High blood pressure disorders are known to cause about 18 % of pregnancy-related deaths in South Africa. Preeclampsia and eclampsia are the most common reasons for these deaths. Preeclampsia is elevated blood pressure in the mother (greater than 140/90) that is accompanied by protein in the urine or other signs of organ problems. It usually occurs after the 20th week of pregnancy. Eclampsia is a serious complication of preeclampsia, causing seizures that may lead to coma or even death. Preeclampsia that has not progressed to eclampsia can still cause serious, life-threatening complications.
Symptoms of preeclampsia may not always be noticeable and are often discovered by blood pressure and urine screenings at routine health provider visits for pregnancy care. Usually, they occur after 34 weeks, but can be as early as 20 weeks. Signs and symptoms of possible preeclampsia are listed below:
The exact cause of preeclampsia is unknown, but there are factors that may increase your risk of developing it. These are listed below.
Some women will develop preeclampsia even with no known risk factors.
To diagnose preeclampsia, a health care provider will check blood pressure and protein levels in urine, perform blood tests to check for organ dysfunction, and may do an ultrasound or other tests to check on the baby. Preeclampsia will be diagnosed if you have blood pressure over 140/90 after 20 weeks gestation accompanied by one or more of the following: protein in the urine or other signs of kidney problems, elevated liver enzymes, vision changes, low platelet count, fluid in lungs, new-onset headache that is not relieved by medication, or a problem with the unborn baby’s growth/nutrition.
The only way to cure preeclampsia is to deliver the baby. This can be lifesaving for both the mother and new-born. It is common to induce labour to deliver the baby when even mild symptoms of preeclampsia are present, and the pregnancy is over 37 weeks along. In severe cases of preeclampsia, this may need to happen even if the baby will be premature. Treatment for severe preeclampsia in the hospital prior to delivery may include medications to lower blood pressure, treat or prevent seizures, and steroids to help mature the baby’s lungs, when possible. Treatment for mild preeclampsia before delivery may include bed rest, frequent monitoring of blood pressure and urine, and medication to lower blood pressure.
Serious, but rare complications that may occur due to preeclampsia include seizures, heart failure, pulmonary oedema (fluid in lungs), stroke, and excessive bleeding after birth. Preeclampsia can decrease blood flow to the placenta, which provides the baby with nutrients that it needs from the mother. This can cause growth problems in the baby, and in rare cases, stillbirth. The baby is also at risk of several complications due to prematurity if pre-term delivery is necessary. It is important to keep all doctor appointments and monitor for any symptoms of preeclampsia throughout pregnancy. Early detection and treatment can help prevent complications caused by preeclampsia.