Preeclampsia: Causes, Symptoms, Diagnosis And Treatment

Preeclampsia is when your doctor diagnosed you and discover you have high blood pressure and protein in your urine during pregnancy.

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Preeclampsia is also a pregnancy complication that follow-up by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. This disease condition can happen at any point after the 20th week of pregnancy, though in some cases it occurs a bit earlier.

This disease condition is also called toxemia or pregnancy-induced hypertension (PIH). Eclampsia is a severe complication of preeclampsia. Eclampsia also includes high blood pressure resulting in seizures during pregnancy.

Preeclampsia: Causes, Symptoms, Diagnosis and Treatment

The NICHD Information Resource Center said approximately 5 to 10 percent of all pregnant women get preeclampsia. If Left untreated, this condition can lead to serious — even fatal — complications for both you and your baby. If you have high blood pressure, the only cure is delivery of your baby.

If you're diagnosed with preeclampsia too early in your pregnancy to deliver your baby, you and your doctor may face a challenging task. Your baby needs more time to mature, but you must avoid putting yourself and your baby at risk of serious complications.

What Are The Causes of Preeclampsia?

Doctors cannot yet identify one single cause of preeclampsia, but some potential causes are being identified. The exact cause of preeclampsia involves several factors. Doctors believe it begins in the placenta — the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta.

In women with preeclampsia, these blood vessels don't seem to develop or function properly. They're narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them.

Causes of this abnormal development may include:

genetic factors
diet
blood vessel problems
autoimmune disorders

There are also risk factors that can increase your chances of developing high blood pressure. These include:

being pregnant with multiple fetuses
being over the age of 35
being in your early teens
being pregnant for the first time
being obese
having a history of high blood pressure
having a history of diabetes
having a history of a kidney disorder

You can definitively prevent this condition by follow-up early and consistent prenatal care. By doing prenatal care may help your doctor diagnose it sooner if you have preeclampsia and avoid complications or risk. Having a diagnosis will allow your doctor to provide you with proper monitoring until your delivery date.

Other high blood pressure disorders during pregnancy

This disease is classified as one of four high blood pressure disorders that can occur during pregnancy. The other three are:

Gestational hypertension. Women with gestational hypertension have high blood pressure but no excess protein in their urine or other signs of organ damage. Some women with gestational hypertension eventually develop high blood pressure.
Chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy. But because high blood pressure usually doesn't have symptoms, it may be hard to determine when it began.
Chronic hypertension with superimposed preeclampsia. This condition occurs in women who have been diagnosed with chronic high blood pressure before pregnancy, but then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy.

Symptoms of Preeclampsia

Preeclampsia may develops without any symptoms. High blood pressure may develop slowly, or it may have a sudden onset. Monitoring your blood pressure is an important part of women's health and during prenatal care, because the first sign of preeclampsia is commonly a rise in blood pressure.

It’s very important to remember that you might not notice any symptoms of preeclampsia. If you do develop symptoms, some common ones include:

Abnormal swelling in your hands and face
Excess protein in your urine (proteinuria) or additional signs of kidney problems
Severe headaches
Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
Upper abdominal pain, usually under your ribs on the right side
Nausea or vomiting
Decreased urine output
Decreased levels of platelets in your blood (thrombocytopenia)
Impaired liver function
Shortness of breath, caused by fluid in your lungs.

Diagnosis of Preeclampsia

To diagnose, you have to have high blood pressure and one or more of the following complications after the 20th week of pregnancy:

Protein in your urine (proteinuria)
A low platelet count
Impaired liver function
Signs of kidney trouble other than protein in the urine
Fluid in the lungs (pulmonary edema)
New-onset headaches or visual disturbances

Previously, preeclampsia was only diagnosed if high blood pressure and protein in the urine were present. However, experts doctors now know that it's possible to have preeclampsia, yet never have protein in the urine.

What is the treatment for preeclampsia?

Delivery of your baby is the only cure.

During pregnancy, your doctor will monitor and manage your condition to ensure you and your baby stay healthy. If you’re at week 37 or later, your doctor may induce labor. At this point, the baby has developed enough and is only minimally premature. You may be at high risk of seizures, placental abruption, stroke, and possibly severe bleeding until your doctor notices a decrease in your blood pressure. Of course, if it's too early in your pregnancy, the delivery may not be the best thing for your baby.

If your preeclampsia is mild, your doctor may recommend:

getting bed rest
reducing your salt intake
drinking more water
making regular visits to the doctor

If your condition is serious, your doctor may want to admit you to the hospital for more thorough monitoring. You might be given intravenous (IV) medications to lower your blood pressure or steroid injections to help your baby’s lungs develop quicker.

If your preeclampsia is severe, your doctor may recommend:

Corticosteroids
Anticonvulsant medications.
Medications to lower blood pressure.

What are the complications of preeclampsia?

This disease can be fatal for both mother and child if it’s left untreated. Other complications can include:

Fetal growth restriction.
Preterm birth.
Placental abruption.
HELLP syndrome. HELLP — which stands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count — syndrome is a more severe form of preeclampsia, and can rapidly become life-threatening for both you and your baby.
Eclampsia. When isn't controlled, eclampsia — which is essentially preeclampsia plus seizures — can develop. It is very difficult to predict which patients will have high blood pressure that is severe enough to result in eclampsia.
Cardiovascular disease. Having high blood pressure may increase your risk of future heart and blood vessel (cardiovascular) disease. The risk is even greater if you've had high blood pressure more than once or you've had a preterm delivery.

Risk factors of Preeclampsia

Preeclampsia develops only as a complication of pregnancy. Risk factors include:

History of preeclampsia.
Chronic hypertension.
First pregnancy.
New paternity. Each pregnancy with a new partner increases the risk of preeclampsia more than does a second or third pregnancy with the same partner.
Age. The risk of high blood pressure is higher for very young pregnant women as well as pregnant women older than 40.
Obesity.
Multiple pregnancies. It is more common in women who are carrying twins, triplets or other multiples.
An interval between pregnancies. Having babies less than two years or more than 10 years apart leads to a higher risk of preeclampsia.
History of certain conditions. Having certain conditions before you become pregnant — such as chronic high blood pressure, migraines, type 1 or type 2 diabetes, kidney disease, a tendency to develop blood clots, or lupus — increases your risk of high blood pressure.
In vitro fertilization. Your risk of high blood pressure is increased if your baby was conceived with in vitro fertilization

Prevention OF Preeclampsia

According to the mayo clinic, some studies have reported an association between vitamin D deficiency and an increased risk of preeclampsia. But while some studies have shown an association between taking vitamin D supplements and a lower risk of preeclampsia, others have failed to make the connection.

In certain cases, however, you may be able to reduce your risk of the disease with:

Low-dose aspirin. If you meet certain risk factors, including a history of preeclampsia with severe features, preeclampsia resulting in preterm delivery, chronic hypertension or a history of kidney disease, your doctor may recommend a daily low-dose aspirin — between 60 and 81 milligrams — beginning late in your first trimester.
Calcium supplements. In some populations, women who have calcium deficiency before pregnancy — and who don't get enough calcium during pregnancy through their diets — might benefit from calcium supplements to prevent preeclampsia. However, it's unlikely that women from the United States or other developed countries would have calcium deficiency to the degree that calcium supplements would benefit them.

It's important that you don't take any medications, vitamins or supplements without first talking to your doctor.

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REFERENCES

Diseases-conditions/symptoms-causes. Mayo Clinic.: Mayo Clinic Hospital Florida. https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745. Accessed Mar. 07, 2018.
Health. Health Line.: Healthline New York. https://www.healthline.com/health/preeclampsia. Accessed Mar. 07, 2018.