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Pre-eclampsia - hypertension in pregnancy

pre; eclampsia; pre-eclampsia; preeclampsia; blood; pressure; high; raised; hypertension; toxaemia; hypertensive; pregnancy; induced; fits; convulsions; swelling; hands; feet; face;

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Pre-eclampsia is a disorder of pregnancy where there is high blood pressure and protein in the urine. It occurs in five to eight percent of pregnancies, and is the leading known cause of preterm birth.

Pre-eclampsia can occur at any time during pregnancy, and up to six weeks after birth. It is most common after 20 weeks of pregnancy and in first pregnancies. It can develop gradually over many weeks, or come on suddenly over a few hours.

It can only be cured by the birth of your baby and usually has gone within 48 hours after the birth.

A woman with pre-eclampsia may feel well and have no symptoms. It is therefore vital to have regular antenatal checks of blood pressure and urine to detect the condition before it becomes dangerous for mother and baby.

The causes of pre-eclampsia are unclear, but genetic factors and the placenta are thought to have significant roles.

Pre-eclampsia is also known as pre-eclamptic toxemia, hypertensive disease of pregnancy and pregnancy-induced hypertension.

Who is at risk?

You are more likely to develop pre-eclampsia if you:

  • have had it before
  • have chronic high blood pressure, diabetes or kidney disorder
  • are in your first pregnancy or a pregnancy to a new partner
  • have a family history of pre-eclampsia, such as your mother, grandmother, or sister
  • are pregnant with multiple babies
  • are over 40 or under 18 years
  • have an autoimmune disorder such as rheumatoid arthritis.

Signs and symptoms

  • A sudden rise in blood pressure, above levels at the start of pregnancy, and protein in the urine are the main signs of pre-eclampsia.
  • Fluid retention with swelling of the face, hands and feet may occur, although this may be part of normal pregnancy.
  • Other symptoms as the condition advances may be sudden weight gain, upper abdominal pain, headaches, dizziness, and changes in vision.

Most women with pre-eclampsia feel well; therefore regular antenatal checks of blood pressure, urine and blood tests are vital.

How pre-eclampsia affects you

Pre-eclampsia can have a number of serious effects on a mother's health involving most body organs. It can cause impaired function of kidneys, liver, brain and blood. If left untreated it can lead to convulsions, organ failure, clotting problems or death. Treatment to control blood pressure may involve medication, regular antenatal visits, time off work, and even hospitalisation. This will have greater impact on you if pre-eclampsia occurs early in your pregnancy.

How pre-eclampsia affects your baby

As your baby grows, it is nourished by the placenta which allows oxygen and nutrients to pass from mother to baby.

In pre-eclampsia the blood flow to the placenta becomes sluggish. If the condition is allowed to progress, your baby can be starved of oxygen and nutrients, and it will not grow well.

This may threaten your baby's life and you may have to give birth early. If this occurs you may be given Celestone (steroid) injections to help mature the baby's lungs.

Care and treatment in the antenatal clinic

If your blood pressure is high at your antenatal visit, you will be asked to provide a urine sample for testing.

You may be asked to return for another blood pressure check in a day or two, or you may be admitted to hospital for more tests.

This may surprise you, especially if you are feeling well.

Care and treatment in hospital

If you are admitted to hospital you may have:

  • Urine tests: You will be asked for urine samples, possibly over 24 hours so that protein levels can be measured thoroughly.
  • Blood tests: You may have blood tests to determine how well your kidneys are working.
  • Blood pressure: Your blood pressure will be measured four hourly during the day and possibly during the night as well.
  • Other observations: You will be asked to report any headaches, upper abdominal pain, or visual disturbances such as stars in front of your eyes. These may indicate spasms in your blood vessels and other changes to your circulation.
  • Cardiotocographs (CTGs): You may have a CTG to trace your baby's heart rate.
  • Ultrasound scan: You may have an ultrasound to assess your baby's size and growth, fluid around the baby, and blood flow through the umbilical cord. These show how well your placenta is working.

Doctors or midwives will discuss your test results with you, and what action will be best for your and your baby's health. Bed rest is usually important. It may be best if your baby is delivered early and the doctors or midwives may recommend that labour is induced.

More to read

  Pregnancy, birth and baby  Pregnancy, Birth and Baby is a national Australian Government service providing support and information for expecting parents and parents of children, from birth to 5 years of age.
http://www.pregnancybirthbaby.org.au/ 

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.

 

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