Understanding Preeclampsia: Causes, Symptoms, Risks, and Treatment

 Understanding Preeclampsia: Causes, Symptoms, Risks, and Treatment

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to another organ system—most often the liver and kidneys. It typically occurs after the 20th week of pregnancy in women whose blood pressure had previously been normal. If left untreated, preeclampsia can lead to serious—even fatal—complications for both the mother and baby.

What Is Preeclampsia?

Preeclampsia is part of a group of conditions known as hypertensive disorders of pregnancy. It is most commonly identified by:

• High blood pressure (≥140/90 mm Hg)

• Protein in the urine (proteinuria)

• Signs of organ damage (particularly to the liver or kidneys)

While preeclampsia often develops without noticeable symptoms, regular prenatal check-ups help in early detection and management.

Causes and Risk Factors

The exact cause of preeclampsia remains unknown, but it is believed to stem from problems with the development of blood vessels in the placenta. Several risk factors increase the chances of developing preeclampsia:

High-Risk Factors

• First pregnancy

• Previous history of preeclampsia

• Family history (mother or sister)

• Multiple gestation (twins or more)

• Chronic hypertension or kidney disease

• Autoimmune disorders (e.g., lupus, antiphospholipid syndrome)

• Obesity or diabetes

• Age over 35

Common Symptoms of Preeclampsia

Although some women may not notice symptoms, others experience:

• Persistent headaches

• Visual disturbances (blurry vision, light sensitivity)

• Upper abdominal pain, usually under the ribs on the right side

• Sudden swelling in the face, hands, or feet

• Rapid weight gain

• Decreased urine output

• Shortness of breath (due to fluid in the lungs)

Note: Some of these symptoms can also occur in normal pregnancies, but if they appear suddenly or seem severe, medical evaluation is critical.

Why Is Preeclampsia Dangerous?

Preeclampsia can progress into more severe conditions, including:

1. Eclampsia

A severe complication that includes seizures. It can lead to coma or death if untreated.

2. HELLP Syndrome

A rare but life-threatening condition involving:

• Hemolysis (breaking down of red blood cells)

• Elevated Liver enzymes

• Low Platelet count

3. Placental Abruption

Premature separation of the placenta from the uterus, which can cause heavy bleeding and risk to the baby’s life.

4. Preterm Birth

Often, early delivery is required to prevent worsening maternal or fetal complications.

Diagnosis and Monitoring

Preeclampsia is diagnosed through:

• Blood pressure measurements

• Urine tests to check for protein

• Blood tests for liver and kidney function

• Ultrasound to monitor fetal growth

• Nonstress tests or biophysical profiles for fetal well-being

Management and Treatment

There is no cure for preeclampsia except delivery. Treatment focuses on managing symptoms and minimizing risks to mother and baby:

Mild Preeclampsia

• Frequent monitoring

• Rest at home or hospital

• Blood pressure medications if needed

Severe Preeclampsia

• Hospitalization

• Medications to lower blood pressure and prevent seizures (e.g., magnesium sulfate)

• Corticosteroids to mature fetal lungs if early delivery is likely

Delivery

If the pregnancy is close to term (37 weeks or more), delivery is usually recommended. In earlier stages, the decision is based on the severity of symptoms and fetal health.

Prevention Tips

While preeclampsia can’t always be prevented, the following may reduce risk:

• Early and regular prenatal care

• Managing chronic conditions (like hypertension and diabetes)

• Aspirin therapy: Low-dose aspirin may be prescribed starting in the second trimester for high-risk women

• Healthy lifestyle: Maintaining a balanced diet, staying active, and avoiding excessive weight gain

After Delivery: Postpartum Preeclampsia

Preeclampsia may also develop after birth, typically within 48 hours but sometimes even later. Symptoms are similar and must be taken seriously. Postpartum preeclampsia also requires urgent medical care and often includes blood pressure medications and magnesium sulfate.

Final Thoughts

Preeclampsia is a complex but manageable condition when identified early. Through vigilant prenatal care, awareness of warning signs, and timely medical intervention, most women with preeclampsia go on to have healthy pregnancies and recover well after delivery. If you are pregnant or planning to become pregnant, consult your healthcare provider to discuss your risks and establish a care plan.

 Dr.Ifrah Hassan Hilaac