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Preeclampsia: Causes, Symptoms, Risk Factors, Complications, Diagnosis & Treatment

Preeclampsia is a disorder characterised by high blood pressure and excess protein excretion in the urine. It is a common medical complication during pregnancy associated with high maternal morbidity and mortality and intrauterine foetal growth restriction [1].

Preeclampsia occurs in about two to eight per cent of all pregnancies globally [2]. According to the National Health Portal of India, preeclampsia affects 8 to 10 per cent of pregnant women. This disorder can pose a risk to the mother and baby's health.

Causes Of Preeclampsia

The exact cause of preeclampsia is not fully understood. Preeclampsia may occur due to abnormal changes in the placenta, an organ that nourishes the foetus during pregnancy. Blood vessels that send blood to the placenta become narrow or don't function properly and react differently to hormonal signals, thereby limiting the blood flow to the placenta.

The abnormality of the placenta has been linked to certain genes and impairment of the immune system [3].

Preeclampsia occurs after 20 weeks of pregnancy. However, in some cases, it may occur earlier [4].


Symptoms Of Preeclampsia

According to the American Pregnancy Association, the symptoms of preeclampsia include the following:[5]

• High blood pressure

• Water retention

• Excess protein in the urine

• Headache

• Blurred vision

• Unable to tolerate bright light

• Shortness of breath

• Fatigue

• Nausea and vomiting

• Pain in the upper right abdomen

• Urinating infrequently

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Risk Factors Of Preeclampsia

• Kidney disease

• Chronic hypertension

• Diabetes mellitus

• Multiple pregnancies

• Had preeclampsia previously

• Antiphospholipid antibody syndrome

• Nulliparity

• Systemic lupus erythematosus

• High altitude

• Family history of heart disease

• Obesity [6]

• Family history of preeclampsia in first-degree relative

• Pregnancy after the age of 40 [7]


Complications Of Preeclampsia

The complications of preeclampsia occur in three per cent of pregnancies [8]. These include:

• Foetal growth restriction

• Preterm birth

• Placental abruption

• HELLP syndrome

• Eclampsia

• Heart disease

• Organ problems [9]

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When To See A Doctor

Ensure that you visit your gynaecologist frequently so that your blood pressure can be monitored. If you experience any of the above-mentioned symptoms consult your doctor immediately.


Diagnosis Of Preeclampsia

The doctor will conduct a physical examination and ask the occurrence of high blood pressure during previous pregnancies if had any. Then a thorough medical history will be obtained by the doctor to identify medical conditions that can increase the risk of preeclampsia.

If the doctor suspects preeclampsia, further tests such as blood tests, urine analysis and foetal ultrasound tests will be done.

The diagnostic criteria for preeclampsia are:

• Persistent systolic blood pressure of 140 mm Hg or higher, or diastolic blood pressure of 90 mm Hg or higher after 20 weeks of pregnancy is considered abnormal [10].

• Protein in your urine (proteinuria).

• Having severe headaches.

• Visual disturbances.

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Treatment Of Preeclampsia

Delivery remains the only treatment for preeclampsia depending on the timing of delivery and the seriousness of the maternal and foetal condition. Labour induction can lower the risk of higher mortality and morbidity.

Hemodynamic, neurological, and laboratory monitoring is necessary after delivery for patients with severe preeclampsia. Laboratory monitoring should be done daily throughout the day in the first 72 hours after delivery.

Antihypertensive drugs are used to lower high blood pressure in severe preeclampsia pregnancies.

Corticosteroid medications can also help treat preeclampsia, depending on the gestational age [11].


Prevention Of Preeclampsia

According to the American Pregnancy Association, there are some ways that may help prevent preeclampsia [12].

• Use less salt in your meals.

• Get enough rest.

• Drink six to eight glasses of water a day.

• Exercise daily

• Don't eat fried or junk foods

• Don't drink alcohol

• Avoid drinking caffeinated beverages.

• Keep your leg elevated several times throughout the day.

Common FAQs

Q. How does preeclampsia affect the unborn baby?

A. Preeclampsia can prevent the placenta from getting enough blood and if it doesn't get enough blood, the baby will get less amounts of oxygen and food, resulting in low birth weight.

Q. Can preeclampsia come on suddenly?

A. Preeclampsia can develop gradually and may sometimes develop without any symptoms.

Q. Does stress cause preeclampsia?

A. Psychological stress may directly or indirectly affect pregnancy and can lead to preeclampsia.

Q. Can a baby die from preeclampsia?

A. Preeclampsia if not diagnosed on time can cause maternal and infant death.

Story first published: Friday, May 29, 2020, 15:10 [IST]