toh

What is pre-eclampsia?

Pre-eclampsia in its most severe form, occurs in 3-5% of all pregnant women. It manifests itself only after 20 weeks and can occur from 20 to 34 weeks (severe form). A mild form of the disease can be seen near the time of delivery. Our clinic focuses on the management of the severe forms of preeclampsia. Although the exact cause of pre-eclampsia is not entirely clear, it is agreed that it originates from poor development of the placenta in the very early stages of pregnancy.

What are the risk factors?

• Being over the age of 40 or under 18
• Twins, triplets etc..
• Family history of pre-eclampsia
• First pregnancy
• Pre-eclampsia in previous pregnancy
• Diabetes
• Pre existing high blood pressure or kidney disease
• Being overweight before pregnancy
• Autoimmune diseases such as lupus
• Sickle cell disease
• Polycystic ovarian syndrome
• Having a new partner as the father of the present pregnancy
• In vitro fertilization
• Having a long interval between deliveries of your previous baby and this one

Can we prevent pre-eclampsia?

Studies have shown that measuring the blood flow in the arteries that supply the blood to your uterus can help us predict your risk of developing pre-eclampsia.

In addition, we strongly recommend that you undergo a test called IPS (integrated prenatal screening). This test consists of measuring the thickness in the back of the neck of your baby between 11 and 14 weeks and then measuring various proteins in your blood. Although this test is designed to provide a risk of Down syndrome ( a chromosomal problem) and/or spina bifida (when your baby’s spine is partially open), we now know that some of the results provided can also help us predict the risk of pre-eclampsia.

What are the symptoms?

• High blood pressure
• Protein in the urine
• Headache
• Abdominal pain
• Visual problems
• Severe nausea and vomiting

What are some of the complications?

Most mothers and babies will do well. However, in severe cases, serious complications can occur. These are more likely to happen if preeclampsia occurs early in your pregnancy (before 34 weeks)

• Seizures (called eclampsia)
• Separation of the placenta from the wall of the uterus, internal bleeding will occur where it was attached; the bleeding is threatening for the mother and the baby.
• Having a baby who is not growing well enough inside the womb (called fetal growth restriction)
• HELPP syndrome; this is a rare complication where the mother develops low blood counts, including low platelets ( the component in your blood that makes your blood clot) and abnormal liver tests

What test do we use?

Pre-eclampsia will be diagnosed by very strict criteria. One of these is high blood pressure. Other tests that can be done include:

• Urine test for protein detection (proteinuria)
• Possible blood tests to verify your liver and kidneys
• Blood tests to assess your haemoglobin (red blood cells) and your platelets

What is the role of ultrasound?

Ultrasound plays a very important role in your care. It allows us to verify the blood flow coming from your baby and going to your baby in the umbilical cord. It also allows us to determine whether your baby is well grown and verify his/her well being

What treatments are available?

Medications to control your blood pressure are often needed and can be administered by mouth or intravenously depending on the situation. This will however not cure you, but only control your pressure.

The only definitive treatment for pre-eclampsia is delivery. However, this may not be immediately indicated. The timing of your delivery needs to be closely assessed by a team of experts who evaluate all your tests, those of your baby and your symptoms and blood pressure. You may be given a medication called magnesium sulphate during your hospitalization. This will help prevent seizures.

If you are delivering before 34 weeks, your doctor may also recommend corticosteroids to make the lungs of your baby develop or mature faster. These also protect your baby’s brain and bowels.

Can we prevent pre-eclampsia?

Studies have shown that in high risk pregnancies, taking 81mgs of aspirin at night before 16 weeks and until the end of your pregnancy helps reduce the risk of pre-eclampsia. You should speak to your doctor/midwife about this as not everyone can, and should take aspirin.

Last updated on: November 18th, 2016