Pre-eclampsia

Pre-eclampsia

Pre-eclampsia is a common condition, the exact cause of which is poorly understood, which can complicate the second half of pregnancy. It occurs in 2-3% of pregnancies. Often it is mild and without symptoms. It is detected by routine measuring of blood pressure and testing for protein in the urine, as high blood pressure and proteinuria are the distinguishing features. Swelling due to fluid retention can also occur, but swelling of the ankles without raised blood pressure or proteinuria is common in pregnancy anyway, and not usually a cause of concern. It is important to detect the condition, because worsening pre-eclampsia has implications for the health of both mother and baby. 1 in 200 pregnant women develop severe pre-eclamsia. In the severest form, pre-eclampsia becomes eclampsia, where maternal convulsions occur.

Pre-eclampsia affects the development of the placenta and can affect the baby’s growth in the womb. There may also be a reduced amount of water (amniotic fluid) around the baby in the womb. If the placenta is severely affected, the baby can become distressed or even die. Monitoring aims to pick up those babies who are most at risk.

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Risk factors

Your risk of developing pre-eclampsia can be increased if any of the following apply:

  • First pregnancy with a new partner
  • Aged over 40
  • Mother or sister had pre-eclampsia
  • Twin pregnancy
  • Obesity
  • Pre-existing high blood pressure or kidney disease

Management

Mild cases are managed with just regular monitoring of blood pressure and urine testing. Extra ultrasounds may be advised to check your baby’s growth and well being are not being affected, as can occur. Medications to lower blood pressure may be needed, and possibly hospital admission for closer observation.

Severe pre-eclampsia is indicated by very high blood pressure, and worsening kidney function with greater amounts of protein being passed out in the urine. Symptoms include severe headaches, blurred vision, abdominal pain and marked swelling of the face. If these symptoms develop, you must contact your doctor immediately.

The only cure for pre eclampsia is to deliver your baby. This may mean inducing labour, or sometimes delivering by Caesarean section.

The condition may take a while to resolve after delivery, so careful monitoring may continue for a few weeks.