Pre-Eclampsia: Know The Signs

What is it?

Pre-eclampsia is a condition affecting approximately 10 of women suffer with it severely.

The exact cause of it is not known, but it's thought it occurs when there is a problem with the placenta.

In most cases pre-eclampsia shows itself in the third trimester, although it can occur from as early as 20 weeks.

The initial symptoms include water retention (oedema), high blood pressure and protein in the urine (which is called proteinuria) – the two latter symptoms together are the real giveaway that pre-eclampsia is present.

If there is protein in your urine you won't know it, but it will be picked up when you supply a sample at routine antenatal appointments.

Some women have slightly raised blood pressure when pregnant, and many more suffer with water retention – neither of those things on its own means pre-eclampsia.

However, if you suddenly get swelling, particularly of the face and hands (not just the ankles and feet), then it's a warning sign, so call your doctor straight away.

Other symptoms of pre-eclampsia include blurry vision, headaches, a pain in the abdomen (right underneath the ribs), and vomiting.

There are some risk factors which determine the likelihood of pre-eclampsia. It is more common in first pregnancies, but if you do have it the first time round, subsequent pregnancies are more likely to be affected too.

If your mum or sister suffered from pre-eclampsia, you're at a higher risk. If you're carrying twins or more, if you are older than 40, or if you were overweight (with a BMI over 30) at the time of becoming pregnant, then you have a higher chance of developing the condition.

Pre-existing medical conditions, including high blood pressure and kidney disease, also make pre-eclampsia more likely.

Pre-eclampsia can have some serious consequences for both you and your baby. For your little one, it can mean his or her growth will be affected, because the placenta is not delivering enough nutrients and oxygen. And for you, if severe, it can lead to eclampsia, when your cerebral membranes (surrounding your brain) become irritated, causing seizures.

Severe pre-eclampsia can also lead to a condition known as HELLP Syndrome, which is a rare liver and blood-clotting disorder: H stands for haemolysis, which is when red blood cells break down; EL stands for elevated liver enzymes; and LP stands for low platelet count (platelets are the cells in the blood which help it to clot).

Other horrid complications arising from severe pre-eclampsia can include cerebral haemorrhage (or stroke), fluid on the lungs, and liver and kidney failure. Although none of these things are at all common, you can see why it is vital that pre-eclampsia is diagnosed and managed as soon as possible.

What can I do?

There is no certain way to prevent pre-eclampsia (although, according to the NHS, some evidence suggests taking aspirin and calcium in early pregnancy may help), so the most important thing to do is to attend all your antenatal checks. This is your best chance of it being spotted early.

If you notice any of the symptoms of pre-eclampsia at any time during your pregnancy, you should seek medical advice as soon as possible.

If you are diagnosed with the condition, and it is mild or moderate, you and your baby are likely to be monitored much more closely, with additional scans, and urine and blood tests. You might also be given medicine to lower your blood pressure, and it is highly advisable to rest as much as possible.

If you get to 39 weeks and your baby hasn't arrived, you might be offered an induction to get labour started. Once your baby is delivered, everything should soon return to normal.

If your pre-eclampsia is severe, you might need to be admitted to hospital, where the the midwives and doctors will keep a very close eye on both you and your baby. Your blood pressure will be checked several times a day, and you might be given medication to reduce the risk of complications, such as eclampsia.

The only cure for pre-eclampsia is to deliver the baby – but of course, the time at which this happens will be very carefully considered. Where at all possible, doctors will delay induction of labour, or a caesarean section, until you have reached at least 37 weeks, at which point your baby is no longer considered premature.

Occasionally though, for the sake of your health and your baby's, it might be necessary for you to give birth earlier. If your baby is born prematurely, they might need to stay in the neonatal unit for a little while, until they are strong enough for you to take them home. It's the best place for them.

Some mums who develop eclampsia or HELLP syndrome will suffer with longer term health problems, but happily almost all women make a full recovery from pre-eclampsia within a few weeks of having their baby.

More resources

Action on Pre-Eclampsia (APEC) has more information on the condition and answers commonly asked questions. There is also a helpline on 020 8427 4217.

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