Everything you need to know about Preeclampsia

Where does the name Preeclampsia originate?

An outdated medical term for preeclampsia is ‘Toxemia’ of pregnancy, derived from the word ‘toxic’.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

The word eclampsia comes 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 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 unfortunately, we know very little about it. It is a primary research topic in many studies, and there are numerous assumptions about what causes it. However, the exact cause remains unknown.
The condition can present in several different ways:
Sometimes, it affects the mother and has no effect on the fetus. Other times, it is the exact opposite; the fetus is greatly affected by it (the fetus’ growth is hindered), and it will need to be delivered early, while the mother is completely unaffected.
There are cases where the condition presents very early in the pregnancy, and it is quite severe. There are also other cases where 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, 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 their first pregnancy necessarily have preeclampsia again in their next pregnancy?

Absolutely not.

Women who have had preeclampsia are at higher risk of developing preeclampsia in their next pregnancy however, this does not always happen. Most of these women will have normal blood pressure in their next pregnancy and will not develop preeclampsia.

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 organs in the body, including the brain, causing strokes, seizures, kidney failure, liver failure, hypercoagulability, and more.

How does preeclampsia affect the fetus?

Preeclampsia can create a hostile environment within the uterus, leading to delayed fetal growth. This condition may cause miscarriage or preterm delivery, along with 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. If started on time, treatment with aspirin, which is the only medication that can decrease the chances of development of preeclampsia, should be considered.

Click here to learn more about the meaning of high-risk pregnancy.

How will I know whether or not I have preeclampsia?

We aim to identify patients who are at high risk of developing preeclampsia at the beginning of their pregnancy. These patients are monitored closely at high-risk units.

All pregnant women are monitored for blood pressure and the presence of protein in the urine. Additionally, it is important to be aware of new-onset symptoms such as headaches, blurred vision, and upper abdominal pain – all of which may indicate the development of preeclampsia.

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

Not necessarily. It is important to remeber, it can be normal to have some protein in urine during pregnancy.

There are additional causes for protein in urine that are not associated with high blood pressure, these include – a new onset of kidney disease, a dormant kidney disease that worsened during the pregnancy, and others.

Also, keep in mind that sometimes protein in the urine is a sign that precedes the onset of hypertension; 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 preeclampsia, 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 refers to any delivery that occurs prior to 37 weeks of gestation.

Fortunately, most cases of preeclampsia are diagnosed during late pregnancy allowing for the pregnancy to continue up to 37 weeks. In a small number of cases, it is necessary to deliver the baby before 37 weeks, and most of these deliveries occur after 34 weeks when the complications of preterm birth are minimal.

How can one be cured of preeclampsia?

The management of preeclampsia is indivisualized and varies from one woman to another. However, the only way to cure for preeclampsia is to deliver their baby and remove the placenta.

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

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

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

It is important to have daily monitoring of blood pressure, the onset of headaches, blurred vision, upper abdominal pain, and rapid development of significant edema. If any of these conditions occur, it is important to report them to your caretaker.

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

Women with preeclampsia tend to have more cardiovascular diseases throughout 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, ranging from mild cases to severe cases that require intervention.

As always, early recognition and prevention are what makes all the difference.

Good luck!