Preeclampsia is known as a silent killer during pregnancy. It is one of the most dangerous and fatal diseases a pregnant woman can experience, frequently going undiagnosed due to the lack of signs and symptoms noticed at home. To summarize, Preeclampsia is high blood pressure during pregnancy, which then can cause multi-organ dysfunction. Typically, Preeclampsia onsets around the halfway point in pregnancy, which is 20 weeks, and subsides or disappears after childbirth. Let's discuss Preeclampsia in more depth and its signs, symptoms, risk factors, diagnosis, complications, treatment, and prevention.
What is Preeclampsia? Signs and Symptoms
Preeclampsia is considered dangerously high blood pressure during pregnancy. A blood pressure of 140/90 and above is warranted for diagnosis and further monitoring by your healthcare provider. Fortunately, attending regular prenatal appointments will ensure your blood pressure is carefully monitored at each visit. In addition to high blood pressure, your body can suffer from additional signs and symptoms that a doctor may only detect. Kidney damage: causing protein to be excreted in your urine, liver damage, severe headaches, abdominal pain, shortness of breath, nausea and vomiting, retained fluid causing swelling, vision changes, and brain damage can occur and worsen, especially if it is not promptly treated.
Risk Factors
Preeclampsia can affect both mother and baby because it involves a placental disruption due to poor circulation. The placenta provides blood flow and vital nutrition from newly developing blood vessels during pregnancy. This blood flow to the fetus comes directly from the mother throughout gestation. When these blood vessels are destroyed or not developed properly, this damages the placenta and harms the growing fetus and the mother's organs. Some risk factors for increasing the likelihood of being diagnosed with Preeclampsia during pregnancy include gestational hypertension, chronic hypertension pre-pregnancy, kidney disease pre-pregnancy, diabetes, autoimmune disorders, having experienced Preeclampsia with a previous pregnancy, and being pregnant with more than one fetus. These risk factors increase your chances of developing Preeclampsia because they strain your body's blood vessels and blood flow.
Diagnosis
Your prenatal doctor typically diagnoses Preeclampsia during a regular checkup. Blood pressure and weight checks ensure proper evaluation of blood flow and fluid retention during pregnancy. Suppose your blood pressure is significantly raised, or your weight has substantially increased from the previous appointment due to retained fluid. In that case, it may be a cause for concern. If additional testing is warranted, your healthcare provider can examine your urine for protein and check your lab work for proper liver and kidney function.
Complications
Many complications can arise from insufficient blood flow throughout the placenta and high blood pressure during pregnancy.
Fetal growth restriction can occur from the lack of adequate blood flow to the fetus. If blood and oxygen aren't circulating correctly, the fetus will struggle to acquire the nutrients needed to thrive and grow to full gestation.
Preterm birth could happen on its own from improper development and placental function or may also be advised by your doctor for safety. Induction of labor may be necessary depending on how severe your symptoms are and what week of gestation your baby is in. This is because Preeclampsia is a severe and sometimes fatal disease if not immediately treated, and delivery typically relieves your symptoms.
Placental Abruption can occur when the lack of blood flow to the placenta causes it to become detached from the uterus. Abruption can happen suddenly and be followed by severe bleeding, which requires immediate medical attention.
Hemolysis Elevated Liver and Low Platelet Count Syndrome (HELLP) is a form of severe Preeclampsia when red blood cells begin to be broken down. The name of this syndrome explains it well: your liver becomes strained from the lack of red blood cells. This is where the signs and symptoms mentioned above, pertaining to abdominal pain, nausea, and vomiting, may come into play. However, this can go completely unrecognized and symptomatic—free.
Eclampsia can develop if Preeclampsia goes unnoticed and undiagnosed. This is a very life-threatening disorder when symptoms such as seizures, a stroke, and going into a comatose state can happen. Immediate medical attention and potential delivery of your baby will need to happen.
Cardiovascular Disease can develop in women who experience Preeclampsia during pregnancy. Blood vessels were damaged, causing poor blood flow from the hypertension, therefore putting a strain on the heart. Cardiovascular Disease can happen later in life from the effects of Preeclampsia on the body, or at least put you at a higher risk of developing it.
Treatment
Treatment will vary based on how severe your particular symptoms are and how far along in pregnancy you are. If you are relatively early in gestation, your doctor may advise you to be monitored more frequently. Your physician may recommend at-home blood pressure checks, more frequent prenatal visits, and additional lab draws. If delivery isn't warranted, hospitalization may be required to monitor your symptoms more closely around the clock. If possible and safe for both the mother and baby, the goal is for the baby to remain in gestation for as long as possible. The closer a baby is to full term, the fewer complications post-delivery, and a decreased rate of a NICU stay is liable to happen. If not delivering the baby is considered unsafe, or if the mother is far enough along in pregnancy at the time of diagnosis, a delivery may be required. This will be called a medical induction. Depending on the severity and urgency, your medical provider will schedule an induction date and time immediately or within a few days. It is important to note that symptoms of Preeclampsia can remain for several weeks postpartum, and you should be closely monitoring them at home. If symptoms present, call your doctor or return to the hospital immediately.
Prevention
If you have any of the risk factors listed above, you can take some steps to attempt to prevent Preeclampsia. Eating a healthy, well-balanced diet, exercising, monitoring your blood pressure or blood sugar, and attending your regularly scheduled prenatal appointments can assist in early detection and prevention. If you previously had Preeclampsia, your doctor may prescribe a baby aspirin during pregnancy to aid in blood flow.
In conclusion, Preeclampsia can be a very dangerous, life-threatening complication of pregnancy. However, regular prenatal visits can assist in early detection, monitoring, and treatment to ensure both mother and baby are safe.
References:
Preeclampsia: Toxemia, Causes, Symptoms & Risk Factors (cleveland https://my.clevelandclinic.org/health/diseases/17952-preeclampsia#management-and-treatmentclinic.org)
Preeclampsia - Symptoms & causes - Mayo C https://my.clevelandclinic.org/health/diseases/17952-preeclampsia#management-and-treatmentlinic
McKenzie Stabile, BSN, RN Assessed and Endorsed by the MedReport Medical Review Board