Views: 608 Posts: 0 Started By: lil_prince Last Poster: lil_prince Last Post Date: Jun 13, 2016
June 13, 2016 ( Post 1 )

Pre-eclampsia is a condition that affects some pregnant women, usually during the second half of pregnancy (from around 20 weeks) or soon after their baby is delivered.

Early signs of pre-eclampsia include having high blood pressure (hypertension) and protein in your urine (proteinuria). It's unlikely that you'll notice these signs, but they should be picked up during your routine antenatal appointments.

In some cases, further symptoms can develop, including:

  • Swelling of the feet, ankles, face and hands caused by fluid retention (oedema)
  • Severe headache
  • Vision problems
  • Pain just below the ribs

If you notice any symptoms of pre-eclampsia, seek medical advice immediately.

Although many cases are mild, the condition can lead to serious complications for both mother and baby if it's not monitored and treated. The earlier pre-eclampsia is diagnosed and monitored, the better the outlook for mother and baby.

Who is affected?
Mild pre-eclampsia affects up to 6% of pregnancies, and severe cases develop in about 1-2% of pregnancies.

Causes of pre-eclampsia
Pre-eclampsia is thought to be caused by the placenta not developing properly due to a problem with the blood vessels supplying it. The exact cause isn't fully understood.

  • Placenta

The placenta is the organ that links the mother's blood supply to her unborn baby's blood supply. Food and oxygen pass through the placenta from mother to baby. Waste products can pass from the baby back into the mother.

To support the growing baby, the placenta needs a large and constant supply of blood from the mother. In pre-eclampsia, the placenta doesn't get enough blood. This could be because the placenta didn't develop properly as it was forming during the first half of the pregnancy.

The problem with the placenta means the blood supply between mother and baby is disrupted. Signals or substances from the damaged placenta affect the mother's blood vessels, causing high blood pressure (hypertension).

At the same time, problems in the kidneys may cause important proteins that should remain in the mother's blood to leak into her urine, resulting in protein in the urine (proteinuria).

What causes problems with the placenta?

In the initial stages of pregnancy, the fertilised egg implants itself into the wall of the womb (uterus). The womb is the organ a baby grows inside during pregnancy. The fertilised egg produces root-like growths called villi, which help to anchor it to the lining of the womb.

The villi are fed nutrients through blood vessels in the womb and eventually grow into the placenta. During the early stages of pregnancy, these blood vessels change shape and become wider.

If the blood vessels don't fully transform, it's likely that the placenta won't develop properly because it won't get enough nutrients. This may lead to pre-eclampsia.

It's still unclear why the blood vessels don't transform as they should. It's likely that inherited changes in your genes have some sort of role, as the condition often runs in families. However, this only explains some cases.

Who's most at risk?
Some factors have been identified that could increase your chances of developing pre-eclampsia. These include:

  • Having an existing medical problem - such as diabetes, kidney disease, high blood pressure, lupus or antiphospholipid syndrome
  • Previously having pre-eclampsia - there's an approximately 16% chance you'll develop the condition again in later pregnancies

Some factors also increase your chances by a small amount. If you have two or more of these together, then your chances are higher;

  • It's your first pregnancy - pre-eclampsia is more likely to happen during the first pregnancy than during any subsequent pregnancies
  • It's been at least 10 years since your last pregnancy
  • You have a family history of the condition - for example, your mother or sister has had pre-eclampsia
  • You're over the age of 40
  • You were obese at the start of your pregnancy (you had a body mass index of 35 or more)
  • You're expecting multiple babies, such as twins or triplets.

If you're considered to be at a high risk of developing pre-eclampsia, you may be advised to take a 75mg dose of aspirin (baby aspirin or low-dose aspirin) every day during your pregnancy from when you're 12 weeks pregnant until your baby is born. Evidence suggests this can lower your chances of developing the condition.

Treating pre-eclampsia
If you're diagnosed with pre-eclampsia, you should be referred for an assessment by a specialist, usually in hospital.

While in hospital, you'll be monitored closely to determine how severe the condition is and whether a hospital stay is needed.

The only way to cure pre-eclampsia is to deliver the baby, so you'll usually be monitored regularly until it's possible for your baby to be delivered. This will normally be at around 37-38 weeks of pregnancy, but it may be earlier in more severe cases.

At this point, labour may be started artificially (induced) or you may have a caesarean section.

Medication may be recommended to lower your blood pressure while you wait for your baby to be delivered.

Although most cases of pre-eclampsia cause no problems and improve soon after the baby is delivered, there's a risk of serious complications that can affect both the mother and her baby.

There's a risk that the mother will develop fits called "eclampsia". These fits can be life-threatening for the mother and baby, but they're rare.

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