Preeclampsia is the most common serious medical problem women face in pregnancy.
The exact number of women who develop preeclampsia is unknown, but experts estimate that preeclampsia affects 5-10% of all pregnancies globally.
An Australian study has indicated Metformin, a drug used to treat diabetes, could be used to prevent or treat preeclampsia.
Further trials are needed to confirm the medication is effective in treating the condition. If so, it could potentially save the lives of over 60,000 women worldwide each year.
What Is Preeclampsia?
Preeclampsia used to be known as toxemia. It is a condition that develops only in pregnant women. Occurring in the second half of pregnancy, or even several days after birth, preeclampsia affects both mothers and their unborn babies.
The condition develops rapidly, and is characterised by high blood pressure in women who haven’t previously experienced high blood pressure. Other symptoms usually develop, but in cases where the condition occurs quickly, women might not experience any other symptoms.
What Are The Symptoms Of Preeclampsia?
Often, the early signs of preeclampsia are things you mightn’t notice yourself, but your care provider should pick up the symptoms during your prenatal appointments.
Early symptoms of preeclampsia are:
- Rising blood pressure (hypertension)
- Protein in urine (proteinuria)
High blood pressure can affect women during pregnancy, and yet not be a cause for concern. However the presence of protein in the urine usually indicates preeclampsia is developing.
As the condition progresses, further symptoms can develop. They should be reported to your care provider immediately.
Further symptoms are:
- Sudden swelling and weight gain over 1-2 days
- Pain in the abdomen, especially in the upper right side
- Severe headaches
- Excessive vomiting and nausea
- Blurry vision, flashing lights or floaters
- Changes to reflexes
- Reduced or no urine output
What Is The Cause Of Preeclampsia?
Scientists have been searching for the cause of preeclampsia for decades. It is believed to occur when there is a problem with the placenta.
As the placenta develops, blood vessels are formed, to act as part of the ‘exchange’ between mother and baby. Oxygen, nourishment and waste are all moved through the placental blood vessels.
In women with preeclampsia, these blood vessels don’t develop properly. They are usually narrower, and respond differently to hormone signals. These factors cause a reduction in the amount of blood flow to the placenta.
When there is insufficient blood flow, the placental blood vessels are damaged, increasing blood pressure. Kidney function is also disturbed and blood proteins leak into the urine.
There are several reasons why these blood vessels don’t develop normally:
- Lack of blood flow to the uterus
- Genetic factors (family history of preeclampsia)
- Damage to blood vessels
- Immune system problems
If preeclampsia is left unchecked, other organs in the body are affected – such as the liver, lungs, brain and heart. Severe complications can result from not treating preeclampsia, such as:
- Convulsions (eclampsia)
- Stroke (cerebral haemorrhage)
- Fluid in the lungs due to heart failure (pulmonary oedema)
- Kidney failure
- Liver damage and blood clotting disorder (HELLP syndrome)
Today, these complications are rare, because care providers tend to recognise the signs of preeclampsia early on.
What Are The Risks To My Baby?
Your baby receives nourishment and oxygen from you, via the placenta. If your pregnancy is complicated by preeclampsia, it can prevent enough blood reaching the placenta. This means your baby won’t receive optimal nourishment and oxygen, which will affect his growth and development.
Preeclampsia is one of the leading causes of premature birth. The placenta can suddenly separate from the uterus. This is called placental abruption. It is a medical emergency and there is a risk of stillbirth. This means your baby will need to be born urgently.
Complications of premature birth for babies include: cerebral palsy; learning difficulties; hearing and vision problems; and heart problems.
Can Preeclampsia Be Treated?
Currently, the only cure for preeclampsia is to give birth to your baby. If you are not close to early full term (37 weeks), your care provider might recommend treatment to manage the preeclampsia until your baby has developed enough to be born safely.
Treatment might include:
- Frequent monitoring of baby
- Medication to lower blood pressure
- Blood and urine tests
- Corticosteroids to promote lung development in your baby, as well as improve your liver and blood clotting functions
- Drugs to prevent seizures
If preeclampsia is severe, early in the second half of pregnancy, treating it becomes a balancing act. While prolonging the pregnancy is ideal for the baby, it can mean a greater risk to the mother.
If preeclampsia becomes severe, you will be hospitalised for careful monitoring of your wellbeing and that of your baby. While some symptoms of preeclampsia can be temporarily relieved by treatments, the condition is progressive and can’t be stopped.
If you are close enough to early full term, or if the condition progresses rapidly and treatment is not an option, you will need to give birth to your baby, regardless of gestational age. Depending on how severe your condition is, and how close to term your baby is, your care provider will either induce labour or perform a c-section.
How Can I Prevent Preeclampsia?
There is a number of risk factors that increase your chances of developing preeclampsia. These include:
- First pregnancy
- Family history of preeclampsia (your mother or sister had it)
- Long interval between pregnancies (at least 10 years)
- Previous pregnancy with preeclampsia (there is a 20% chance of developing the condition again)
- Your age (teens and women over 40 years of age are more likely to develop the condition)
- Preexisting medical conditions, such as kidney disease, hypertension, migraines, diabetes
- Being obese before pregnancy (a body mass index of 30 or more)
- Pregnancy with multiples
If you are at risk for developing preeclampsia, your care provider will recommend you attend regular prenatal check ups. If the condition does develop, this will help to detect it as early as possible.
Optimising your health before pregnancy is ideal, but not all pregnancies are planned. Make sure you discuss your risk factors for preeclampsia with your maternity care provider. Have your blood pressure checked regularly, and your urine tested for protein. Small amounts of protein in urine can be normal, but anything more than a trace should be investigated.
Unfortunately, preeclampsia doesn’t always provide women with early warning symptoms or signs. Make sure you have regular prenatal care. If you have any worrying signs or symptoms during pregnancy, contact your care provider immediately.
Being diagnosed with preeclampsia early in pregnancy can be stressful and worrying. It can mean many weeks of feeling concerned about your baby’s wellbeing.
Having it appear late in pregnancy can be a shock. You are likely to have your baby sooner, and without waiting for labour to being on its own. All these factors can have a big impact on your emotions. Seek the support of your partner, family and friends to cope with this complication.
Being informed as much as possible about preeclampsia can help you work with your care provider in deciding on your best treatment options.