Preeclampsia

Preeclampsia complicates 5 to 6% of pregnancies, but it increases up to 25% in women with preexisting hypertension.

What Is Preeclampsia? Preeclampsia is an increased blood pressure, and protein in the urine (as a result of kidney problems related condition) starts after the 20th week of pregnancy. Preeclampsia affects the placenta and mother's kidney, liver, and brain. Preeclampsia is a leading cause of fetal complications including low birth weight, premature birth, and stillbirth.

What is superimposed preeclampsia? Superimposed preeclampsia is characterized by worsening of high blood pressure and protein in the urine in chronic hypertension patients with the vascular or renal disease. About 25% of pregnant women with preexisting hypertension develop superimposed preeclampsia. Superimposed preeclampsia risk is especially high among women with severe chronic hypertension and pre-existing cardiovascular or renal disease. The diagnosis may be difficult if there is pre-existing proteinuria as a result of the renal disease. You can suspect its diagnosis if there is a sudden increase in proteinuria, blood pressure, or abnormal liver enzyme levels.

Preeclampsia that develops when you already have high blood pressure is called "superimposed preeclampsia." Between 13 and 40 percent of women with high blood pressure develop superimposed preeclampsia during pregnancy.

Most women who develop preeclampsia should be closely monitored to avoid problems. The only way to cure preeclampsia is to deliver the baby.

What is Eclampsia? If the preeclampsia left untreated, it might result in seizures known as eclampsia, the second-leading cause of maternal death.

How common are hypertension and preeclampsia during pregnancy? Hypertension occurs in 6 to 8 % of all pregnancies in the U.S., 70 % of them are first-time pregnancies.

Over the past decade, the preeclampsia has increased by about one-third. This raise in preeclampsia is due to rise in the older mothers and multiple births. The number of births to women aged 45 and older is increasing. Also, rates of twin births increased about 50%, triplet and other higher multiple births increased more than 400% mostly among women in their 40s.

In a severe case of preeclampsia, there may be red blood cell breakdown, low counts of blood platelet, impaired liver function, kidney dysfunction, swelling, shortness of breath (due to fluid in the lungs), or visual disturbances.

Preeclampsia risk factors

The following factors may increase the risk towards preeclampsia:

1. Mothers with chronic hypertension; high blood pressure diagnosed before pregnancy.
2. First-time mother
3. Hypertension or Preeclampsia during previous pregnancy
4. Obese women or have a BMI of 30 or greater.
5. Pregnancy before age 20 or after age 40
6. Women have diabetes, kidney disease, rheumatoid arthritis, lupus or scleroderma.
7. If your sisters or mother had preeclampsia
8. Mother carrying multiple babies
9. Increased insulin resistance
10. Hypercoagulability (inherited thrombophilia)
11. Hydatidiform mole

Preeclampsia symptoms

Symptoms of mild preeclampsia are hypertension, water retention and proteinuria (protein in the urine).

Symptoms of sever preeclampsia are persistent headaches, blurred vision, light sensitivity, urinate small quantity, upper right abdominal pain, and tendency to bruise easily. Consult your doctor immediately, if you experience these symptoms.

Preeclampsia causes

Those with chronic hypertension have a preeclampsia risk of 7 to 8 times higher than others.

There is no definitive known cause of preeclampsia, though likely related to a below causes:

1. Abnormal formation and development of the placenta
2. Immunologic factors
3. Endothelial dysfunction
4. Environmental factors such as air pollution

Preeclampsia Diagnosis

How do I know if I have preeclampsia? There is no test to diagnose preeclampsia. Signs of preeclampsia are high blood pressure and proteinuria (protein in the urine). Symptoms of preeclampsia are persistent headaches, blurred vision, light sensitivity, and abdominal pain. All these symptoms are common during healthy pregnancy, thus regular prenatal checkup likely more frequently than recommended for pregnancy is the best way for early detection of preeclampsia.

Additionally, your doctor may also order other tests such as checking kidney and blood-clotting functions; ultrasound scan to check your baby’s growth, and Doppler scan to measure the efficiency of blood flow to the placenta.

Does preeclampsia lead to long-term heart or blood vessel problems?

According to the National High Blood Pressure Education Program (NHBPEP), preeclampsia is not a risk factor for chronic hypertension or heart-related problems. Also, it reports, women with healthy blood pressure and develops preeclampsia after the 20^th week of pregnancy, their BP goes away within six weeks after delivery. Still, these women have increased risk towards high blood pressure or another heart disease later in their life.

Even though hypertension and preeclampsia during pregnancy are serious, most women have successful pregnancies. More frequent prenatal care is important for you and your baby’s health.

Prevent Preeclampsia

Ways to prevent preeclampsia are healthy lifestyle changes such as maintaining a healthy weight, exercise regularly, eat smartly (stop fried & junk foods), stay hydrated (drink 6 to 8 glasses of water), get enough rest, elevate your feet several times a day, stop alcohol, and avoid caffeine beverages.

There is no proven method to prevent or avoid preeclampsia. Therefore, those who develop signs of a preeclampsia should monitored closely to reduce or avoid relating complications. The one and the only way to cure preeclampsia are to deliver the baby.

Preeclampsia Treatment

The only cure for preeclampsia is delivery. You are at increased risk of seizures, placental abruption, stroke and severe bleeding until your blood pressure drop to a healthy range.

Treatment for preeclampsia depends on how close it is to your due date? If you are close to due date and baby is healthy, then you doctor want to deliver your baby as early as possible.

If you have mild preeclampsia and baby has not reached full development, then you need to be more careful until you are close to the due date or baby develop fully.

1. Always take rest by lying on your left side, this takes the baby’s weight off from your major blood vessels.
2. Increase the frequency of prenatal checkups.
3. Reduce the sodium salt consumption.
4. Drink more water, at least 8 glasses of water per day.
5. Consume more fruits and vegetables rich in potassium such as banana, papaya, prune, raisins, mango, kiwi, orange, cantaloupe, honeydew melon, and pear.
6. Exposing to morning sunlight gives you enough vitamin D, which helps to lower your BP.
7. Do regular walking helps to lower your blood pressure.
8. Elevate your feet several times during the day.
9. Avoid alcohol and tobacco use; it further hardens the blood vessels.
10. Avoid caffeine-containing beverages; it produces short-term spikes in blood pressure.

If you have severe preeclampsia and baby have not reached full development, then you need to take your blood pressure lowering medication along with above said lifestyle changes and supplementations.

1. Antihypertensive medication – You require taking blood pressure lowering medications to control your blood pressure at or below 140/90 mmHg. Certain antihypertensive medication is not safe during pregnancy, discuss with your doctor to choose a best.
2. Corticosteroids – In the case of severe preeclampsia or HELLP syndrome, corticosteroid medications can improve liver and platelet function temporarily, this help prolong your pregnancy, help your baby’s lungs to mature within 48 hours. It is important for preparing a premature baby for its life outside the womb.
3. Anticonvulsant medications – For severe preeclampsia, you doctor may suggest magnesium sulfate to prevent seizure.

How can preeclampsia affect the mother and baby?

• Mother - If not treated properly in time, preeclampsia leads to the liver or renal failure and in the future cardiovascular events for the mother. Additionally, it leads to life-threatening conditions such as eclampsia (severe preeclampsia with seizures) and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count).
• Baby – It affects blood supply to the placenta, so your baby receives less blood and oxygen resulting in low birth weight.

Most women can able to deliver a healthy baby if the preeclampsia is diagnosed early and provide proper treatment with more frequent prenatal care.