Pre-eclampsia
Pre-eclampsia is a condition that affects some pregnant women usually during the second half of pregnancy (from around 20 weeks) or immediately after delivery of their baby.
Women with pre-eclampsia have high blood pressure, fluid retention (oedema) and protein in the urine (proteinuria). If it’s not treated, it can lead to serious complications and in one to 2 in every 100 cases can be life threatening. In the unborn baby, pre-eclampsia can cause growth problems.
Although the exact cause of pre-eclampsia is not known, it is thought to occur when there is a problem with the placenta (the organ that links the baby's blood supply to the mother's). Pregnant women with pre-eclampsia may not realise they have it.
Pre-eclampsia is usually diagnosed during routine antenatal appointments. Mild pre-eclampsia can be monitored with blood pressure and urine tests at regular antenatal appointments and usually disappears soon after the birth. Severe pre-eclampsia may need to be monitored in hospital.
Pre-eclampsia symptoms
Early symptoms
Pregnant women with pre-eclampsia develop the following symptoms first:
- high blood pressure (hypertension)
- proteinuria (protein in the urine)
You probably won’t notice these symptoms, but your doctor or midwife should pick them up during your antenatal appointments. High blood pressure affects 1 in 10 of all pregnant women, so this alone does not suggest pre-eclampsia. However, the presence of protein in the urine is a good indicator of the condition.
Progressive symptoms
As pre-eclampsia develops, it can cause fluid retention (oedema), which often causes sudden swelling of the feet, ankles, face and hands. Oedema is another common symptom of pregnancy, but it tends to be in the lower parts of the body, such as the feet and ankles. It will gradually build up during the day. If the swelling is sudden, and it particularly affects the face and hands, it could be pre-eclampsia.
As pre-eclampsia progresses, it may cause:
- severe headaches
- vision problems, such as blurring or seeing flashing lights
- dizziness
- pain in the upper abdomen (just below the ribs)
- shortness of breath
- nausea and vomiting
- excessive weight gain due to fluid retention
- less urine
- feeling generally unwell
If you notice any symptoms of pre-eclampsia, seek medical advice immediately. Without immediate treatment, pre-eclampsia may lead to a number of serious complications, including:
- eclampsia (convulsions)
- HELLP syndrome - a combined liver and blood-clotting disorder
- problems in the kidneys and brain
- stroke
However, these complications are rare.
How pre-eclampsia affects your unborn baby
Around 5 to 10 in 100 pre-term deliveries in Australia are due to pre-eclampsia or its associated complications.
The main sign of pre-eclampsia in the unborn baby is slow growth. This is caused by poor blood supply through the placenta to the baby. The growing baby receives less oxygen and fewer nutrients than it should, which can affect development. This is called 'intra-uterine growth restriction', or 'intra-uterine growth retardation'.
Risk factors
Some factors have been identified that could increase your chance of developing pre-eclampsia. The main risk factors are:
- You had pre-eclampsia in a previous pregnancy. There is an approximately a 1 in 5 chance that you will develop the condition again in later pregnancies.
- You have an existing medical problem: for example, diabetes, kidney disease, migraines or high blood pressure.
Other risk factors are:
- It is your first pregnancy. Pre-eclampsia is more likely to happen during the first pregnancy than during any subsequent pregnancies.
- It has 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 are a teenager or are aged over 40.
- You were obese at the start of your pregnancy (you had a body mass index of 30 or more).
- You are expecting multiple babies, such as twins or triplets (this places more strain on the placenta).
Treating pre-eclampsia
Pre-eclampsia can be managed by lowering blood pressure and managing the other symptoms, sometimes with medication. Some women with pre-eclampsia will need to be monitored in hospital.
The only way to cure pre-eclampsia is to deliver the baby.
Read more about how pre-eclampsia is treated.
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