pregnancy

Pre-eclampsia

Pre-eclampsia is a serious illness for pregnant women. According to Action on Pre-eclampsia, about 10% of pregnant women will develop mild pre-eclampsia (high blood pressure with protein in the urine) but severe pre-eclampsia is responsible for the deaths of six mothers each year. So it is rare but the symptoms need to be taken seriously.

 

 

What is it?

Pre-eclampsia only happens in pregnancy and the exact cause of it is not really known but it is connected to the placenta, which may not be working properly. Pre-eclampsia can develop after 20 weeks of pregnancy, although it is more likely to happen in the third trimester.

 

 

What are the signs of pre-eclampsia?

At your antenatal checks, your midwife will carry out tests to look out for high blood pressure and protein in your urine, which are signs of pre-eclampsia.

You also need to watch out for other signs of pre-eclampsia which include:

sudden swelling of your face, hands or feet

problems with your vision, such as blurring or flashing before your eyes

intense headaches

severe abdominal pain

being very unwell

feeling confused

Headaches, swelling and feeling a bit unwell can be a normal part of pregnancy but it is always worth getting these symptoms checked out, especially if you just don’t feel right, because they can be signs of severe pre-eclampsia.

 

 

What can you do to prevent it?

It is hard to predict who is going to develop pre-eclampsia however some women are more likely than others to develop it:

you are pregnant for the first time (NHS 2009)

you are obese

you are older than 40

you are expecting more than one baby

your mum or your sister had pre-eclampsia

you had pre-eclampsia in a previous pregnancy – one mum in five gets it again (NHS 2009)

you have a medical condition such as kidney disease, diabetes or high blood pressure (NCCWCH 2008)

Your community midwife should talk to you about pre-eclampsia and the tests that are needed throughout your pregnancy to check for signs of the condition, especially if you are considered more likely to develop it. So while there is no way to prevent it, your antenatal appointments will monitor your health and pick up any signs of pre-eclampsia.

 

 

How is it treated?

If your antenatal checks pick up mild pre-eclampsia, you will be monitored more closely by your community midwife.

If these symptoms get worse, you may be admitted into hospital for closer monitoring – which will include regular blood pressure checks, urine and blood tests and scans to check the wellbeing of your baby. It could also include bedrest and medical treatment to manage any headaches and to prevent seizures.

If you develop severe pre-eclampsia, labour may need to be induced or a caesarean may be needed to deliver your baby safely and to prevent you from developing eclampsia, which is a life-threatening condition that causes seizures and serious complications such kidney, liver or lung failure.

Eclampsia is rare, occuring in 1 in 2000 pregnancies.

 

 

After the birth of your baby

You may need to stay in hospital for a few days for closer monitoring of your blood pressure and to check for protein in your urine. You may also need medication if your blood pressure stays high.

You will need plenty of rest and support to help your body recover and if you developed severe pre-eclampsia or eclampsia, you will see an obstetrician to discuss what happened, why it happened and to answer any questions you may have.

Thankfully, for the majority of women, delivery of the baby reverses all the effects of pre-eclampsia.

 

 

References

Royal College of Obstetricians and Gynaecologists (RCOG):
Pre-eclampsia: What you need to know 

NICE Guideline: Hypertension in Pregnancy 

Action on Pre-eclampsia