to control your blood pressure, changes in the signs or symptoms, and the health of your baby. You'll likely be asked to check your blood pressure every day at home.

Treatment of severe pre-eclampsia

Severe Preeclampsia requires you to be in the hospital to control your blood pressure and its possible complications. Your health care provider often control the growth and well-being of your baby.

Medications to treat severe preeclampsia usually include:

  • Antihypertensive drugs to reduce blood pressure
  • Antiseizure medication, such as magnesium sulfate to prevent seizures
  • Corticosteroids to promote the development of the baby's lungs before delivery

Delivery

If you have pre-eclampsia is not severe, your doctor may recommend early delivery after 37 weeks. If you have severe preeclampsia, your doctor will likely recommend delivery before 37 weeks, depending on the severity of the complications and the health and readiness of the baby.

The method of delivery — vaginal or c-section, since it depends on the severity of the disease, the baby's gestational age and other considerations that I would discuss with your health care provider.

After delivery

You need to be monitored for high blood pressure and other signs of preeclampsia after delivery. Before they go home, they will tell you when you should seek medical attention if you have symptoms of postpartum pre-eclampsia, such as headaches, vision changes, severe abdominal pain, nausea, and vomiting.

Coping and support

Discover that you have a potentially serious complication of pregnancy can be scary.

If you're diagnosed with pre-eclampsia, late pregnancy, you may be surprised to learn that speedy delivery may be recommended. If you are diagnosed before your pregnancy, you may be concerned about the monitoring of signs and symptoms in the home and bring more frequent appointments with your primary care provider.

This can help you learn more about your condition. In addition to talking with your provider, do some research. Make sure you understand when to call your provider and how to monitor signs and symptoms.

Preparing for your appointment

Pre-Eclampsia is often diagnosed during a regularly scheduled prenatal appointment. If your primary care provider will recommend certain tests for a diagnosis of pre-eclampsia, you can also discuss some of the following questions:

  • Do you have preeclampsia or other complications in a previous pregnancy?
  • If you are having symptoms of pre-eclampsia, when do you start?
  • You do not have anything to improvement of symptoms or made them worse?
  • You have made recent changes in medications, vitamins, or dietary supplements?

After a diagnosis of preeclampsia and in the follow-up appointments, you can ask the following questions:

  • How can I make sure that I am doing the readings of blood pressure correctly at home?
  • How often should I check my blood pressure at home?
  • What is the blood pressure reading should be considered high?
  • When should I call the clinic?
  • When should I get emergency care?
  • How will we monitor the health of my baby?
  • When should I schedule my next appointment?
  • How are we going to decide on the suitable time for delivery?
  • What are the benefits and the risks of delaying the delivery?
  • What they may need medical attention you need my baby after a premature birth?
Symptoms and treatment of pre-Eclampsia