What is Preeclampsia in Pregnancy?

 Preeclampsia is a complication of pregnancy, characterized by the following signs and symptoms...

Symptoms of Preeclampsia in Pregnancy

  • High blood pressure
  • Proteinuria  ... protein in the urine, (equal or greater than 300mg per day)
  • Usually preeclampsia occurs after the 20 weeks of conception (pregnancy)

There may be other symptoms, which may be present. But the above, are the main key facts of the disease.

The pregnant woman must have been confirmed to have normal blood pressure before conception.

Even though, preeclampsia typically develops during the period after the 20 weeks of pregnancy or later. Please note, it rarely occur before then, and... up to six (6) weeks postpartum...after delivery.

Preeclampsia is the modern term. This disease, also has older terms... formerly known as:

  • Toxemia
  • Pregnancy toxemia
  • Edema, proteinuria , hypertension (EPH)
  • Toxemia during pregnancy
  • Preeclamptic toxemia   (PET)

There are TWO MAIN TYPES

  • Preeclampsia – eclampsia
  • Superimposed Preeclampsia on chronic hypertension

There has been recent discoveries and breakthroughs in research, and new guidelines are being formulated by different regulating organizations around the world.

For the latest and newest discoveries and how to monitor your pregnancy health, with natural remedies and ways … read more here

What Causes Preeclampsia in Pregnancy?

 Causes of Preeclampsia in Pregnancy or toxemia is not well known at the moment. There is intense research going on in this area.

Scientists and researchers believe, pre eclampsia typically develops during the early formation and establishment of the placental blood vessels, when it starts to take root in the wall of the uterus (the womb) of a pregnant woman.

Scientists believe, some abnormality may have developed in which the blood vessels are not performing as they should reducing the blood flow and nutrients to the growing fetus in the womb.

This abnormality of the placental development can be attributed to the paternal and maternal genes of the fetus.... because of these, the mom-to-be, may develop a systemic endothelial dysfunction and damage, plus generalized inflammation.

Endothelium is the lining of the blood vessels, like the veins, arteries etc., and regulates and modulates the equilibrium, that is, it ensures everything is working well in the circulatory system.

Any disruption of this important structure, leads to many signs and symptoms of preeclampsia.


Because of these abnormal placental development, there will be:

  • low blood flow to the fetus
  • resulting in low oxygen
  • low nutrients and sustainance to the fetus

 Pre-eclampsia Statistics

  •  Pre eclampsia occurs in   2  -  7 percent of pregnancies around the world.
  • According to World Health Organization  5  -  8 percent of pregnant women has this medical condition in the developing countries.
  • About 10  percent of all pregnant women around the world suffer from the Hypertensive  Disorders of  Pregnancy (HDP) , which Preeclampsia happens to be one of them.
  • About  10  -  15 percent of direct maternal deaths from complications of Hypertensive Disorders of Pregnancy are related to preeclampsia and eclampsia
  • Pregnant women who develop preeclampsia has increased risk of developing it in subsequent pregnancies.
  • Non-smokers tend to have higher risk of this disease, than smokers....  very strange, isn't it...!
  • If you have this medical problem before, you have higher risk of developing heart disease and / or stroke in the next six to sixteen years.

Preeclampsia is a very dangerous and mysterious disease. For the latest statistic available and to learn how to protect yourself and your loved ones, read more here

 

  Can you have preeclampsia in pregnancy without high blood pressure?

         Yes.... this is a short answer.

The bench mark of blood pressure equal or greater than 140/90 is for general population of pregnant women.

Human beings are unique in different ways... you have tall, short, skinny and not too skinny etc.

Sometimes, a blood pressure of 100/60 may be normal for a specific pregnant lady... keep in mind, a blood pressure of 130/76 may be considered HIGH, for her, that is, 30 more of systolic and 15 more of the diastolic blood pressure.

In this case, this pregnant lady, if she has other symptoms of - proteinuria, and this occurs after 20 weeks... may be treated as preeclamptic toxemia.

Severe Preeclampsia

Severe preeclampsia is a medical state, when the signs and symptoms of this disease is getting worse and the preeclamptic woman is exhibiting the symptoms more profoundly.

Severe Preeclampsia Symptoms

  •  Incessant headaches despite the use of analgesics... most preelamptic women describe it, as the most "profound headache they have ever experienced"
  • Severe preeclamptic toxemia symptoms also includes... confusion, or decrease level of awareness or altered mental status...this is most scary for the family members witnessing this....!!
  • Severe nausea and vomiting
  • Vision disturbance.... light sensitivity to the eyes
  • Abdominal pain, usually around the stomach area

Other signs of toxemia, and symptoms of preeclampsia in severe form include:

  • Very high  and uncontrolled blood pressure, usually higher than 160/100
  • Doctors will have discovered ... over 500 milligrams of protein in urine, in 24 hours
  • Intra-uterine growth retardation as confirmed by ultrasound for pregnancy
  • Severe shortness of breath and possibly water in the lungs of the preeclamptic woman
  • Doctors will generally by now, have severe abnormal blood results...  particularly the liver enzymes
  • The preeclampic lady will also have reduced urine output, despite being well hydrated, less than 500 cc in a day....!!!
  • Sudden facial swelling during pregnancy
  • Sudden hand and leg swelling in pregnancy... or sudden weight gain within short period of time.

 What are the Preeclampsia Risk Factors?

 Preeclampsia risk factors refer to the circumstances or situations that increases your chances of developing pre eclampsia


These include: 

  • Teenage pregnancy.....   18 years and younger
  • A pregnant woman aged 40 years or more
  • Chronic kidney disease or chronic hypertension in pregnancy
  • If you have Diabetes before you conceived.
  • Obesity.... with body mass index (BMI)  of over 30
  • A woman who has never borne a child, or who has never been pregnant.... (null parity)
  • Large intervals in between pregnancies.... like 10 years intervals
  • Carrying more than one fetus.... twins, triplets etc.... (multiple gestation)
  • Preeclampsia in previous pregnancy
  • Autoimmune disorders like LUPUS
  • If your mother or sister has this medical condition   (family history)
  • If the pregnant woman is married to a man, born with preeclampsia
  • If the pregnant woman is married to a man whose previous partner or wife has pre eclampsia
  • People with Polycystic Ovarian Syndrome also have high risk of this medical problem
  • People with In Vitro Fertilization... has increased risk also.

See all the 17 Preeclampsia risk factors, that your doctor may not tell you here

Preeclampsia Treatment

The best preeclampsia treatment or toxemia treatment... if possible is the delivery of the baby so that, the actual "cure phase" can start. Keep in mind, pregnant women can still develop eclampsia ... which is essentially... SEIZURE.... even after the birth or delivery of the baby.

Usually, the care and management of high risk pregnancy like preeclamptic toxemia like this, is managed if possible, by the obstetrician gynecologist / pregnancy doctor / and the Maternal Fetal Medicine Specialist... who has more than enough experience, training and knowledge in these aspects.


These specialist generally take into cognizance the following:

  • The fetal and maternal conditions
  • Pregnancy stage, whether early or near term...
  • The severity of toxemia ( pre eclampsia)
  • Risk of prematurity of the baby and possible post-delivery complications
  • Risk of serious pregnancy complications and the well being and  life of the pregnant lady
  • The general vital signs of the the mom-to-be and  the baby
  • Ultrasound confirmation that the life of the fetus is not compromised

 In very severe preeclampsia... the delivery of the baby is contemplated at the earliest opportunity.

Main Preeclampsia    Treatment

  •  Very high blood pressure is controlled... with appropriate medication like labetolol, hydralazine or nifedipine
  • Close vital signs and blood tests monitoring
  • Continuous assessment of fetal growth and general well-being with ultrasound for pregnancy, and other diagnostic tools.
  • Most Maternal Fetal Medicine Specialist will give Magnesium sulphate, to prevent seizures just before, or during delivery of the baby.

Prevention of Preeclampsia

Prevention of preeclampsia is very difficult to achieve, because of different presentations and severity in different pregnant women. Also because there is no clear cut information about its causes.

According to World Health Organization...."" Preeclampsia stands out among the hypertensive disorders of pregnancy, for its impact on maternal and neonatal health. It is one of the leading causes of maternal and perinatal mortality and morbidity worldwide.""


Because what causes Preeclampsia in Pregnancy is not yet fully understood... few options are available for its prevention.    

RELATED  ARTICLES:

       Pregnancy Induced Hypertension

       HELLP Syndrome

       Folic Acid during Pregnancy

       Postpartum Pre eclampsia