Preeclampsia is a disorder of pregnancy that involves high blood pressure along with other symptoms, such as protein in the urine. It is one of four hypertensive disorders of pregnancy, and can be very serious for both mom and baby. If you have high blood pressure during your pregnancy, your doctor will want to find out if preeclampsia is the cause.
Other names for preecampsia include toxemia, pregnancy induced hypertension (PIH), and gestosis.
How Does Preeclampsia Affect Mom?
Preeclampsia is a disease that can cause great harm, and even death, to both mom and baby. Even in cases where preeclampsia seems mild, it can get very serious very quickly. If you have preeclampsia, even if you only have a few, mild symptoms, visiting your doctor often is very important.
The first symptom that many people notice is increased blood pressure. Your blood pressure usually drops during your first trimester, reaches a low point around 22-24 weeks, then gradually increases. In moms with preeclampsia, the blood pressure rises more than normal during the last half of pregnancy.
Because preeclampsia affects many organ systems in the body, increased blood pressure is only one of many symptoms that may be present. Other symptoms of preeclampsia include increased protein in the urine and generalized swelling.
In some women, preeclampsia becomes very severe. Signs that the condition is worsening should be reported to your doctor immediately and include:
- Reduced urine output
- Trouble with your vision
- Abdominal pain
- Headache
- Nausea/vomiting
- Seizures
Severe, untreated preeclampsia can lead to HELLP syndrome (a multi-organ sydrome) or eclampsia (a seizure disorder). Both complications are very serious and can lead to death of the mother if not treated promptly.
How Does Preeclampsia Affect the Baby?
Preeclampsia affects the baby primarily by reducing the amount of blood that flows through the placenta. Because the placenta is the fetus's only source of nourishment, this can cause the baby to grow poorly, a condition called intrauterine growth restriction (IUGR).
If the baby is not growing well or if the disease puts the mother's life in danger, then doctors may decide that preterm delivery is the safest thing for mom and baby. If there is time and the baby will be very early, doctors may try to give the mother steroids to speed the baby's lung development or magnesium sulfate to prevent eclampsia in the mother and to help prevent cerebral palsy.
Risks to the baby from preterm delivery depend on how many weeks gestation the baby is at delivery. Preeclampsia usually happens near the end of pregnancy, when the baby has mostly matured and will have only mild consequences of prematurity. In some cases, though, the baby must be delivered much earlier and may have more serious health issues. Prior to 23 to 24 weeks gestation, the baby is too young to survive outside the mother.
Read more: Prematurity Week by Week
What Causes Preeclampsia?
Doctors aren't sure what causes preeclampsia. The formation and implantation of the placenta seem to play a role, but this isn't always the case. There are many women with placentas that form normally who develop the disorder, and there are many women with poorly formed placentas who go on to have healthy pregnancies.
Although doctors don't know what causes preeclampsia, they do know that certain women are at greater risk than others. Risk factors include:
- First pregnancy
- Teen pregnancy
- Obesity
- Chronic hypertension
- Diabetes
- Twin/multiple pregnancy
- Previous history of preeclampsia
- Advanced maternal age
- Donor egg pregnancies
How is Preeclampsia Treated?
If you are pregnant and have high blood pressure that seems to be related to preeclampsia, your doctor will probably want to watch you very carefully. You may need to schedule more frequent doctor's appointments, and your doctor may ask you to collect your urine for 12 or 24 hours to measure its total protein.
If you have signs of severe or worsening preeclampsia, then you may need to be admitted to the hospital for observation and treatment. You will be monitored for signs of HELLP syndrome or eclampsia, and your baby's health and growth will be monitored.
Medical treatments for preeclampsia can only treat the symptoms, not the disorder itself, and include medicines to lower blood pressure and magnesium sulfate to prevent seizures. Your doctor may prescribe blood pressure medicine for you to take at home, but magnesium sulfate must be given in the hospital.
Although medication may reduce symptoms, it will not cure the disorder. The only cure for preeclampsia is delivery of the baby. Once the baby and placenta have been delivered, the mother will recover. Recovery is not immediate, and the mom may need to be in the hospital for several days or even weeks until she recovers fully.
How Can I Prevent Preeclampsia?
Unfortunately, there is no way to prevent 100% of cases of preeclampsia. Studies have shown that calcium supplementation or low dose aspirin may help some women in specific circumstances, but not enough to recommend them for all pregnant women.
Leading a healthy lifestyle can help you to reduce your risk for preeclampsia. Regular exercise and a diet high in vegetables and low in processed foods has been shown to reduce the incidence of the disorder for some women. Exercise and a healthy diet can also help to control obesity, chronic hypertension, and diabetes, which are all risk factors for preeclampsia.
Sources:
World Health Organization. "WHO Recomendations for Prevention and Treatment of Pre-eclampsia and Eclampsia." (2011) Accessed April 10, 2012 from http://www.preeclampsia.org/images/pdf/2011c-who_pe_final.pdf
Schroeder, B. "ACOG Practice Bulletin on Diagnosing and Managing Preeclampsia and Eclampsia." American Family Physician July 15, 2002: 66, 330-334.
Lindheimer, M., Taler, S., Cunningham, G. "ASH Position Article: Hypertension in Pregnancy." Journal of the Americn Society of Hypertension 2008: 2, 484-494.
Steegers, E., von Dadelszen, P., Duvekot, J., Pijnenborg, R. "Pre-eclampisa." Lancet 2010: 376, 631-644.
Brantsæter, A., Haugen, M., Samuelsen, S., Meltzer, H. "A Dietary Pattern Characterized by High Intake of Vegetables, Fruits, and Vegetable Oils Is Associated with Reduced Risk of Preeclampsia in Nulliparous Pregnant Norwegian Women." Journal of Nutrition Jan 2009: 139, 1162–1168.
