There are many health conditions that women should be aware of when they are pregnant. One of these conditions to watch out for is preeclampsia.
Preeclampsia is a pregnancy condition characterized by high blood pressure and protein in the urine. If not treated properly, it can lead to serious and life-threatening complications to pregnant women. It can also affect the baby’s growth or may cause stillbirth.
According to the National Health Service in the U.K., preeclampsia rarely happens before the 20th week of pregnancy. Most of the time, this condition occurs after 24 weeks and towards the end of the pregnancy.
Meanwhile, the Singapore College of Obstetricians and Gynecologists defines two types of preeclampsia:
- Preeclampsia. When the expectant mom is at least 20 weeks pregnant and has a blood pressure reading exceeding 140/90 mmHg and protein in the urine exceeds 0.3g/24hr.
- Severe preeclampsia. This occurs when the pregnant woman’s blood pressure reading exceeds 160/110mmHg or the protein in the urine exceeds 3g/24hr. In addition, symptoms of impending eclampsia such as seizure in a woman diagnosed with preeclampsia, in the absence of other causes, may also lead to severe preeclampsia.
Preeclampsia can be diagnosed during your regular appointments with your gynaecologist. Pregnant women who have preeclampsia usually experience mild symptoms and this can be managed by monitoring blood pressure and urine tests.
Symptoms of preeclampsia
The following are the symptoms that you need to take note for your next visit to the doctor:
Increase in blood pressure. Always monitor your blood pressure reading and make sure that it does not exceed 140/90 mmHG. Get your blood pressure at least twice a day with a minimum interval of four hours.
Increase in urine protein. Excess protein in urine (higher than 0.3g/24hr) and other kidney-related problems may cause preeclampsia.
Severe headaches. While it may be common for pregnant women to experience headaches, severe and persistent headaches should be taken seriously. These may indicate a preeclampsia symptom.
Abdominal pain or heartburn. Abdominal pain is also a common condition among expectant moms. However, don't ignore the pain when it becomes unbearable especially if it’s in the upper abdomen.
Vision problems. If you experience blurred vision, seeing double, and increased light sensitivity, consult with your doctor.
Swelling. This condition is normal among pregnant women due to water retention. But a rapid swelling (oedema) in your hands, feet, and face can be a sign of preeclampsia. This may be accompanied by sudden weight gain.
Expectant moms need to always observe the changes in their body and how they feel. If you notice any of these symptoms of preeclampsia, consult with your doctor immediately.
Causes of preeclampsia
The main cause of preeclampsia is yet to be known. However, obstetrician and gynaecologist expert Dr. Regina Zuzarte-Ng mentioned the following factors that contribute to preeclampsia:
- Placental dysfunction. The placenta is an important organ for the development of the baby inside the mother’s womb. It acts as a life support system that passes the oxygen and nutrition from mother to baby. A reduced blood flow to the placenta may lead to preeclampsia as the mother’s body has to work harder, which causes an increase in blood pressure, to continuously supply oxygen and nutrients to the baby.
- Damaged blood vessels. To serve blood to the placenta, new blood vessels develop during pregnancy. If these become damaged, the blood flow to the placenta will be restricted and this can result in preeclampsia.
- Autoimmune conditions. This health condition happens when the body’s immune system mistakenly attacks its own. Autoimmune disorders, which are generally incurable, double the risk of preeclampsia. These diseases, like lupus, affect the various body systems such as heart, lungs, and kidneys.
- Pre-existing renal problem. A kidney failure, when the organs cannot properly filter waste products from the blood, may also contribute to the risk of preeclampsia.
Cholesterol crystals and its connection to preeclampsia
In an article published on Norwegian SciTech News, one of the researchers named Gabriela Silva explained that cholesterol, a major cause of cardiovascular disease, is naturally high during pregnancy because both the baby and the placenta need cholesterol.
However, women with preeclampsia have higher levels of cholesterol. Likewise, they have higher levels of bad cholesterol, which is a type of cholesterol found in people who are at risk for cardiovascular disease.
When bad cholesterol accumulates in the blood vessel wall, cholesterol crystals are formed. These crystals, which are powerful initiators of inflammation in our body, may clog the blood vessels which may then lead to blood clots.
To avoid this, cholesterol crystals need to be cleared out of the body because they are identified as harmful substances. The defence cells, however, cannot break these crystals down alone, so they will send signals to immune cells for help but to no avail. As a result, the immune response runs wild and the inflammatory process escalates.
Based on their study, Silva said that inflammation was at the highest in the maternal-fetal interface, where the mother’s cells come into direct contact with fetal cells at the placenta and uterine wall.
“This direct contact means that the inflammation directly affects the communication between the mother and foetus and contributes to even greater inflammation in the mother,” said Silva.
Since women become more at risk of preeclampsia during pregnancy, they must check their cholesterol regularly.
Risk factors of preeclampsia
These are several risk factors that may increase your chance of developing preeclampsia:
- Existing medical conditions such as high blood pressure or hypertension, kidney disease, migraines, and diabetes.
- Preeclampsia in a previous pregnancy.
- Expecting your first child.
- Below the age of 18 or over the age of 35.
- You were obese before pregnancy.
- Expecting multiple babies.
Take note that these are not the only factors that may lead to preeclampsia. Women with none of these conditions may still be susceptible to preeclampsia, so it is important to monitor every pregnancy very closely.
Complications of preeclampsia
Pregnant women should be aware of the symptoms of preeclampsia so that when they experience any of these, they can notify their doctor immediately. Ignoring these symptoms may lead to serious complications such as:
- Eclampsia. The expectant mom is severely affected and seizures occur.
- HELLP syndrome. Hemolysis or breaking down of red blood cells, EL or elevated liver enzymes, and LP or low platelet count. In short, this life-threatening condition is a combined liver and blood-clotting disorder.
- Damage to the organs. Preeclampsia can also cause kidney problems, liver failure, stroke, and seizures.
- Concealed hemorrhage. When not diagnosed early, preeclampsia can cause massive internal bleeding that can lead to death. Indications of serious internal bleeding include ringing in the ears, extreme weakness, and visual problems.
- Placental abruption. This condition–which is a partial or complete separation of the placenta from the uterus prior to delivery–worsens with preeclampsia. If small abruption remains unnoticed, the fetus may be deprived of oxygen and nutrients, which can lead to growth problems, premature delivery or stillbirth. Placental abruption can also cause severe bleeding which is dangerous to you and your baby.
- Reduced thyroid function. Women with preeclampsia are at risk of experiencing hypothyroidism–a condition where the thyroid gland produces insufficient hormones. This can lead to overall weakness and increase the risk of cardiovascular diseases.
Keeping aware of the symptoms is one way of determining whether you have preeclampsia. To make sure of your condition, the doctor may perform the following tests on one of your visits:
- Blood test. This helps determine the state of your liver and kidneys. It can also check your blood count as preeclampsia can cause low platelets, the cells that help avoid blood clot.
- Urine test. Urine protein collection tests over a 24-hour period can check excessive loss of protein in the urine. This helps in determining the severity of preeclampsia.
- Ultrasounds. Aside from the expectant mom, you also need to closely monitor the baby’s condition as preeclampsia can affect the baby’s growth. Ultrasound images can help your doctor to keep track of the baby’s weight and your amniotic fluid or the fluid around the fetus.
- Cardiotocography (CTG) scan. During your third trimester, this test is usually done to monitor the fetal heartbeat and the contractions of the uterus. It also helps monitor any signs of fetal distress.
Treatments and drugs
Preeclampsia may sound scary for expectant moms. According to experts, the only cure for it is through delivery, which may be advised when you are closer to your term.
But what happens when you receive this diagnosis during the early stage of your pregnancy? Fortunately, you can manage this condition by lowering blood pressure and other symptoms with prescribed medications.
- Oral blood pressure medications. Methyldopa and Nifedipine are medications that treat high blood pressure. You can take these with prescription, if your preeclampsia condition is not severe. Expect also its side effects such as palpitations and dizziness.
- Intravenous medication. Drugs like Magnesium Sulfate and Labetalol may be prescribed to women with severe preeclampsia.
- Corticosteroids. Doctors may prescribe these to pregnant women who are diagnosed with HELLP syndrome as this helps the liver and platelets to function better.
- Steroids jab. Doctors may prescribe this when you’re delivering before full term to help strengthen the baby’s lungs.
- Aspirin. Your doctor may prescribe this if you experienced preeclampsia in a previous pregnancy to help improve the blood flow to the placenta. You can take it from the end of the first trimester until 34 weeks into pregnancy.
- Statins. Based on the study on cholesterol crystals, researcher Silva, mentioned that there are several clinical studies looking at the use of statins or cholesterol-lowering drugs during pregnancy.
Make sure to consult with your gynaecologist first before taking any of these medications to ensure your and your baby’s health and safety.
Aside from early diagnosis, it’s also better to prevent the possible causes of preeclampsia to keep a healthy pregnancy. Here are some tips to avoid high blood pressure, one of the characteristics of preeclampsia:
- Stay away from stress. As much as possible, try to always relax to keep a good blood pressure. You may try to destress before going to bed by using aromatherapy.
- Keep a healthy lifestyle. Try to lose weight if you are overweight by eating healthy–less salty food–and following a regular exercise routine. You may also add prenatal vitamins to your regular diet.
- Get your blood pressure under control. If you have pre-existing hypertension, do not forget to take your prescribed medication. Also, keep track of your blood pressure.
- Avoid alcohol and cigarettes. Not only are these strictly prohibited to pregnant women, they also contribute to high blood pressure.
In the case of severe eclampsia, expectant moms may be advised to be hospitalized to perform a series of tests and to monitor the mother and the baby’s condition.
This can be a serious concern especially when you need to extend your stay, because of the additional costs it may incur to your budget. Make sure to know the different maternity packages of several hospitals, so you can immediately choose the right one for you in case of emergency.
It would also help to learn about maternity insurance and if it covers conditions like preeclampsia, so you can be prepared for possible outcomes and have one thing less to worry about.
After giving birth
There’s a possibility that preeclampsia may disappear after delivery. However, take note that you may still experience high blood pressure after giving birth, where your doctor may advise you to continue taking your prescribed medication. Your blood pressure should return to normal 12 weeks after giving birth.
On the other hand, pregnant women who experienced preeclampsia in the early stage of pregnancy may have a higher risk of experiencing hypertension and other heart conditions later in life. So, it’s better to continue monitoring your blood pressure after you deliver your baby.
Taking in all of this information is a little overwhelming. But always keep in mind that you can prevent getting this condition if you avoid its possible causes. If ever you do have preeclampsia, don’t panic as this can be managed with better understanding of the condition. Lastly, always take care of yourself to ensure a healthy and safe delivery.
Original Publisher: theAsianparent