Everything you need to know about preeclampsia

Wow. Eclampsia is a quite a scary name given to a relatively common condition. But at the end of the day, every medical condition out there has a beginning, a middle and an end. And since medicine is so advanced these days, we on this website believe that if you are aware of what kind of medical condition you are dealing with and you reach out to the best consultants, you will be able to achieve good health and good results. At the same time, it is worthwhile remembering that most cases of eclampsia result end without any significant complications.

Dr Sivan Farladnsky, a senior gynecologist and the director of the high-risk pregnancy unit in a large public hospital, whose contact information you can find here, has compiled this post for us to teach you everything you need to know about preeclampsia.

Where does the name preeclampsia originate?

An outdated medical term for preeclampsia is ‘toxemia’ of pregnancy, from the word ‘toxic’. Toxemia is still used in slang terminology in gynecology. The idea is that the pregnancy ‘poisons’ the body.

The word eclampsia is from the Greek term for lightning, and it is used to describe the seizure that occurs as a result of uncontrolled high blood pressure (obviously our goal is to keep it controlled). Preeclampsia is anything (or the condition) that occurs prior to the seizure.

What happens when a woman has preeclampsia?

Preeclampsia is a condition specific to pregnancy, originating in the placenta, and we actually know very little about it. It is the primary research topic in many studies and there are lots of assumptions about what causes it but nobody really knows the real cause.
The condition can present in several different ways:
Sometimes the condition affects the mother and has no effect on the fetus. And other times it is the exact opposite; the fetus is greatly affected by it, does not grow well, and will need to be delivered early, while the mother is completely unaffected.
At times, the condition presents very early in the pregnancy, and it is quite severe while other times it only presents towards the end of the pregnancy, and progresses very slowly.

How common is preeclampsia and who is at greater risk for developing the condition?

Preeclampsia occurs in about 5% of pregnant women.
Risk factors include first pregnancy, young mother under 18 or older mother over 40 years of age, multiple-fetus pregnancies, underlying kidney disorders, obesity and chronic hypertension.

Will a woman who was diagnosed with preeclampsia in her first pregnancy have preeclampsia again in the next pregnancy?

Absolutely no.

Women with preeclampsia have a higher chance of developing preeclampsia in their next pregnancy but this does not have to happen. Most of these women will have normal blood pressure in their next pregnancy and will not develop preeclampsia.

And most importantly, there are ways to decrease the risk of recurrence.

How does preeclampsia manifest?

The manifestations of preeclampsia include hypertension, protein in the urine, headaches, blurred vision, upper abdominal pain and sometimes an early presentation of significant edema.

Can preeclampsia be life-threatening?

Yes.

In severe cases preeclampsia can affect all the organs of the body, including the brain, causing strokes and seizures, kidney failure, liver failure, hypercoagulability, etc.

How does preeclampsia affect the fetus?

Sometimes preeclampsia creates a hostile environment inside the uterus which causes a delay in the growth of the fetus. Such a condition can cause miscarriage or preterm delivery and its accompanying complications.

Are there ways to prevent preeclampsia?

At the beginning of the pregnancy, it is important to identify risk factors for the development of preeclampsia. Treatment with aspirin, which is the only medication that can decrease the chances of development of preeclampsia if started on time, should be considered.

Women who are at high risk of developing preeclampsia should be followed at a high-risk pregnancy unit where blood pressure is monitored, a very high increase in weight is avoided and urinary protein is monitored. Click here to learn more about the meaning of high-risk pregnancy.

How will I know whether I have preeclampsia?

We try to identify patients who are at high risk of developing preeclampsia already at the beginning of their pregnancy. We then monitor them more closely at high-risk units.

All pregnant women are monitored for blood pressure and the presence of protein in the urine. In addition, it is important to be aware of new onset of headache, blurred vision and upper abdominal pain – all of which indicate the development of preeclampsia.

So, if I have protein in my urine during pregnancy, does this mean I have preeclampsia?

Not necessarily. Keep in mind that it can be normal to have some protein in the urine during pregnancy.

There are additional causes of urinary protein that are not associated with high blood pressure, these include – a new onset of kidney disease, a presentation of a dormant kidney disease that worsened during pregnancy and more.

Also, keep in mind that sometimes protein in the urine is a sign that precedes the onset of hypertension, and therefore blood pressure should be strictly monitored in such patients.

Does edema in my lower limbs mean I have preeclampsia?

Not at all. Edema is indeed one of the signs of worsening pre-eclampsia, but most of the time edema during pregnancy is not caused by preeclampsia. Almost all women develop edema in their lower limbs towards the end of their third trimester.

Does having preeclampsia necessarily mean I will have a preterm baby?

Not at all.

Preterm delivery is any delivery that occurs prior to 37 weeks’ gestation.

Fortunately, most cases of preeclampsia are diagnosed during late pregnancy and allow for the pregnancy to continue up to 37 weeks. In a small number of cases, it is necessary to deliver the baby prior to 37 weeks, and most of these will still be carried out after 34 weeks when the complications of preterm delivery are minimal.

How can one be cured of preeclampsia?

The management of preeclampsia is obviously individual and varies from one woman to the other. But the only way to cure a woman from preeclampsia is to deliver their baby and remove the placenta.

When preeclampsia presents during late pregnancy, the treatment is normal delivery or C-Section. However, when the preeclampsia is severe and presents early in the pregnancy, sometimes it is necessary to deliver the baby early, even if it means risking preterm complications.

What if I have preeclampsia? What is the correct management?

When one has preeclampsia, strict monitoring in a high-risk unit is required.

Daily monitoring of blood pressure, the onset of a headache, blurred vision, upper abdominal pain or fast development of significant edema. When one of these signs presents, it is important to report them to the caretaker.

How does preeclampsia affect the rest of the woman’s life?

Women with preeclampsia tend to have more cardiovascular diseases during their lifetime. It is therefore important for them to maintain a healthy lifestyle, exercise regularly, maintain normal weight and monitor their blood pressure closely.

In summary, this is a relatively common condition, with a spectrum of manifestations, from mild cases to severe cases that require intervention.