What is Preeclampsia?
Preeclampsia is a serious condition that affects 5 -10% of pregnant women. Women with preeclampsia have high blood pressure and protein in their urine. It usually starts after the 20th week, but can occur any time during the second half of pregnancy. If left untreated, it can lead to a more dangerous condition called eclampsia or toxemia of pregnancy. Eclampsia causes seizures and can lead to a coma or death in the mother. 
Preeclampsia is a medical condition where hypertension arises in pregnancy (pregnancy-induced hypertension) in association with significant amounts of protein in the urine. Preeclampsia refers to a set of symptoms rather than any causative factor, and there are many different causes for the condition. It appears likely that there are substances from the placenta that can cause endothelial dysfunction in the maternal blood vessels of susceptible women. While blood pressure elevation is the most visible sign of the disease, it involves generalized damage to the maternal endothelium, kidneys, and liver, with the release of vasoconstrictive factors being secondary to the original damage.
Preeclampsia may develop from 20 weeks gestation (it is considered early onset before 32 weeks, which is associated with increased morbidity). Its progress differs among patients; most cases are diagnosed pre-term. Preeclampsia may also occur up to six weeks post-partum.
What are the symptoms?
- Swelling in your hands and feet
- Severe headache
- Problems with vision
- Confusion
- Pain in the upper part of your abdomen
- Quick weight gain (fluid retention)
How is it diagnosed?
At every prenatal appointment, your doctor will take your blood pressure and perform a urine test. If your blood pressure is high, the doctor will watch you closely for the rest of pregnancy.
High blood pressure alone is not enough to diagnose preeclampsia. It is usually diagnosed when high blood pressure is accompanied by a large amount of protein in the urine.
You may be diagnosed with preeclampsia if you have swelling, extra protein in your urine and one of the high blood pressure.
Who is at risk?
- Experts do not know why some pregnant women get preeclampsia.
- Who is at a greater risk?
- Woman younger than 20 years old or older than 35
- First pregnancy
- Pregnant with multiples
- Have high blood pressure, diabetes, kidney disease, blood-clotting disorders, lupus or other conditions before pregnancy
- Preeclampsia in a previous pregnancy
- Family history of preeclampsia
- Overweight
- African-American ethnicity
How is it treated?
Preeclampsia affects all the organs in your body and can be dangerous for both you and your baby. The only “cure” for it is delivery. Once the baby is born, women usually are free of the condition. Luckily, it can often be managed well until your baby is mature enough to be born.
If you were diagnosed with high blood pressure but not preeclampsia, both you and your baby should be closely monitored for the rest of the pregnancy. What starts as simple high blood pressure can quickly turn into preeclampsia with little or no warning.
The main goal of treatment is to protect your health and that of your baby. Preeclampsia can cause serious organ damage and even death. It affects many organs in the body. It puts added stress on the kidneys, which causes protein to build up in the urine. In severe cases, it can cause damage to the mother’s kidneys, heart, brain, liver and eyes.
The second goal is to deliver your baby as close to term as possible. A doctor will try to balance these goals to get the best possible outcome for both mother and baby.
Treatment is based on how severe of the disorder is and how far along in the pregnancy you are. You are less likely to have problems if you develop mild preeclampsia at 37 weeks or later. The risks are higher for women diagnosed with preeclampsia before 37 weeks.
If preeclampsia is mild, your doctor may recommend:
- Reduced activity or bed rest, which may help lower blood pressure
- Frequent blood pressure and urine testing
- Tests to check your baby’s condition, such as nonstress testing, fetal heart monitoring and ultrasound
If Preeclampsia becomes severe:
You may be admitted to the hospital. There you will rest and be monitored closely to try to keep you healthy until your baby is mature enough for birth (usually by the 34th week of pregnancy). You may be given:
- Medications to control your blood pressure
- Anti-seizure medication to prevent seizures (eclampsia)
- If your blood pressure stays too high, the doctor may need to act quickly to deliver the baby. At this stage you may be given:
- Medication to induce labour
- Corticosteroid medication to help mature your baby’s lungs if it is earlier than the 34th week of pregnancy
- You may be able to have a vaginal birth, but in some cases, a caesarean section is needed. A baby who is born prematurely may have problems and need to spend time in intensive care. Still, this may be safer than spending more time in the uterus.
Your blood pressure will continue to be monitored after delivery. For most women with preeclampsia, blood pressure returns to normal within a week or two after delivery.
How will it affect my baby?
Many women with preeclampsia give birth to healthy babies.
Babies born to moms who have preeclampsia often have to be delivered early. Pre-mature babies are at-risk for various health issues, including low birth weight and long-term disabilities. The earlier your baby has to be delivered, the greater the risk for complications.
