a dangerous condition.
Pre-eclampsia can ocur in pregnancy and sometimes soon after childbirth. Make sure you know the signs of pre-eclampsia.
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The most common of the serious complications of pregnancy. It is related to problems in the placenta, which supplies the baby with nutrients and oxygen from the mother. We do not know the exact cause.
Pre-eclampsia is symptom-less in the early stages, and is detectable only by regular antenatal checks on the mother's blood pressure and urine. Pre-eclampsia used to be called toxaemia.
Mild pre-eclampsia affects about one in 10 pregnancies; severe, one in 50 pregnancies. It is only potentially life-threatening to mother and baby if allowed to develop and progress undetected.
Pre-eclampsia can’t be predicted, reliably prevented, or treated. Its cause remains unknown. Pre-eclampsia is usually relieved by the birth of the baby, although maybe not immediately. Babies may need to be born early, which puts some at risk from prematurity. it can also occur after childbirth.
Most at risk are:
• first-time mothers, or where it is ten years or more since a last baby;
• the over-40s;
• those with a Body Mass Index over 35;
• women with a family history of pre-eclampsia and those who have had it before;
• those suffering from high blood pressure, diabetes or kidney disease;
• those carrying more than one baby.
Tests and Signs of Pre-Eclampsia
All of these signs may have other simple causes. A combination of several of the signs suggests pre-eclampsia.
|KNOW THE SIGNS:
- Bad headaches.
- Blurred vision, flashing lights or spots in front of your eyes.
- Bad pain just below your ribs, especially on the right side (see HELLP below).
- Swelling of your hands, feet or face.
- High blood pressure
- Protein in your urine.
Urine checks can give information about the health of mother and baby. Urine checks may show:
• Bacteria – a sign of infection.
• Glucose (sugar) – a possible sign of diabetes, which can appear for the first time in pregnancy.
• Protein – a possible sign of pre-eclampsia. More than a trace of protein is noted as one or more + signs, up to four at the most. The more + signs you have, the greater the risks.
An average blood pressure of 110/70 or 120/80 is normal for women. There is no clear line between normal and high blood pressure: yours may be higher or lower, and still be completely normal for you. Blood pressure often falls around the middle of pregnancy, then rises back up to normal in the last few weeks. Stress, worry or activity can raise your blood pressure for a while. Concern may arise over readings of 140/90 or more.
If your blood pressure is high, your midwife or doctor will need to check it more often – maybe every few days. Each time, they should also check your urine for protein and ask if you feel ill. High blood pressure in pregnancy, without other symptoms, is called Pregnancy-Induced Hypertension or PIH. It is only a problem if severe, and usually resolves soon after the baby is born.
If you have pre-eclampsia
it is recommended that you go into hospital, or a day ward, for observation.
This is because pre-eclampsia doesn't get better until after the baby is born - and then, not straight away. Also, your baby may need to be delivered early if it gets worse.
Eclampsia is a Greek word meaning 'bolt from the blue'. It means one or more convulsions occurring during, or immediately after, pregnancy. Confusingly, very few cases of pre-eclampsia become eclampsia, and eclampsia can sometimes occur without pre-eclampsia! Eclampsia is rare, affecting about 400 women per year in the UK.
A multinational trial in 1995 indicated that Magnesium Sulphate injections help prevent the convulsions of eclampsia. However, this seems to have no effect on pre-eclampsia. In the USA, magnesium is routinely given to women with pre-eclampsia. This is not currently standard practice in the UK. Consult a doctor before taking any supplements in pregnancy.
HELLP Syndrome is the medical term for one of the serious complications of pre-eclampsia, in which there is a combined liver and blood clotting disorder (The letters represent the different elements of the syndrome). HELLP is as dangerous as eclampsia (convulsions), but still rare, and less easy to diagnose. It may come on during pregnancy, but is usually after delivery.
HELLP symptoms may be preceded by signs of pre-eclampsia, but it can also arise out of the blue. The typical presenting symptom is pain just below the ribs ('epigastric pain'), sometimes accompanied by vomiting and headaches. This pain is sometimes confused with heartburn, a very common and harmless pregnancy ailment.
Unlike heartburn, the pain of HELLP syndrome is not burning, does not spread up towards the throat, and is not relieved by antacid. The pain is often severe, with tenderness over the liver (right side).
Hospital admission is essential for all suspected cases. The only treatment is delivery of your baby, no matter what stage of pregnancy. Please ask for further details from your midwife or other health care professional.
HELLP has no specific effects on the unborn baby. However, the baby may suffer growth retardation, as a result of the underlying cause - a shortage of maternal blood flow to the placenta.
What about the next pregnancy?
If you have had HELLP, it is thought you have a one in 20 chance of suffering again. At present, there is no way of predicting a recurrence, and no specific means of prevention. Regular ante-natal checks are recommended, and counselling can help you cope with this upsetting condition.
See your doctor. Do not rely on medical information on the internet.
“If you trust Google more than your doctor then maybe it's time to switch doctors.”
Jadelr and Cristina Cordova, Chasing Windmills, 2006
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