PREECLAMPSIA AND ECLAMPSIA
Preeclampsia is a pregnancy-related complication characterized by the onset of high blood pressure and a significant amount of protein in the urine (proteinuria).
- Preeclampsia usually begins after the 20th week of pregnancy.
- It can also occur during the days following birth, this is referred to as postpartum preeclampsia. Some reports describe postpartum preeclampsia as occurring up to 4 to 6 weeks after birth, although most cases occur within 48 hours of delivery.
- In preeclampsia, the mother’s high blood pressure may lead to a reduction in the supply of blood to the fetus, resulting in less oxygen and fewer nutrients to the fetus.
- Preeclampsia affects about 2%-8% of pregnancies worldwide.
- Hypertensive disorders of pregnancy (preeclampsia included) are one of the most common causes of death due to pregnancy. They resulted in 46,900 deaths in 2015.
- If left untreated, preeclampsia can lead to a more serious and fatal complication for both the mother and the baby, and in rare cases cause death. This complication is referred to as eclampsia.
- Eclampsia is defined as the development of seizures in a woman who has preeclampsia.
- Without treatment, estimates have shown that 1 out of 200 cases of preeclampsia will progress to eclampsia.
- Because eclampsia can be very fatal with serious consequences, delivery becomes necessary, regardless of how far along the pregnancy is.
- Other complications of preeclampsia are fetal growth restriction, placental abruption, cardiovascular disease, and other organ damage.
- Women who have had preeclampsia are at an increased risk of heart disease and stroke later in life
CAUSES
The exact cause of preeclampsia is unknown. Experts believe that several factors are responsible for the development of preeclampsia. Some of these factors include:
- Abnormally implanted placenta (formation and development of the. There is strong evidence that this is a major cause predisposing women to this condition.
- Environmental factors such as air pollution.
- Immunologic factors
- Dietary factors or Nutritional factors.
Risk factors include:
- Chronic hypertension
- First pregnancy
- Age, the risk of the condition is higher for pregnant women older than 40 as well as young pregnant women
- Obesity
- Multiple pregnancy, the condition is more common in women carrying twins, triplets or other multiples.
- History of preeclampsia in previous pregnancy
- In vitro fertilization
- History of certain conditions before getting pregnant such as migraine, kidney disease, type 1or type 2 diabetes.
SYMPTOMS
In mild preeclampsia, symptoms are not usually present. The hallmark symptom of preeclampsia as mentioned above are elevated blood pressure and the presence of protein in the urine. Other symptoms may include:
- Severe headaches
- Nausea or vomiting
- Decreased urine output
- Impaired liver function
- Upper abdominal pain
- Decreased level of platelet in the blood
- Shortness of breath due to fluids in the lungs
DIAGNOSIS AND TREATMENT
To make a diagnosis, the doctor will:
- Check your blood pressure. A high blood pressure reading in excess of 140/90 mm Hg is abnormal in pregnancy.
- Order kidney function tests, liver function tests, and also measure your platelets.
- Order a urine analysis to measure the amount of protein in your urine
- Order a fetal ultrasound to monitor your baby closely
- Carry out a biophysical profile. This procedure uses an ultrasound to measure the baby’s breathing, movement, muscle tone, and the volume of amniotic fluid in the uterus.
TREATMENT
The best possible treatment for preeclampsia includes:
Medications
- Medications to lower high blood pressure
- Corticosteroids
- Anticonvulsant medications
Bed rest
Hospitalization
Delivery, the most effective treatment is delivery. If the condition is diagnosed early in pregnancy, delivery may not be the best line of action.