Preeclampsia and High Blood Pressure During Pregnancy
What is Preeclampsia in pregnancy?
Once known as Toxemia, it is caused by a defect in the placenta which causes a pregnant woman’s blood pressure to rise, endangering mother and baby. Affecting about 7% all pregnancies, it is the most common of the serious complications of pregnancy. About one in 50 women are afflicted by severe preeclampsia.
In severe cases, preeclampsia can be very dangerous to both mother and baby. The mother could develop seizures and, due to the possibility of a low platelet count caused by the disease, could hemorrhage. In the meantime, the baby would be living in a hostile environment due to the elevated blood pressure. There would be a reduced level of blood flow to the baby, which would result in a reduced flow of oxygen and nourishment.
Is Preeclampsia dangerous?
It can be. High blood pressure can kill, and preeclampsia can reduce the amount of blood passing through the placenta thus reducing the air and food that reaches your baby, resulting in low birth weight and other health problems.
Am I at risk of Preeclampsia?
Those most at risk are women with family histories of preeclampsia, long-standing high blood pressure or kidney disease, pregnancy induced diabetes, autoimmune diseases such as systemic lupus, and those over 40 years old.
When in pregnancy does preeclampsia occur?
Preeclampsia is a disease that usually afflicts the second half of pregnancy, usually within the last weeks of woman’s term. In certain cases, such as those with risk factors, it can occur much earlier.
Who is more likely to be at risk of Preeclampsia?
Preeclampsia often runs in families, so if your mother or sister had preeclampsia, you will be at risk. As will women who are overweight (a BMI of over 30) or are at either age extreme – teenagers and women over 40. Most at risk are those women who had preeclampsia during the previous pregnancy.
Risk factors for Preeclampsia include:
- Becoming pregnant as a teen or over 40
- High blood pressure before pregnancy
- Multiple pregnancy
- A past history of kidney disease, high blood pressure or diabetes
- Women who are pregnant for the first time, or who carry more than one child at a time, are more at risk for preeclampsia.
High blood pressure
Usually defined as a reading higher than 140/90. However, if you normally have low blood pressure, a risk to less than 140/90 could indicate you are at risk. You can buy blood pressure gauges from your pharmacist if you want to establish your baseline as soon as you know you are pregnant.
A certain amount of swelling is normal during pregnancy and you may find it difficult to wear a ring for the full term. Swelling, or edema, that could provoke concern is caused by excess fluid and usually appears in the face, legs, and hands.
Try pressing your thumb into the swelling, if the indentation remains for a few seconds after you remove your thumb, tell the nurse at your next prenatal visit.
Protein in your urine
This is not a symptom you will be able to spot or monitor. You will be tested at each prenatal check-up.
Sudden weight gain
An increase in your weight of more than 2 pounds in a week or 6 pounds in a month will ring alarm bells. If your weight is increasing at that sort of rate, don’t diet or try to lose the weight. Tell the experts at your prenatal, it is important that they know and let the nurse or doctor judge whether you are likely to have preeclampsia.
If you suffer from migraine-like headaches which are not relieved by over-the-counter painkillers (do not take aspirin), contact your doctor immediately.
The nausea that all mothers experience occurs early in pregnancy and goes away. If you experience sudden vomiting in the second half of your pregnancy, contact your doctor. Of course, this could just be a bug, but your doctor will check your blood pressure and urine to see if you have other symptoms of preeclampsia.
Treatment for Preeclampsia
- Allow frequent monitoring of both you and your baby by your doctor. When a woman has been diagnosed with preeclampsia, it’s very important to monitor the situation closely. Monitoring includes frequent ultrasounds, biophysical profiles, non-stress tests, blood pressure checks, weighting for the mom and checking the amount of protein present in the mom’s urine.
- Go on bed rest, either at home or in the hospital, if it’s too early to deliver the baby. For mild cases of preeclampsia, bed rest at home can be indicated. Bed rest helps increase blood flow to the baby and helps lower the mom’s blood pressure. In case of severe preeclampsia, bed rest at the hospital is likely. Being at the hospital can allow for closer monitoring of both the mom and the baby.
- Take medications prior to delivery to help with preeclampsia. Corticosteroids can help mature the baby’s lungs in case early delivery occurs. Taking drugs, such as hydralazine, can help lower the mom’s blood pressure and prevent preeclampsia from progressing. Your personal doctor will know which medications are best for you and your baby.
- Deliver the baby. Delivery is the only real cure for preeclampsia. If the baby is at or near full term and a woman is diagnosed with preeclampsia, labor may be immediately induced, or a cesarean section scheduled. If it’s too early to deliver the baby, doctors may try to hold off delivery using the other treatments described in this article until delivery is absolutely necessitated.
- Use the drug magnesium sulfate during labor and delivery. For women with preeclampsia, magnesium sulfate can help prevent seizures in the mom during delivery and help increase blood flow to the baby and the placenta. IVs are often used to administer magnesium sulfate to the mom during delivery.
Depending on the disease severity, the management varies. There have been several nonpharmacological therapies shown to be helpful in the prevention or, at the least, the progression of preeclampsia. “Eight milligrams of baby aspirin can be of some benefit to the at-risk mother as well as 2 grams of calcium daily”, says Atlas. Women should avoid taking vitamin E while pregnant because of the higher risk of developing preeclampsia.
Have you announced your pregnancy yet?
If not, here are a few creative ideas for pregnancy announcement: