Preeclampsia: Risk Factors, Symptoms and Treatment

A number of different conditions can affect pregnant women, especially in the later stages of pregnancy. Regular checkups and monitoring is important during pregnancy, as this can help detect and prevent many of these conditions before they become serious and put the mother or baby at risk.

One of these conditions is known as preeclampsia, a complication that is characterized by high blood pressure and indications of damage to other organs, like the kidneys. Preeclampsia is the earlier stage of eclampsia, a serious condition that can negatively affect both the mother and baby.

Most cases of preeclampsia are noticeable at around 20 weeks of pregnancy, and it requires immediate medical attention. If not treated right away, preeclampsia can lead to additional complications.

 

Causes and Risk Factors

Doctors have not yet found any exact causes of preeclampsia. However, they are certain of a few things:

Preeclampsia affects functions of the placenta, which provides nutrients for the fetus during the pregnancy. The placenta receives blood from new blood vessels that develop in pregnancy, but in cases of preeclampsia, this process doesn’t happen correctly. Usually, this occurs because the blood vessels don’t develop properly, e.g., they are too narrow, don’t respond the right way to hormone signals, etc. There are a few known causes of this unusual blood vessel development including:

• Genetics
• Limited blood flow to the uterus
• Damaged blood vessels
• Complications in the immune system

 

Though there aren’t any definite causes, there are several factors that have been known to raise the risk of preeclampsia for pregnant women such as:

• Family history of preeclampsia or conditions like high blood pressure, diabetes, kidney disease and others
• Age: Women over 40 are at a higher risk
• Multiple babies: Women carrying twins or triplets are at higher risk
• First-time pregnancy
• New partner: Even if it’s not your first baby, the risk increases if this is your first with pregnancy with a different partner.
• Obesity
• Interval: If the time between pregnancies is under two years or over 10 years, your risk increases

 

Symptoms and Complications

Symptoms of preeclampsia aren’t always noticeable. However, blood pressure is often the most common sign—even a small increase from the recommended 140/90 threshold can be a sign of the disease.

Other symptoms can include:

• Severe headaches or loss of vision
• Nausea, vomiting and upper abdominal pain
• Excess protein in the urine, or related kidney problems
• Less urine
• Shortness of breath
• Damaged liver function
• Fluid in lungs
• Sudden weight gain
• Swelling in the face and hands

Because some of these factors might signify other conditions, particularly weight gain and swelling, doctors usually look for a presence of multiple symptoms to make a diagnosis—usually high blood pressure and another symptom.

If it’s not treated the right way, and promptly, preeclampsia can lead to several complications:

• Eclampsia: This condition presents many of the same symptoms as preeclampsia, but they are more severe and accompanied by seizures. Eclampsia usually forces premature delivery despite the mother’s stage of pregnancy.
• Placental abruption: This is when the placenta detaches from the uterus before delivery, causing bleeding and life-threatening damage to the placenta.
• Blood flow problems: If the placenta can’t receive enough blood, it will give less oxygen and nutrients to the baby and can cause breathing problems for the baby.
• HELLP syndrome: HELLP syndrome damages several organs, and can come on suddenly.
• Cardiovascular disease: This can be prevented by healthy diet and exercise, but in many cases, preeclampsia can lead to heart and blood vessel problems.

 

Diagnosis

Diagnosis of preeclampsia requires the presence of high blood pressure and one or more of the symptoms listed above. There are other conditions that high blood pressure might indicate, so your doctor will have to rule those out. A few extra tests that might be needed to confirm preeclampsia include:

• Blood test: Blood tests can show your doctor how well your liver and kidneys function.
• Ultrasound: This is important to monitor baby growth and amniotic fluid levels.
• Urine test: A urine test can measure protein levels.
• Nonstress test: This test checks your baby’s heart rate when moving.
• Biophysical profile: This combines ultrasounds and a nonstress test to check on the baby’s breathing and movement, along with the amount of amniotic fluid in the uterus.

 

Treatment and Prevention

During pregnancy, there is only one cure for preeclampsia: delivery. However, depending on the severity, there are ways it can be managed without an early delivery, which may put the baby and mother at risk. Your doctor will look at several factors when deciding if you need to deliver right away. If you don’t, treatment can include:

• Blood pressure medications
• Anticonvulsant medications – prevents seizures
• Corticosteroids – improves liver and platelet function, help baby’s lungs mature
• Hospitalization – in severe cases

Unfortunately, there are limited proven ways to prevent preeclampsia. There are only two medications that have shown a reduced risk in some cases:

• Aspirin: Taken in low doses, aspirin may help women with certain specific cases of preeclampsia.
• Calcium supplements: These are unlikely to help most women in the United States, but can help some rare cases where calcium deficiency is a concern before pregnancy.

In general, doctors recommend staying as healthy as you can both before and during pregnancy. If you are at risk for preeclampsia or are demonstrating symptoms, don’t wait—prompt treatment can make a big difference, so be sure to speak to your doctor right away.

 

Obstetricians/gynecologists at Revere Health OB/GYN provide a full range of healthcare services to women throughout all stages of their lives including; puberty, child-bearing years, menopause.

 

Sources:

“Preeclampsia.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/preeclampsia/basics/definition/con-20031644

“Preeclampsia and Eclampsia.” WebMD. http://www.webmd.com/baby/guide/preeclampsia-eclampsia#1