World Pre-eclampsia Day – How to spot the signs

Dr Shree Datta, Consultant Obstetrician & Gynaecologist at MyHealthcare Clinic addresses some frequently asked questions about the risks of pre-eclampsia in pregnancy

Affecting at least 5-8% of all pregnancies, pre-eclampsia remains a leading cause of maternal and infant mortality around the world. Thanks to advances in pregnancy care in Britain, deaths resulting from pre-eclampsia are now rare – but left untreated can lead to serious complications for both mother and baby.

Pre-eclampsia typically occurs from the twentieth week of pregnancy onwards and is characterised by a sudden in increase in blood pressure as well as swelling, weight gain, headaches and changes in vision. However, early signs are easily missed, which is why proper antenatal care is essential to diagnose and manage the condition.

What is Pre-eclampsia?

Preeclampsia is a pregnancy disorder that can occur during pregnancy or after childbirth, characterized by high blood pressure and signs of damage to other organs, most commonly the liver and kidneys. Preeclampsia is usually seen after 20 weeks of pregnancy in women whose blood pressure had previously been normal.

Are there any risk factors?

Common risk factors for pre-eclampsia include obesity, ethnicity (AfroCaribbean women are more likely to have pre-eclampsia) and age (both very young women and women over the age of 40). If you have medical conditions such as hypertension or diabetes, kidney disease or blood clotting disorders you may also be at risk of pre-eclampsia.

In women who have been pregnant previously, having pre-eclampsia in a previous pregnancy or having a baby less than 2 years or over 10 years’ apart also increases your chance of pre-eclampsia. IVF and twin pregnancies are also more at risk of developing pre-eclampsia

For women who have developed pre-eclampsia, is there risk for future pregnancies?

Yes. It’s important for your doctor to know if previous pregnancies were affected by pre-eclampsia, the treatment you required and whether it influenced the timing and type of delivery you had.

What are the first signs of pre-eclampsia?

Symptoms to watch for including headaches which don’t disappear with simple painkillers, a change in your vision (such as blurring), persistent heart burn, pain just under your ribs, swelling of your hands, face or legs, and generally feeling very unwell. We will look for an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver blood test results, pain over the upper abdomen, fluid in the lungs, or a severe headache or changes in vision.

How does pre-eclampsia affect the unborn baby?

Pre-eclampsia can affect the development of your placenta (afterbirth), which may affect your baby’s growth and the amount of fluid around your baby in the womb.

If the placenta is severely affected, your baby may become very unwell. In some instances, the baby may even die in the womb. Monitoring the baby’s heart and ultrasounds aim to pick up those babies who are most at risk

What qualifies pre-eclampsia?

Pre-eclampsia is high blood pressure presenting after 20 weeks, usually at 140/90 or higher, with significant proteinuria. It affects around 2-8 women in 100 women during pregnancy.

Can pre-eclampsia be treated?

Yes, treatment depends on your blood pressure, kidney and liver function and the baby’s growth. Treatments include medications to lower blood pressure (antihypertensives) and to prevent seizures (magnesium sulphate). You will be monitored closely and in some instances given medication. If there are concerns about you or your baby, you may need to be delivered early, by being induced or by caesarean section.

How long can you have pre-eclampsia before delivery?

If you have preeclampsia, we will review you regularly in order to monitor your blood pressure and urine and to check your liver and kidney function. We may also ask for an ultrasound to check on the growth of your baby. Based on all of these factors, we may need to consider medication to manage pre-eclampsia. In some cases, the most effective treatment is delivery of your baby. Even after delivering the baby, it can still take a while for you to get better.

Can a woman die from pre-eclampsia?

Globally, pre-eclampsia is still a major killer of pregnant women but thanks to advances in maternity care, it is now exceptionally rare in the UK. However, if pre-eclampsia is not treated, it can lead to serious complications for both you and your baby.