Preeclampsia

Preeclampsia is a medical condition that occurs around 20 weeks into pregnancy with major detrimental health effects for the foetus and the pregnant mother. Read on to learn more about its symptoms, causes, treatment, and other details.

Previously called toxaemia, preeclampsia is a disorder that can crop up around the 20th week of pregnancy, leading to increased blood pressure, elevated levels of protein in the urine, and leg swelling.

If ignored, it can become critical and harm the mother as well as the baby. Some women also develop low levels of platelets that may lead to an increased risk of bleeding.

Preeclampsia can be severe or mild. Sometimes, it develops after delivery, which is known as postpartum preeclampsia. Even those with normal blood pressure readings during pregnancy can develop this postpartum condition.

If not treated in time, preeclampsia results in seizures, a condition known as eclampsia. To prevent complications during pregnancy, patients must regularly visit their healthcare provider for ante-natal care.

There are different opinions in the medical fraternity about what causes preeclampsia. Some experts are of the view that higher body fat and nutrient deficiency can cause it.

Others are of the opinion that it is caused by the reduced blood supply to the placenta due to damaged or narrower blood vessels. Some research has also indicated certain autoimmune conditions or genetic factors as the causative factors for preeclampsia.

Apart from the above-mentioned causes, listed below are several preeclampsia risk factors that can raise one’s odds of getting the condition:

• Maternal age of 40 years or above
• Teenage pregnancy
• Obesity
• Multiple pregnancies
• First pregnancy
• History of preeclampsia during previous pregnancies
• Known history of high blood pressure
• IVF pregnancy
• Family history of preeclampsia or postpartum preeclampsia
• If the gap between two pregnancies is less than 2 years or more than 10 years
• History of kidney disease and diabetes

Typically, the primary signs and symptoms of preeclampsia include high blood pressure, leg swelling or leg oedema, and protein in the urine (proteinuria). However, some patients only show one symptom or occasionally no symptoms at all.

Some other symptoms are as follows:

• Blurred vision
• Excessive weight gain within a short period of time.
• Headaches
• Upper right-sided abdominal pain
• Giddiness
• Shortness of breath
• Frequent urination or absence of urination
• Nausea and vomiting
• Pain in the shoulder
• Disorientation

Preeclampsia can prove to be disastrous for the mother as well as the baby’s health if left unaddressed. It can cause serious complications, including:

1. Complications in the Mother:
   • HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome: It is the most dreaded complication of preeclampsia and is considered a medical emergency. The symptoms experienced are chest pain, stomach pain, bleeding from the nose, headache, fatigue, vision problems, etc. It results in damage to the liver cells and red blood cells, causing the platelets to lose their ability to clot the blood, giving rise to the above-mentioned symptoms.
   • Excessive bleeding after delivery (postpartum haemorrhage).
   • Cardiac failure
   • Paralysis
   • Convulsions
   • Fluid in the chest cavity
   • Temporary blindness
   • Liver bleeding
2. Complications in the Baby:
   • Foetal growth restriction and low birth weight in babies due to decreased blood supply through the placenta.
   • Premature birth or preterm birth of the baby before the beginning of the 37th week of pregnancy.
   • Cerebral palsy
   • Learning disabilities
   • Seizures
   • Difficulties in hearing or eyesight.

Patients with preeclampsia sometimes present with the symptoms mentioned earlier. However, sometimes the symptoms may not be obvious, and the condition might be diagnosed while the mother is undergoing a routine prenatal checkup.

Doctors may discover the condition when checking the patient’s blood pressure or from a urine test, which shows high levels of protein.

If we doubt that a patient is suffering from preeclampsia, we order the following tests to confirm the diagnosis:

• Blood report to examine the number of platelets present and check how the liver and kidneys are functioning.
• Urine report to look for the amount of protein present.
• Ultrasonography and different foetal monitoring tests to check the foetal growth and volume of amniotic fluid.

The patient will be diagnosed with the condition if their blood pressure is high and they exhibit at least one of the following:

• A high amount of protein in the urine
• Reduced platelet count
• Increased liver enzymes
• An increased amount of kidney chemicals
• Pleural effusion or fluid in the lungs
• Headaches
• Giddiness

There have been no breakthroughs as far as a cure for preeclampsia is concerned. However, it can be managed effectively under the guidance of healthcare professionals.

The management will depend upon factors like the intensity of the preeclampsia and the duration of pregnancy. If the preeclampsia is mild and develops in the early weeks of pregnancy, our doctors will usually allow the foetus to grow inside the womb and prescribe the following:

• Medicines to improve symptoms.
• Complete bed rest, lying on the left side.
• Medicines to help the baby grow faster.
• Regular ultrasound examination
• Frequent antenatal visits to keep an eye on the condition.
• Sometimes, patients may need hospitalisation for close monitoring.

For patients nearing term pregnancy that is 37 weeks or further, our doctors may suggest delivery (normal or caesarian section) to get rid of preeclampsia. The symptoms may subside 1 to 6 weeks after delivery but sometimes last longer.

Occassionally, healthcare providers may advise immediate delivery if the symptoms are severe, even if the pregnancy duration is nowhere near 37 weeks.

If you are pregnant and experiencing symptoms of preeclampsia, call us at the CK Birla Hospital to book an appointment and get immediate help. Our team of Obstetrics are ready to support you through every stage of pregnancy, leading to safe delivery.

Our competent doctors guide expectant mothers under the ‘Pregnancy to Parenthood Programme’, taking care of every need, such as nutrition, Lamaze, counselling, high-risk pregnancy care, post-delivery maternal and neonate care, etc. With international standard labour and delivery rooms, a water birthing facility, efficient labour pain management, and ultra-modern neonatal intensive care units, you are in safe hands at the CK Birla Hospital. Book an appointment to get treated by leading Obstetrician Dr. Seema Sehgal.