Pregnancy Complications: Pre-Eclampsia

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Following on from our magazine article “How Much is Too Much?” in the October issue, we will be blogging about other pregnancy complications throughout the month here on beijing-kids.com. In this magazine we covered morning sickness and Braxton Hicks contractions, and this week we look at pre-eclampsia.

What is Pre-eclampsia?
Pre-eclampsia is a condition that can develop in pregnancy that is characterized by high blood pressure (hypertension) and protein found in the urine. The exact causes are not fully known, though it is thought to result from problems with how the placenta functions. Some research also suggests that genetic and lifestyle factors may play a role.

Many cases are mild and will have no long term effect on the health of you or your child but nonetheless, it is a serious condition that should be monitored closely. The earlier it is diagnosed the better the outlook, when it comes to the development of further complications.

Although thankfully rare, the condition can progress into full-blown eclampsia, in which expectant mothers may experience seizures or unexplained comas, with severe risk to both baby and mother.

Who’s at Risk?
Pre-eclampsia effects between approximately five and nine percent of pregnancies and is severe in up to two percent of moms-to-be. Even if you have no previous history of high blood pressure you can still develop the condition, though you are at higher risk.

Other risk factors believed to make the development of pre-eclampsia more likely include:

  • Age – women in their teens or over 40
  • Having relatives who have had the condition
  • Being overweight or obese
  • A history of diabetes, lupus, kidney disease or rheumatoid arthritis
  • First pregnancies and multiple babies (twins, for example)

 

What are the Symptoms?
One of the most dangerous aspects of pre-eclampsia is that the two telltale symptoms – high blood pressure and protein – are largely imperceptible to expectant mothers.

For this reason it is hugely important to have your routine checks, as this may be the only way that you know whether you have developed the condition, according to Dr Lianfang Wu, a Gynecologist at New Century Women’s and Children’s Hospital.

“We will test your blood pressure, your weight, and your urine to check for protein. But you can also check for hypertension at home [with a home blood pressure monitor]or sample your urine using testing sticks available from the pharmacy,” she says.

If you are still in the early stages of pregnancy and would like to keep an eye these symptoms between check-ups, speak with your doctor to make sure that you know how to accurately monitor your readings. Remember that self-assessment should only be used in addition to regular check-ups, not in place of them.

Aside from these major symptoms, there are some other signs that women should be mindful of:

  • Rapid weight gain, often over the course of just a day or two.
  • Edema (swelling) in the feet, hands, legs, ankles, face or eyes. Although some swelling is normal during pregnancy you should keep an eye out for “pitting edema” where an indent remains in your skin for a few seconds after being pressed.
  • Abdominal pain or pain just below the ribs.
  • Severe headaches.
  • Problems with your vision or feelings of confusion or impending doom.
  • Changes in your reflexes (hyperreflexia).
  • Reduction in the volume of your urine flow.

Pre-eclampsia usually occurs in the second half of pregnancy, from about 20 weeks onwards. If you are experiencing any of these symptoms significantly before this period then you should speak with your doctor consider other potential causes.

What is the Treatment?
Due in part to the fact that the exact causes of pre-eclampsia have not been discovered, there is no medical cure for pre-eclampsia for pregnant women. The only really known cure is giving birth. In some severe cases, induced labor or cesarean section may be the recommended course of action. In other instances, medication to lower blood pressure may also be deemed appropriate by your doctor.

What is most important is that your condition is closely monitored so that the symptoms are managed. This means that if induced labor or cesarean section is necessary, or further complications emerge, then clinical decisions can be made and implemented quickly.

What Can You Do to Reduce the Risk of Developing it?
Due to the uncertainty surrounding its causes, there is little medical consensus on what course of action, if any, women can take to prevent the onset of pre-eclampsia. Because of this, having knowledge of the symptoms and going for regular check-ups are often considered the most important advice for pregnancy women.

But some research has suggested that lifestyle choices can reduce the risk. In many cases, these are steps that will improve your general health in any instance.

“If you have high risk factors then our doctors will advise you to ensure a healthy diet, one with less salt and less oil, and to do regular exercise,” says New Century’s Dr Wu.

There is some evidence to suggest that taking low-dose aspirin daily can be beneficial in high-risk patients, though you should consult your doctor before pursuing this course of action.

Next week we will be looking at toxoplasmosis, a condition that can develop from contact with cats and uncooked food.

Picture courtesy of Tatiana Vdb (Flickr)

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