Pre-eclampsia

Pre-eclampsia is a condition of high blood pressure in pregnancy.

It affects seven to 10 percent of pregnancies in the US and is the second-leading cause of maternal death, and the leading cause of pre-term delivery. It typically occurs after 20 weeks but can occur earlier in some cases.

What are the symptoms?

Pre-eclampsia is characterized by high blood pressure; water retention which can cause swelling in the hands, feet and face; and protein in the urine. At each prenatal check, your OB-GYN or nurse-midwife will check for these symptoms.

In severe cases, symptoms may progress to include persistent headaches, blurred vision and flashing lights and abdominal pain on the right side of the body below the ribcage. However, many women suffering from pre-eclampsia feel fine and only learn they have the condition when their blood pressure measures high.

Am I at risk?

Pre-eclampsia can affect anyone, but those more at risk are moms-to-be who are over 40; teenage moms-to-be; women carrying more than one baby; and women with diabetes, a history of blood pressure problems, kidney or rheumatology problems. Genetics can also be a factor – you’re at higher risk if your mom had it.

What’s the treatment?

It’s not clear what causes pre-eclampsia, but research suggests it may be linked to an immune reaction to the baby or the placenta. If you develop the condition you and your baby will be closely monitored since it can restrict blood flow through the placenta and affect your baby’s growth, resulting in low birthweight.

If pre-eclampsia is detected early and effectively treated your baby should be fine. If you’re not at term when you develop it, you’ll be advised to take bed rest, reduce your salt consumption and drink plenty of water. You may also be prescribed medication to lower your blood pressure. If these measures don’t help, your baby may need to be induced ahead of term (37 weeks). This usually cures the condition though it can take around 48 hours for the symptoms to subside.

In more severe cases, where you’re in danger of developing eclampsia (a serious condition resulting in seizures and possibly coma) urgent delivery of your baby is required and you’ll be treated with drugs to stop any seizures.

Can I prevent it?

Not as such, although there are precautions you can take to cut your risk of developing high blood pressure:

- Avoid adding salt to your food, avoid junk food and drink plenty of water.

- Try to cut down on stress by getting plenty of rest with your feet propped up higher than your head, and taking regular gentle exercise.

- Avoid alcohol and drinks containing caffeine (see also alcohol and pregnancy). 

- Attend every prenatal check so your OB-GYN or nurse-midwife can measure your blood pressure and check your urine for high levels of protein.

Will I have pre-eclampsia again with my next pregnancy?

If your first pregnancy was normal (apart from the pre-eclampsia) your risk of developing it again with your next pregnancy is very low. But if there are other factors, such as a family history of high blood pressure, or you being overweight or past 40, you’ll be closely monitored during your next pregnancy, just to be on the safe side. A UK study has suggested that one woman in 150 whose blood pressure was entirely normal in their first pregnancy suffered from pre-eclampsia in a second pregnancy.