Preeclampsia - Symptoms, Causes, Diagnosis, and Treatment

What Is Preeclampsia?

Preeclampsia is a condition seen in pregnant women, where the blood pressure becomes high and organs like kidneys and liver show signs of damage. These signs include protein in the urine and low platelets. It usually begins after 20 weeks of pregnancy, even if the mother’s blood pressure was normal previously. If left untreated, it can cause a lot of complications for both the mother and her baby, and can even be fatal. Pregnant women with preeclampsia are most commonly treated by delivering the baby immediately. But if the condition gets diagnosed too early during pregnancy, then delivering the baby might not be an option, as it might be riskier.

In some rare cases, preeclampsia can develop after the baby is born. This condition is called postpartum preeclampsia. If preeclampsia is left untreated, it can result in eclampsia, which is a condition that results in seizures due to high blood pressure. Around 5 % of all pregnant women develop preeclampsia.

What Are the Other Conditions That Cause High Blood Pressure During Pregnancy?

The three other conditions that result in high blood pressure are:

1. Gestational Hypertension - Here, only the blood pressure is high, but no protein in the urine or other signs of organ damage are detected. But eventually, this condition can lead to preeclampsia.

2. Chronic Hypertension - Hypertension before pregnancy or before 20 weeks of pregnancy is called chronic hypertension.

3. Chronic Hypertension with Superimposed Preeclampsia - Here, the woman is diagnosed with chronic hypertension before getting pregnant, but the condition worsens during pregnancy. It leads to protein in the urine and other signs and symptoms of preeclampsia.

What Are the Symptoms of Preeclampsia?

Sometimes, preeclampsia does not cause any symptoms. The blood pressure can rise suddenly or it can increase slowly. This is the reason, regular monitoring of blood pressure is crucial during pregnancy. The early sign of preeclampsia is an increase in blood pressure more than 140/90 mmHg during two readings four hours apart. The signs and symptoms of preeclampsia are:

• Proteinuria - the presence of protein in the urine.

• Light sensitivity.

• Severe headaches.

• Temporary loss of vision or blurred vision.

• Pain in the upper abdomen.

• Nausea.

• Vomiting.

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• Reduced urine output.

• Edema (swelling) in the face and hands.

• Thrombocytopenia (low platelet count).

• Impaired liver function.

• Dyspnea (shortness of breath).

As most of these symptoms are also seen during normal pregnancy, it is important to differentiate symptoms caused by preeclampsia. Your doctor will help you with it.

When to Consult a Doctor?

Go for regular prenatal checkups, so that the doctor can monitor and note any changes in blood pressure early on. If you suddenly develop any of the symptoms of preeclampsia, consult a doctor immediately or go to an emergency room.

What Are the Causes of Preeclampsia?

A single and definite cause of preeclampsia is still not known. But it is believed to be linked to the many factors. During early pregnancy, new blood vessels develop to send blood to the placenta. In preeclampsia, these blood vessels are narrower than usual and do not develop or function efficiently. The other factors include:

1. Genetics.

2. Autoimmune conditions.

Risk Factors:

The factors that increase the risk of preeclampsia are:

• Carrying more than one fetus (multiple pregnancy).

• Maternal age over 35 years or early teens.

• First pregnancy.

• Obesity.

• Known diabetic patient.

• History of kidney disease.

• Second pregnancy in less than 2 years or more than 10 years.

• History of hypertension.

• In vitro fertilization.

Even though some doctors prescribe baby Aspirin after the first trimester to prevent preeclampsia, but it is not proven to be effective.

How Is Preeclampsia Diagnosed?

Your doctor will diagnose you with preeclampsia if you are 20 weeks or more pregnant, your blood pressure is higher than 140/90 mmHg, and you exhibit one or more of the following complications:

1. Proteinuria - protein in the urine.

2. Thrombocytopenia - low platelet count.

3. Impaired liver function.

4. Other signs of kidney problems.

5. Pulmonary edema - fluid in the lungs.

6. Severe headaches.

7. Visual disturbances.

A single high blood pressure reading does not necessarily mean that you have preeclampsia. Only if you have two consecutive high reading, taken 4 hours apart, you will be diagnosed with this condition. In addition to this, the doctor might also suggest you get the following tests done:

• Blood tests - to check liver and kidney functions, and platelet count.

• Urine analysis - to measure the amount of protein in the urine.

• Fetal ultrasound - to monitor the baby's growth through ultrasound.

• Nonstress test - it checks how the baby's heart rate reacts when it moves.

• Biophysical profile - it measures the baby's breathing, muscle tone, and movement, with the help of an ultrasound.

How Is Preeclampsia Treated?

Delivering the baby is the most effective treatment for preeclampsia. But if you get diagnosed during early pregnancy, then delivery might not be the choice of treatment. The treatment options include:

1) Complete Rest - Doctors used to recommend bed rest for women with preeclampsia. But as it increases the risk of blood clots, bed rest is no longer suggested.

2) Hospitalization - In severe cases, hospitalization might be needed.

3) Medications

• Antihypertensives - to lower blood pressure.

• Corticosteroids - it can temporarily improve liver function and platelet count.

• Antiseizure medicine - to prevent seizures, Magnesium sulfate might be prescribed.

4) Delivery - If you are already in your late third trimester, then the doctor may induce labor and deliver the baby through c-section or vaginal birth.

What Are the Complications of Preeclampsia?

The possible complications of preeclampsia are:

1. Fetal Growth Restriction - When the arteries that supply the placenta get affected, the baby does not get sufficient blood, oxygen, and nutrients. This inhibits the baby’s growth and development, resulting in a condition called fetal growth restriction. Such babies have low birth weight.

2. Placental Abruption - It is a condition where the placenta gets separated from the wall of the uterus before delivering the baby. It can result in severe and life-threatening bleeding.

3. Preterm Birth - As the treatment for preeclampsia is delivering the baby early through c-section, the baby is born prematurely. Premature babies have breathing and other problems.

4. HELLP Syndrome - HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome is a severe and potentially fatal form of preeclampsia. Its symptoms include nausea, headache, and pain in the upper right abdomen.

5. Eclampsia - Preeclampsia progresses and causes seizures.

6. Heart Disease - Preeclampsia increases the risk of future cardiovascular disease.

7. Organ Damage - This condition can affect the functioning of kidneys, liver, heart, lungs, brain, and eyes.

To know more about preeclampsia, consult an obstetrician and gynecologist online!