Preeclampsia Awareness: Know the Symptoms & Causes

Preeclampsia is a serious pregnancy-related condition that affects many women in the world. Pregnant women suffering from preeclampsia experience high blood pressure, protein in the urine swelling, frequent headaches, and blurry vision-like symptoms, but some pregnant women might be asymptomatic. 

Although the condition often develops post 20th week of pregnancy, it can be managed and prevented with early detection. In this blog, we will discuss preeclampsia's symptoms, causes, and risk factors, emphasizing the importance of regular prenatal care.

What is Preeclampsia?

Preeclampsia is a condition characterized by persistent high blood pressure that develops during pregnancy or the postpartum period. It is often associated with high levels of protein in the urine, or the new development of decreased blood platelets and issues with the kidneys or liver.

According to the World Health Organization (WHO), preeclampsia is one of the top causes of maternal and perinatal morbidity and mortality worldwide.

Preeclampsia affects approximately 2-8% of pregnancies globally. In India, it impacts about 5-15% of all pregnancies. Despite the prevalence of preeclampsia, the exact cause remains unclear, which makes awareness and education about the symptoms and risk factors even more critical. 

Preeclampsia is characterized by:

• High blood pressure- A constant high blood pressure reading above 140/90 mmHg.
• Protein in the urine- An indication of kidney damage.
• Other symptoms- These can include severe headaches, vision changes, swelling, abdominal pain, and shortness of breath.

In more severe cases, preeclampsia can develop into eclampsia, which is characterized by seizures.

Symptoms of Preeclampsia

Some pregnant women might not have any noticeable symptoms. Also, symptoms like hypertension do make it difficult to diagnose between gestational hypertension and preeclampsia. Along with high BP, preeclampsia signs and symptoms may include- 

• Sudden weight gain: Rapid weight gain due to fluid retention.
• Severe headaches: Persistent or worsening headaches.
• Vision changes: Blurred vision, light sensitivity, or seeing spots.
• Upper abdominal pain: Pain under the right ribs.
• Shortness of breath: Difficulty breathing.
• Nausea and vomiting: Especially if it occurs late in pregnancy.
• Decreased urine output: Reduced urination frequency.
• Swelling: Noticeable swelling in the hands, face, or feet.
• Decreased levels of platelets

Weight gain and swelling are common during healthy pregnancies. But sudden weight gain or sudden changes in the appearance of edema in your face and hands may be a sign of preeclampsia.

However, if you experience any of these, you must contact your healthcare provider immediately.

Understanding the Causes and Risk Factors of Preeclampsia 

Preeclampsia occurs due to constriction in placental blood vessels that restrict the blood supply to the fetus. However, the exact cause needs to be clarified.

• Placenta problems: The placenta is the organ that links the mother's blood supply to the baby's blood. Food and oxygen are transported through the placenta from mother to baby. In preeclampsia, the placenta doesn't get enough blood because it didn't develop properly during the first half of the pregnancy. The problem arises because the blood supply between mother and baby is disrupted. 
• Blood vessel abnormalities: Changes in blood vessels can restrict blood flow to the placenta. Signals from the damaged placenta affect the mother's blood vessels and cause high blood pressure.
• Immune system dysfunction: An overactive immune system might contribute to preeclampsia.
• Genetic predisposition: A family history of preeclampsia may increase the risk.

The exact cause of preeclampsia is not entirely understood, but several factors can contribute to preeclampsia. These factors include problems with the blood vessels, immune system, and genetic factors. Research also suggests poor nutrition and insufficient uterine blood flow may play a role.

Here are some risk factors that can increase your chance of getting preeclampsia.

• History of preeclampsia
• Chronic Hypertension
• Kidney disease
• Diabetes
• Pregnancy with twins, triplets, or more
• Obesity
• Autoimmune conditions such as lupus

Other Risk factors

• Being pregnant for the first time
• BMI over r30
• Being older than 35
• Having IVF
• Being pregnant more than ten years after your last pregnancy
• Having complications in your previous pregnancies

The Impact of Preeclampsia on Mother and Baby

Preeclampsia can cause severe health consequences for both the mother and the baby if not managed appropriately. The complexity of the condition can vary, with some women experiencing only mild symptoms and others developing severe complications.

For the mother, preeclampsia can lead to:

• Eclampsia
• Kidney and liver damage
• Placental abruption
• Stroke

For the baby, the risks include:

• Preterm birth can cause respiratory distress syndrome and developmental delays.
• Low birth weight
• Stillbirth

How to diagnose Preeclampsia?

A placental growth factor (PlGF) blood test helps predict pre-eclampsia in pregnant women. PIGF is a glycoprotein that helps the placenta's blood vessels develop, and its levels increase throughout pregnancy, especially during the third trimester. 

Plgf and sflt -1 are two biomarkers that can help screen, diagnose, and monitor for preeclampsia.

PlGF can help in screening for preeclampsia in the first trimester of pregnancy, with ideal weeks being between 11 and 13+6 weeks.

The screen can help identify pregnant women who are at high risk of developing preeclampsia post-20 weeks. FMF also recommends this test for preeclampsia screening. After 20 weeks, the salt / PlGF ratio can be carried out in high-risk cases to diagnose or rule out PE.

Treatment and Management of Preeclampsia: Taking Control

Regular prenatal care is essential in managing and preventing preeclampsia. Women with high-risk factors may be prescribed low-dose aspirin after the first trimester to manage the condition. Maintaining a healthy weight, managing other health conditions, and getting a properly balanced diet during pregnancy are all important preventive measures against preeclampsia.

Mild preeclampsia may be managed with bed rest, dietary changes, and close monitoring of blood pressure and fetal health. 

Delivery

If you're at 37 weeks or later, your doctor may induce labor. At this point, your baby has completely developed and will not be considered premature.

But, if you have preeclampsia before 37 weeks, your doctor will review the status of your health of both you and the baby before deciding the timing for your delivery. However, this may rely on many factors, including your baby's gestational age, if the labor has begun, or how severe the disease is. Hence, managing early preeclampsia is crucial. 

Other treatments

Sometimes, your doctor may advise you on some medications to lower high blood pressure. They may also recommend medication to prevent seizures, a possible complication of preeclampsia.

Your doctor might suggest intravenous medications to lower your high blood pressure or steroid injections to help your baby develop his lungs appropriately. 

If you experience symptoms of preeclampsia, it's crucial to seek immediate medical attention. Consulting your doctor if you notice any unusual symptoms during pregnancy is always important.

Treatment after delivery

As per the Preeclampsia Foundation, once the baby is delivered, preeclampsia symptoms may resolve on its own within 48 hours. 

Moreover, research shows that the symptoms resolve themselves, and liver and kidney function return to normal within a few months.

In some cases, preeclampsia can also occur after delivery, even if you had complications during pregnancy. The National Institute of Child Health and Development says that postpartum preeclampsia usually occurs between 48 hours and six weeks after delivery. 

Therefore, if you had preeclampsia during pregnancy, consult with your doctor and take regular health checkups to maintain your and your baby's health. 

Conclusion

It is important to keep yourself and your baby healthy during pregnancy. You can achieve a healthy pregnancy by consuming a balanced and nutritious diet, taking prenatal vitamins and supplements, and not skipping regular health checkups. But sometimes, with proper care, preeclampsia can occur during or after delivery. 

Preeclampsia is a complex, life-threatening condition that requires awareness, early detection, and proper management. However, it is important to understand the symptoms, recognize the risk factors, and know the potential impacts to lower the effect of preeclampsia on mother and fetal health. Talk to your healthcare expert to understand the risk of preeclampsia and its symptoms. Preeclampsia is not completely preventable, but with regular health checkups, it can be managed early.