What is pre-eclampsia?

Posted on 31 January 2020

This condition affects women after 20 weeks of pregnancy. If it is detected early, outcomes are better for you and your unborn child.

Pre-eclampsia is a serious blood pressure disorder that can affect all your organs. Although many cases are mild, the condition can lead to complications for both you and your baby if it is not monitored and treated. The earlier pre-eclampsia is diagnosed and monitored, the more likely mother and baby can be helped. Signs of pre-eclampsia should be picked up during your antenatal check-ups.

“The condition occurs when you have high blood pressure and protein in your urine during pregnancy or after delivery,” says Dr Spencer Nkosi, a gynaecologist and obstetrician at Mediclinic Medforum and Mediclinic Midstream. “You may also have a low number of clotting factors (platelets) in your blood and signs of abnormal kidney or liver functioning.”
Pre-eclampsia usually occurs after 20 weeks of pregnancy and most cases occur after 24 to 26 weeks. When it occurs before 34 weeks of pregnancy, it is called early-onset pre-eclampsia. It can also occur in the postpartum period.

Experts are still not entirely sure what causes pre-eclampsia, but recent research suggests it occurs when the placenta does not anchor itself deeply enough within the wall of the uterus during the first trimester. What causes this abnormal anchoring is unclear, but it may be influenced by the mother’s or father’s genes or the mother’s immune system, and medical conditions the mother may have, such as diabetes or high blood pressure. At the moment, doctors say there is no definite way to prevent pre-eclampsia because factors that lead to high blood pressure can’t always be controlled.

Treatment decisions for pre-eclampsia need to take into account how severe the condition is, the potential for maternal complications, how far along the pregnancy is, and the potential risks to the foetus. “It can often be managed with oral or IV medication until the baby is sufficiently mature to be delivered,” says Dr Nkosi. “This often requires weighing up the risks of early delivery versus the risks of continued pre-eclampsia symptoms.”

If the pre-eclampsia is mild, your doctor may recommend bed rest to lower your blood pressure and increase blood flow to your placenta. “You will also be tested to assess your platelet counts, liver enzymes, kidney function and urinary protein levels,” Dr Nkosi explains. “Your unborn baby will also be closely monitored. This might include ultrasound, heart rate monitoring, plus foetal growth and amniotic fluid assessments.”

If your pre-eclampsia is severe, you will be admitted to hospital. Treatment might include intravenous medication to control blood pressure and prevent seizures or other complications, as well as steroid injections to help speed up the development of your baby’s lungs.

The good news is that although your pre-eclampsia might mean that you have to stay in hospital longer after giving birth, your blood pressure should return to normal in the weeks after delivering.


Published in Pregnancy

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