What is preeclampsia?
Preeclampsia is a condition unique to pregnancy that complicates up to 8 percent of all deliveries worldwide. It is characterized by high blood pressure (hypertension) and high levels of protein in the urine (proteinuria) in the mother. Preeclampsia typically occurs in first time mothers and in the later part of pregnancy (after 20 weeks gestation). It can also affect other organs in the body and can be dangerous for both the mother and her baby. Because of these risks, preeclampsia needs to be treated by a healthcare provider.
What are some of the risks with preeclampsia?
Risks of preeclampsia can include:
- Seizures in the mother
- Stroke or bleeding in the brain
- Temporary kidney failure
- Liver problems
- Blood clotting problems
- Placental abruption: The placenta pulls away from the wall of the uterus, causing distress to the baby and bleeding in the mother
- Poor growth of the baby
- Premature (early) delivery of the baby
- A cesarean delivery
What is HELLP syndrome?
HELLP syndrome is a severe form of preeclampsia that develops in 4 to 12 percent of cases. The name stands for:
- (H): Hemolysis (breakdown of red blood cells)
- (EL): Elevated liver enzymes (from damage to the liver)
- (LP): Low platelets (platelets are important in helping blood clot)
HELLP syndrome can be present without many of the typical signs of preeclampsia, including high blood pressure (hypertension) and proteinuria (protein in the urine), and in some cases the diagnosis can be missed or delayed.
Common symptoms of HELLP syndrome can include:
- Right side or mid abdominal pain
Diagnosis is usually made with blood tests. Delivery is generally necessary in order to treat HELLP syndrome and for the abnormalities to correct themselves. Complications associated with HELLP syndrome include rupture of the liver, massive bleeding, stroke and seizures.
What is eclampsia?
Eclampsia is a life-threatening complication that develops in approximately 1 percent of women with preeclampsia and results in seizures or coma. Warning signs to watch for can include:
- Severe headaches
- Blurred or double vision
- Seeing spots
- Abdominal pain
These patients often will have overactive reflexes. Treatment is based on preventing further seizure activity and generally involves use of magnesium sulfate given intravenously (directly into the vein) for at least 24 to 48 hours. High blood pressure must be treated aggressively in these patients. Generally, once the mother’s condition has been stabilized the baby is delivered. If the baby is extremely premature (less than 32 weeks), delivery may be delayed for 24 to 48 hours so that steroids may be given to the mother. These steroids help the baby’s lungs mature and prevent other complications related to premature birth. In some cases, eclampsia can occur following a seemingly normal delivery, even after the patient has gone home from the hospital.
What causes preeclampsia?
Preeclampsia is thought to arise from a problem with the health of the placenta (the organ that develops in the uterus during pregnancy and is responsible for providing oxygen and nutrients to the baby). It is thought that the blood supply to the placenta is decreased in preeclampsia, and this can lead to problems with both the mother and baby.
Who is at higher risk of developing preeclampsia?
A woman is more likely to develop preeclampsia if she:
- Is expecting her first child
- Is under age 20 or over age 40
- Has a history of chronic hypertension
- Has had preeclampsia during past pregnancies
- Has a family history of preeclampsia or chronic hypertension
- Is overweight
- Has an immune system disorder, such as lupus or rheumatoid arthritis
- Has kidney disease
- Is expecting multiple babies
- Had in vitro fertilization
- Is African American
What symptoms may patients with preeclampsia experience?
Symptoms patients with preeclampsia may have include:
- Blurry vision
- Dark spots appearing in their vision
- Right side abdominal pain
- Swelling in their hands and face
- Increased weight gain