Preeclampsia 

Pregnancy is a beautiful journey every woman encounters at least once in her lifetime. But some beautiful journeys may be accompanied by obstacles due to medical emergencies such as “Preeclampsia.” This is a life-threatening pregnancy complication characterized by high blood pressure and damage to vital organs, affecting approximately 5-8% of pregnancies worldwide. This multisystem disorder can lead to severe maternal and fetal morbidity, accounting for a significant proportion of preterm births, low birth weights, and maternal mortality. If left untreated, preeclampsia can progress to eclampsia, a critical condition involving seizures and potentially fatal outcomes. Early detection, monitoring, and timely intervention are crucial in managing preeclampsia, emphasizing the importance of comprehensive prenatal care and awareness among expectant mothers and healthcare providers alike.

This informative blog will help you understand the complexities of this near-fatal pregnancy complication to keep you well-informed. 

What is Preeclampsia?

Preeclampsia is a pregnancy-specific multisystem disorder characterized by the onset of hypertension (increased blood pressure) and end-organ damage after 20 weeks of gestation. The American College of Obstetricians and Gynecologists (ACOG) defines preeclampsia as a systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg on two separate occasions, accompanied by proteinuria (excess protein in urine) or other signs of end-organ damage, such as liver dysfunction, thrombocytopenia, or renal insufficiency.

There are two main types of preeclampsia:

• Mild Preeclampsia:
• Blood pressure: 140-149/90-99 mmHg
• Minimal proteinuria (protein in urine)
• No severe symptoms
• Severe Preeclampsia:
• Blood pressure: ≥160/110 mmHg
• Heavy proteinuria
• Signs of severe organ damage (e.g., liver dysfunction, thrombocytopenia)

Additionally, preeclampsia can be classified based on onset:

• Early-Onset Preeclampsia: Before 34 weeks of gestation
• Late-Onset Preeclampsia: After 34 weeks of gestation

What Are the Causes of Preeclampsia?

Though the exact cause of preeclampsia is still not completely understood, several factors can contribute to its development:

• Abnormal placental development and function.
• Family history of preeclampsia or hypertension.
• Abnormal maternal-fetal immune interaction.

Furthermore, certain risk factors can increase the incidence of preeclampsia, such as:

• Multiple gestations (twins, triplets)
• Previous history of preeclampsia or hypertension
• Chronic medical conditions like diabetes, PCOS, kidney disease, or thyroid disorders
• Age over 35 years
• Obesity
• History of antiphospholipid syndrome or thrombophilia
• Family history of cardiovascular disease
• Environmental factors like high altitude and pollution
• Nutritional deficiencies (e.g., calcium, vitamin D)
• Hormonal imbalance
• Endothelial dysfunction
• Inflammation and oxidative stress

What Are the Symptoms Associated with Preeclampsia?

Symptoms of preeclampsia depend on the type and severity of the condition. These may include the following:

Mild Symptoms

• Elevated blood pressure (more than 140-149/90-99 mmHg)
• Proteinuria (excess protein in urine)
• Mild headache
• Fatigue (tiredness)
• Nausea and vomiting
• Abdominal pain
• Sudden weight gain

Severe Symptoms

• Severe headache (often described as throbbing or pounding)
• Vision problems (double vision, blind spots, sensitivity to light)
• Chest pain or tightness
• Breathing difficulties
• Severe throbbing abdominal pain in the right upper quadrant
• Severe and sudden onset of swelling in the face, hands, and feet
• Liver dysfunction (elevated liver enzymes)
• Thrombocytopenia (low platelet count)
• Renal insufficiency (decreased kidney function)
• Pulmonary edema (fluid in lungs)
• Confusion or altered mental state
• Seizures (eclampsia)

How do Doctors Diagnose Preeclampsia?

Doctors diagnose preeclampsia by evaluating clinical signs, symptoms, and laboratory tests. Here are the steps involved in diagnosing preeclampsia:

Clinical Evaluation

• Blood Pressure Measurement: Regular blood pressure checks are essential during pregnancy. A 140/90 mmHg or higher blood pressure reading is considered elevated.
• Symptom Assessment: Doctors ask about symptoms such as headaches, vision changes, abdominal pain, and nausea.
• Physical Examination: A physical exam helps identify signs of preeclampsia, such as swelling in the hands, feet, or face.

Laboratory Tests

• Urine Protein Test: A urine protein test checks for proteinuria (excess protein in the urine), a hallmark of preeclampsia.
• Blood Tests: Blood tests evaluate liver function, platelet count, and creatinine levels.
• Complete Blood Count (CBC): A CBC helps identify anemia, low platelet count, or other disorders.

What Are the Complications of Preeclampsia?

Preeclampsia can lead to several complications for both the mother and the baby. Some of these complications can be severe and even life-threatening. Here are some of the possible complications of preeclampsia:

Maternal Complications

• Seizures (Eclampsia): Preeclampsia can progress to eclampsia, characterized by seizures.
• Stroke: High blood pressure can cause a stroke, which can lead to brain damage or death.
• Kidney Failure: Preeclampsia can damage the kidneys and lead to kidney failure.
• Liver Damage: The liver can be damaged, leading to liver failure.
• Placental Abruption: The placenta can separate from the uterus, cutting off the baby's oxygen supply.
• Cardiovascular Disease: Preeclampsia increases the risk of cardiovascular disease later in life.

Fetal Complications

• Preterm Birth: Preeclampsia can lead to preterm birth, which can increase the risk of health problems for the baby.
• Low Birth Weight: Babies born to mothers with preeclampsia may have low birth weight.
• Respiratory Distress: Babies may experience respiratory distress due to premature birth.
• Increased Risk of Stillbirth: Preeclampsia increases the risk of stillbirth.
• Fetal Growth Restriction: The baby's growth may be restricted due to inadequate oxygen and nutrient supply.

Other Complications

• HELLP Syndrome: A rare but life-threatening condition characterized by hemolysis, elevated liver enzymes, and low platelet count.
• Disseminated Intravascular Coagulation (DIC): A condition where blood clots form in small blood vessels throughout the body.
• Amniotic Fluid Embolism: A rare but life-threatening condition where amniotic fluid enters the mother's bloodstream.

How is Preeclampsia Treated?

Treatment for preeclampsia depends on the severity of the condition, the gestational age of the pregnancy, and the overall health of the mother and baby. Here are the common treatment options for preeclampsia:

Mild Preeclampsia

• Regular check-ups with a healthcare provider to monitor blood pressure, urine protein, and fetal well-being.
• Bed rest or reduced activity to help manage blood pressure.
• Medication to control blood pressure, if necessary.

Severe Preeclampsia

• Hospitalization: Admission to the hospital for close monitoring and treatment.
• Blood Pressure Medication: Aggressive blood pressure management with medication.
• Corticosteroids: Medication to promote fetal lung maturity in case of preterm delivery.
• Magnesium Sulfate: Medication to prevent seizures (eclampsia).
• Fetal Monitoring: Continuous monitoring of fetal heart rate and well-being.

Delivery

• Inducing labor to deliver the baby if the mother's condition worsens or the baby is at risk.
• Delivering the baby via cesarean section, if necessary.

Postpartum Care

• Continued monitoring of blood pressure and overall health after delivery.
• Continued blood pressure management with medication, if necessary.
• Regular follow-up appointments with a healthcare provider to monitor for potential complications.

Conclusion 

Preeclampsia is a serious and potentially life-threatening condition that affects thousands of pregnant women worldwide. It is essential for expectant mothers to be aware of the signs and symptoms of preeclampsia and to seek medical attention immediately if they experience any concerns. 

With prompt diagnosis and treatment, the risks associated with preeclampsia can be minimized, and a healthy outcome for both mother and baby can be achieved.