Every couple looking forward to their own child will make sure the wife is able to have a healthy pregnancy. Healthy pregnancy and a safe delivery will lead to better chances for the baby to be born healthily. It is important for a baby to be healthy even before they are born because it does have an effect on the future of the baby. However, there can be many problems affecting a mother and ultimately affecting the baby. In this DoctorOnCall’s article, we will be learning about one of the health problems faced by pregnant mothers known as preeclampsia.
Preeclampsia is a hypertensive disease that occurs during pregnancy. Hypertensive disease means a high blood pressure. This disease accounts for 2-8% of pregnancy-related complications, causing more than 50 000 maternal deaths and more than 500 000 fetal deaths around the world. Hence, it is important to understand this condition so that early diagnosis and prompt treatment can be provided to the mother. This will hope to ensure both mother and child in safe condition.
Preeclampsia usually affects the mother during the second half of pregnancy (from 20 weeks) or can occur soon after the baby is delivered, usually within 48 hours of delivery. There are several risk factors in which if a person has one of the factors, it makes them have a higher chance to have preeclampsia. Risk factors for preeclampsia are first pregnancy (nulliparity), twins or more (multi-gestation pregnancy), advanced maternal age greater than 35 years old, in-vitro fertilisation or other form of assisted reproductive technology, maternal comorbidity meaning health conditions experienced by mother (such as diabetes, thyroid disease, obesity pre-pregnancy BMI greater than 30, chronic hypertension or chronic kidney disease), family history of preeclampsia, history of placental abruption, preeclampsia in previous pregnancy or intrauterine fetal growth restriction.
The exact causes for preeclampsia are unknown but having risk factors can certainly increase chances for developing one. You may have wondered how preeclampsia happens. In early pregnancy, new blood vessels develop and evolve to supply oxygen with nutrients through the placenta for the baby in womb. However, in people with preeclampsia, these blood vessels do not seem to develop or function properly. The problem with the blood circulation in the placenta leads to irregular regulation of blood pressure of the mother’s blood circulation system. Abnormal placentation can lead to the vast abnormality of the remodelling of the placental blood vessels. This then led to progressive low blood supply to the placenta and release of the distress markers. Then, this will lead to imbalance of the increased competition between the essential growth factors for the blood vessels and the inflammation marker. Eventually, the abnormal vessel formation and inadequate vascular blood supply function for multiple organ systems is the latter. Most noticeable functions affected by preeclampsia are cardiovascular (heart and blood vessels), kidney (renal) and liver (hepatic).
Symptoms of preeclampsia started with high blood pressure and presence of protein in urine (proteinuria). These signs usually go unnoticed unless the mother goes for routine antenatal appointments. Patients also complain of sudden headaches that are not associated with previous history of headache or migraine and are unresponsive to medication. At times, it can cause vision problems such as blurring or flashing. Pain may be felt just below the ribs (epigastric pain) and nausea or vomiting. Sudden swelling of the face, hands or feet can be seen in mothers with preeclampsia. Shortness of breath may also occur. The blood pressure suspected with preeclampsia are systolic blood pressure (the top number) of 140 mmHg or greater or diastolic pressure (the bottom number) of 90 mmHg or greater. Blood pressure readings on 2 measurements at least 4 hours apart are needed for patients at greater than 20 weeks or pregnancy.
Whenever a mother has any of the symptoms of preeclampsia, the mother needs to be taken to a nearby healthcare facility for immediate medical advice. Even though many cases are mild, the conditions can lead to serious complications if it is not monitored and treated. The earlier preeclampsia is diagnosed and monitored, the better outcome for both mother and baby.
Treatment for preeclampsia is to deliver the baby. Thus, the mother diagnosed with preeclampsia is usually monitored regularly until it is time to deliver the baby which is normally around 37 to 38 weeks. However, delivery may need to be earlier in a severe case. At this point, labour may be induced through artificial medication or probably be needed to go for caesarean section surgery. Doctors may also offer antihypertensive drugs to be given while waiting for the suitable delivery time. Medicine to prevent seizure and steroid injections to help mature baby lungs may be given while the patient is observed in the hospital. Symptoms of preeclampsia should go away within 1 to 6 weeks but it is possible for symptoms to stay for a bit longer.
In essence, preeclampsia needs to be taken seriously. Mothers who have any symptoms of preeclampsia or have high risk for it should talk to a doctor. Lifestyle changes such as losing some weight and keeping blood pressure or blood sugar within optimal levels can help. Doctors may also prescribe low-dose aspirin to lower risk for preeclampsia.