What is preeclampsia

Preeclampsia is the most common complication of pregnancy, and has been around for as long as we have been keeping records. The disorder has been known by various names over the years, including Toxaemia and Pregnancy Induced Hypertension (PIH). These are all exactly the same disorder but preeclampsia is now considered the most appropriate name. Most commonly preeclampsia is first picked up by an increase in blood pressure but it is important to understand that it is a complex disorder which may affect your kidneys, liver and/or blood clotting and may also affect your baby?s growth. It can be quite a mild problem or a very serious one. About 1 in 10 women having their first baby will suffer from Preeclampsia and may need to come into hospital (either just for half a day or for much longer) for tests and monitoring. Preeclampsia also occurs in subsequent pregnancies but this is less common. It is also more common with multiple pregnancies (twins, triplets etc.). It does not occur before the second half of pregnancy.

My blood pressure was high at my check-up today. Does that mean I have Preeclampsia?
Not necessarily, but it does mean you need to have some tests to find out, and to check that you and your baby are O.K. Sometimes women have one or two high readings and never have a problem again. Also blood pressure may be high for other reasons. Some women have high blood pressure or a tendency towards it before the pregnancy and the demands of carrying the pregnancy cause it to go up further. Occasionally high blood pressure may be a symptom of another problem such as kidney disease. However Preeclampsia is the most common cause. It is also possible to have high blood pressure for these other reasons and then develop Preeclampsia as well.

What tests will I have?
To start off with, you will have to have a series of blood pressure readings over a period of time. This is much more helpful than taking the one or two readings your midwife or doctor is able to take at checkups as individual readings vary and it is the general trend that is important. You will also have some blood tests. These check that your kidneys, liver and blood clotting are O.K., as these can be affected by Preeclampsia. Minor changes, although not affecting your well-being, can confirm the diagnosis and be used to monitor the disorder. Testing your urine for protein is also helpful in monitoring your kidney function and we will now test this more often. If there is significant protein you may have a more accurate test. This is a 24-hour urine collection, which is then analysed by the laboratory giving a much better indication of how your kidneys are functioning. Regular weighing can be used to keep a watch on any swelling due to Preeclampsia, however some swelling is very common in pregnancy especially in the hands and feet and does not signify a problem.


But I don?t feel sick?
Very often women with preeclampsia have no symptoms and feel quite well.. Sometimes, however, you may experience headaches, or visual disturbances such as blurred vision or seeing spots or stars., severe pain in the top of your tummy which id different from heartburn, or just feel generally unwell. You should tell your midwife or doctor about any of these things.

What happens now?
Your continued care focuses on close observation of you and your baby, either in hospital, day stay, or clinic. If everything else is stable but your blood pressure is high you may be given medication to help to control this, however there is no treatment for preeclampsia other than delivering the baby and placenta. Whilst in the past women were often confined to bed rest this is now known to be of no benefit. Preeclampsia tends to get worse as the pregnancy progresses, either gradually or sometimes suddenly, so it may happen that eventually your doctor makes a decision to deliver your baby, either around your due date or sometimes before.

How will my baby be born?
Most commonly you will be able to have a vaginal birth either spontaneously or induced. Whilst caesarean is always a possibility, it is usually only necessary when preeclampsia is very severe.

What happens after my baby is born?
Preeclampsia is a problem of pregnancy and goes away afterwards. There will be no permanent damage to your body. Usually everything goes back to Norman quite quickly, but sometimes the first day or two can become a little unstable before getting better. Sometimes your blood pressure can take a few weeks to settle down and your doctor may decrease your medication slowly after you have gone home.

What about my next pregnancy?
While you have more chance of having preeclampsia again that someone who has never had it before, it is a problem of first pregnancies only and may not happen again. Your doctor or midwife will keep a close eye on you next time just in case.

Symptoms of Worsening Preeclampsia:
? Persistent headache.
? Blurred vision or ?spots?, ?stars?, ?zig zags? that last for more than a few minutes.
? Deep pain in the upper abdominal area.
? Reduced urine output.
? Reduced foetal movements.
? Pain or constant tightness of your uterus.
? Vaginal bleeding.
? Feeling generally unwell
? Flu like symptoms.

Thanks for that Alan.

just a quick question, i had PE last pregnancy and im just wanting to know wat is classed as high blood pressure? at my OB appt yestersday mine was 145/65 and im assuming that is ok?

Hi Blanche
145/65 is OK but worth keeping an eye on. Looking at the numbers I suspect that they took your BP shortly after you walked into the office and that would explain the 145 (which it at the upper end of acceptable). Or you had a bad day yesterday

thanks Alan, im so worried i will get PE again..yeah the midwife took my BP as soon as i walked in her office, but she didnt say anything and neither did my OB when i seen him, so i wasnt sure if it was ok or not. (silly me didnt ask!) i was just looking at my notes from my checkup weeks ago and it was 140/80 then

i was sortoff having a bad week!!

Because this is your second pregnancy you have less chance of getting PE this time round. Also getting a high BP does not mean that you have PE
I'm sure that you will be fine

I had PE late in my pregnancy with my twin girls.Labour started on my own and I had a vaginal delivery.My kidneys had started to shut down the day I delivered but I would not have known it as I felt ok.
My BP stayed high for around 6 months after and I had to see a renal specialist.Next pregnancy I will be put on meds once viable as a precaution....