EARLY SIGNS OF PREECLAMPSIA AND HOW TO DETECT THEM
Preeclampsia is a condition unique to pregnancy. It is a leading cause of maternal and child death. Most women with preeclampsia are likely to develop healthy babies and fully recover. Some women, however, develop life threatening complications which may affect both mother and baby.
Preeclampsia is characterized by hypertension which exceeds 140/90mmHg documented on at least two different occasions, four hours apart as well as proteinuria (presence of abnormal quantities of protein in urine). It usually arises during the second half (20 weeks) of pregnancy. It can also occur after birth (postpartum preeclampsia).
In the United Kingdom, it is second most common cause of direct death and it is known to complicate approximately 2-3 percent of pregnancies. It could progress to eclampsia if left uncontrolled. Eclampsia is a severe complication of preeclampsia which presents with hypertension and convulsions.
WHAT CAUSES PREECLAMPSIA?
Although the main causes of preeclampsia are unknown, some potential causes are still being researched. They include:
- Autoimmune disorders
- An abnormally functioning placenta
- Insufficient blood flow to the uterus
- Poor nutrition
- High body fat
RISK FACTORS OF PREECLAMPSIA
- Family history of preeclampsia (in mother or sister)
- Age (40 years or above)
- Multiple pregnancy
- Being pregnant for the first time
- Certain Medical Conditions
- Pre-existing renal disease
- Pre-existing hypertension
- Pre-existing diabetes
- Antiphospholipid syndrome (a disorder in which the immune system mistakenly attacks normal proteins in the blood)
- Booking proteinuria on more than one occasion
- Molar pregnancy (an abnormal form of pregnancy where a non-viable fertilized egg implants in the uterus and fails to develop)
EARLY SIGNS OF PREECLAMPSIA
It is important to note that most women with preeclampsia are asymptomatic. However, these symptoms are to be expected if you develop symptoms. They include:
- Frontal headache
- Visual disturbance
- Epigastric pain (pain felt in the middle of the upper abdomen, just below the ribcage)
- Rapidly progressive swelling of the face and hands
- Sudden weight gain
- Shortness of breath
- Nausea or vomiting
Your doctor may also find the following during clinical examination
- High blood pressure of 140/90mmHg or higher
- Abnormal liver enzymes
- Low platelet count
- Oliguria (low urine output) less than 500ml per 24 hours
- Impaired kidney or liver functions
MANAGEMENT AND TREATMENT
There is no cure for preeclampsia. However, the most effective treatment is delivery of the baby. Vaginal delivery is the preferable form of delivery, but cesarean sections are performed on seriously ill patients with unfavorable cervixes. Symptoms should resolve once the baby is delivered. In some cases, however, blood pressure can become elevated again after delivery. You should therefore inform your doctor about this.
Magnesium sulphate has been identified as the drug of choice for preeclampsia to prevent it from progressing into eclampsia thus preventing convulsions from occurring.
Antihypertensive therapy can also be done to lower blood pressure without limiting uterine blood flow and destroying. the fetus.
- Labetalol can be given both orally and intravenous also has a good safety record for pregnancy.
- Methyldopa can also be administered. However, it can only be given orally and takes 24 hours to get effective.it also has unpleasant side effects such as depression.
- Nifedipine can also be administered since it has a rapid onset of action. It can however cause severe headaches which may mimic the worsening of the disease.
COMPLICATIONS OF PREECLAMPSIA
- Preterm birth (birth that occurs before the 37th week of pregnancy)
- Placental abruption (separation of the placenta from the inner wall of the uterus before delivery)
- HELLP syndrome (Hemolysis (destruction of red blood cells), elevated liver enzymes and low platelet count
- Ecclampsia-basically preeclampsia plus seizures(convulsion)
- Other organ damage-depending on the severity of preeclampsia, the kidneys, liver lungs, heart or eyes may get involved. A stroke may even occur.
Make sure you inform your doctor if you have any of the symptoms. Even with proper care during pregnancy, certain unavoidable complications can occur. Your doctor may administer low dose aspirin and calcium supplementation which reduces the risk of preeclampsia. Keep taking your vitamins and maintain a healthy diet as they are important for the well being of you and your baby.