What Exactly Is Preeclampsia?
Preeclampsia is a high blood pressure condition in pregnant women whose blood pressure had previously been within the normal range (Less than 120/80 mm Hg). Preeclampsia commonly occurs after the 20th week of pregnancy and can continue even after childbirth (postpartum Preeclampsia). It can trigger new-onset hypertension and proteinuria (high protein levels in the urine) which cause damage to the organs like the brain, liver and kidneys. Preeclampsia is dangerous to both the mother and the baby and should be treated1.
Hypertension or simply high blood pressure occurs when the blood circulation applies extreme force on the body’s arteries2. Women with Preeclampsia have elevated blood pressure which is higher than 140/90 mmHg. High blood pressure developed during pregnancy can stress the heart of pregnant women. Medically, hypertension during pregnancy is called gestational hypertension, which can develop into Preeclampsia.
If this condition is not treated on time, it can cause serious complications for both the mother and the baby, like preterm birth, fetal growth restriction, placenta abruption, HELLP syndrome and more3. These complications are explained below, keep reading to know more.
What Are The Symptoms Of Preeclampsia?
Preeclampsia symptoms can be mild or severe. If you have developed mild Preeclampsia, you will have high blood pressure and proteinuria as primary symptoms. Whereas serious kidney or liver damage along with hypertension is a clear indication of severe Preeclampsia-like condition 1.
In general pregnant women experiencing a systolic to diastolic (systolic blood pressure is when there is pressure against the arteries when the heart contracts, diastolic is the pressure when the heart relaxes between contractions) ratio ‘over’ 140/90 can develop symptoms of Preeclampsia such as3, 4, 1
Symptoms of severe Preeclampsia includes:
- A severe increase in blood pressure (BP is 160/110 mmHg or higher)
- Impaired kidney or liver function
- Fluid in the lungs
- Decreased blood platelet levels1
The exact cause of Preeclampsia is still unknown.
Some agree on the fact that Preeclampsia happens due to improper functioning of the placenta. The placenta is a fetal organ connected via a pipe-like umbilical cord to provide nutrition to the growing fetus during pregnancy. Blood supply to the placenta is low in patients with Preeclampsia which leads to problems in both the mother and the baby 1.
Others believe that poor nutrition or excess body fat or genetics can be the core contributing factor to developing Preeclampsia during pregnancy 5.
Risk Factors Associated With Preeclampsia
Conditions that are directly related to a high risk of Preeclampsia are -
- History of hypertension during previous pregnancies
- Mothers having chronic kidney disorder, autoimmune disease, diabetes or chronic hypertension
- Family history of Preeclampsia
- Expecting multiple babies
- Mothers with ≥40 years of age or with BMI (basal metabolic index) ≥ 35 kg/m6
- Fetal genotype (genetic makeup) 6
And several other clinical factors like - polycystic ovarian syndrome, sleep-disordered breathing, gum infection, urinary tract infections during pregnancy, and invitro-fertilization increase Preeclampsia risk 6.
If your screening test results say that you have a higher risk of developing Preeclampsia, do not worry. The screening tests are specifically kept for 10-13 weeks, so that the doctor can start the medication before the 16th week for early detection of Preeclampsia 6.
Complications Of Preeclampsia
Here are some complications of Preeclampsia:
- Preterm birth: An unplanned delivery of the baby occurs before 37 weeks. This leads to developmental delays, breathing difficulties, hearing issues, vision problems, cerebral palsy. Certain treatments before preterm delivery can help reduce some of these risks.
- Fetal growth restriction: Preeclampsia impedes proper blood circulation to the placenta. Due to this the baby’s oxygen, blood and nutrient supply remains low which may result in slow growth. This is called fetal growth restriction.
- Placental abruption: In this condition, the placenta gets detached from the inner walls of the uterus before childbirth. Having Preeclampsia increases the risk of placental abruption. This could be dangerous to both the mother and the baby.
- HELLP syndrome: Severe Preeclampsia or eclampsia (uncontrolled Preeclampsia) are known to cause HELLP syndrome in pregnant women7. Even though instances of developing HELLP syndrome are quite rare. That is 1 in 5 women suffering from Preeclampsia or eclampsia can develop HELLP syndrome7. The symptoms of HELLP syndrome include vomiting, nausea and upper right belly pain. It stands for -
- ‘H’ for hemolysis, breaking down of red blood cells (which carry oxygen in the blood).
- ‘EL’ for elevated liver enzymes (chemicals that help to break down protein in your body) in the blood.
- ‘LP’ for low platelets (responsible to stop bleeding and heal wounds) count7.
- Eclampsia: A condition that occurs due to severe Preeclampsia. This condition affects brain function which could lead to seizures and coma. Eclampsia is difficult to predict. Some symptoms include migraines, issues with vision, confusion and altered behavior.
- Organ damage: Preeclampsia could damage some organs like the kidneys, liver, heart, lungs, eyes and the brain.
- Still birth: Loss of a baby before or during delivery3 8.
Preeclampsia: Screening And Diagnosis
Your doctor will check your blood pressure and urine sample on every prenatal consultation. If the blood pressure reading is higher than 140/90, especially in the 21st week of your pregnancy, you will be asked to get some tests done. They may include urine tests, blood tests to check for liver and kidney functions and certain marker tests 8.
At LifeCell, we offer the following combined prenatal non-invasive screening tests which can provide an accurate risk assessment of both Preeclampsia and the most common chromosomal abnormalities.
These screening tests measure the levels of biomarkers like PAPP-A (Pregnancy-Associated Plasma Protein A), Inhibin A, PlGF (Placental Growth Factor), and sFlt-1 (Soluble FMS-like Tyrosine Kinase-1) along with blood pressure measurements to predict Preeclampsia risk. Altered levels of these biomarkers from the normal range can predict risk in soon to be mothers.
Treatment For Preeclampsia
Your doctor will take into consideration several factors, like the severity of Preeclampsia, potential risks for you and your baby and how far along you are in your pregnancy. Your health care provider will most likely deliver the baby if you are more than 37 weeks pregnant. If not, they will closely monitor you and your baby. This will include blood and urine tests, heart rate monitoring and ultrasound. Medications will be prescribed to control your blood pressure and avoid seizures 8.
How Can I Prevent The Risk Of Having Preeclampsia?
Globally, Preeclampsia affects around 8% of all deliveries1. Women with risk factors should:
- Maintain a healthy weight
- Control diabetes or high blood pressure if they have it before pregnancy
- Exercise regularly
- Get enough sleep
- Eat healthy
- Avoid caffeine and salt in your diet