This pregnancy condition can affect some pregnancies from around 20 weeks until birth; Pre-eclampsia varies in severity. Mild pre-eclampsia affects up to 6% of pregnancies, and severe cases develop in about 1-2% of pregnancies. The cause of pre-eclampsia isn’t yet known, however, there is some evidence that suggests it occurs when there is a problem with the placenta. The majority of cases are mild, however, if it is not monitored then it can lead to serious (even fatal) complications for both mother and baby. Therefore, early diagnosis is essential.
Your midwife or obstetrician will be checking for early signs of pre-eclampsia during your routine antenatal appointments, these include:
- High blood pressure (hypertension)
- Protein in your urine (proteinuria)
In some cases, further symptoms can develop, including:
- Swelling of the feet, ankles, face and hands caused by fluid retention (oedema)
- Severe headache
- Vision problems
- Pain just below the ribs
If you notice any symptoms of pre-eclampsia, seek medical advice immediately by calling your midwife, obstetrician, GP or midwifery triage.
Your risk of developing pre-eclampsia increases if you:
- Have had diabetes, high blood pressure or kidney disease before starting pregnancy
- Have a blood clotting condition, such as lupus or antiphospholipid syndrome
- Have developed the condition during a previous pregnancy
- Other things that can slightly increase your chances of developing pre-eclampsia include:
- Having a family history of the condition
- Being over 40 years old
- It has been at least 10 years since your last pregnancy
- Expecting multiples (twins or triplets)
- Having a body mass index (BMI) of 35 or over
The only way to treat pre-eclampsia is to deliver your baby. Therefore, if you’re diagnosed with pre-eclampsia you’ll be monitored closely to determine how severe the condition is and whether you need to be admitted to hospital. You will be monitored regularly until delivery and very often the baby is delivered at early term in the UK (37-38 weeks). However, if the pre-eclampsia becomes severe then the baby may need to be delivered earlier. The labour may be induced, or you may need to have a caesarean section and I would urge you to follow your doctors’ advice on this. You may be given medication to lower your blood pressure while waiting for delivery.
Complications are rare and most cases of pre-eclampsia cause no problems during pregnancy and improve after the baby is born; however, there is a number of conditions can develop if pre-eclampsia isn’t diagnosed and monitored.
It is estimated that Eclampsia develops in 1 in 4,000 pregnancies in the UK. The word eclampsia describes a type of convulsion. These convulsions usually last less than a minute and during that time the mother’s arms, legs, neck or jaw will twitch in repetitive, jerky movements. She may lose consciousness and may urinate. ‘While most women make a full recovery after having eclampsia, there’s a small risk of permanent disability or brain damage if the fits are severe. Of those who have eclampsia, around 1 in 50 will die from the condition. Unborn babies can suffocate during a seizure and 1 in 14 may die’ NHS Website. Magnesium Sulfate medication can reduce the risk of fatality by 50% and it is now widely used to treat the condition.
This is a rare liver and blood clotting disorder, it can appear after 20 weeks gestation, however it usually occurs immediately after the birth.
HELLP stands for:
- H – haemolysis (the red blood cells break down)
- EL – elevated liver enzymes (proteins) (a high number of enzymes in the liver is a sign of liver damage)
- LP – low platelet count (platelets help the blood to clot)
HELLP syndrome can be as dangerous as eclampsia. Delivering the baby is the only way to treat the condition and once the mother is receiving treatment, it’s possible for her to make a full recovery.
If the high blood pressure affects the brains blood supply then this can lead to a stroke (cerebral haemorrhage). If the brain doesn’t get enough oxygen and nutrients from the blood, brain cells will start to die, causing brain damage and possibly death.
- Pulmonary oedema (fluid builds up in and around the lungs which stops the lungs from working properly)
- Kidney failure (the kidneys cannot filter waste products from the blood, causing toxins and fluids to build up in the body)
- Liver failure (the liver has many functions; including digesting proteins and fats, producing bile and removing toxins)
Disseminated Intravascular Coagulation
The body’s ability to form blood clots can be affected. If there aren’t enough proteins in the blood then it can stop the blood from clotting which will cause excessive bleeding; if the proteins are abnormally active then it can result in blood clots developing throughout the body. These blood clots can damage organs by reducing blood flow through the blood vessels.