Pre-eclampsia

When is swelling a sign of something serious?

During pregnancy, swelling in the ankles and toes is normal and very common. It is called oedema and means that you have extra fluid in your body. However, swelling in other parts of the body, particularly if it is sudden, is something you should bring to the attention of your midwife.

What is pre-eclampsia?

AdvertisementPre-eclampsia is a pregnancy-induced condition, which can occur in the second half of pregnancy. It is characterised by high blood pressure, swelling that happens suddenly along with rapid weight gain due to fluid retention, and protein in the urine.

Pre-eclampsia can range from mild to severe and can affect various systems of the body. Although there is no treatment that will stop it completely during pregnancy, pre-eclampsia can be managed.

Since it reduces the flow of blood to the placenta, pre-eclampsia can be quite dangerous for your unborn baby. It can restrict your baby's growth because not enough oxygen or nutrients get through. If you have any reason to suspect that you might have pre-eclampsia, contact your doctor or midwife immediately.

If pre-eclampsia develops into eclampsia, your blood pressure will become extremely high and both you and your baby will be at great risk. Eclampsia can cause seizure or convulsions, which can lead to coma and can be fatal. If it happens, eclampsia usually develops in late pregnancy or just after the baby is born.

Are some women more likely to develop pre-eclampsia?

Mild pre-eclampsia affects about seven in every 100 pregnant women. Eclampsia is much rarer; only 1 in 100 women with pre-eclampsia go on to develop it. Almost half the cases of eclampsia (44 per cent) occur after the baby has been born.

The exact cause of pre-eclampsia is not known but there are recognised risk factors. You're more likely to get pre-eclampsia in a first pregnancy or if there is a big gap, usually of at least ten years, between this and your last pregnancy.

You are also more at risk if you:

1. are 40 or older
2. were very obese at the start of your pregnancy, with a BMI of 35 or more
3. have a chronic medical problem that affects your blood system, including high blood pressure, lupus, kidney problems, or diabetes
4. are carrying twins or multiples
5. have a family history of pre-eclampsia, such as your mother or sister had it • have had it before - one in five women get it again

How can I prevent it?

There is no certain method of preventing pre-eclampsia. However, the best way of ensuring that neither you nor your baby comes to any harm if you do develop it is to attend your antenatal appointments regularly. The main reason for the urine tests and blood pressure readings carried out by your midwife when you go to your antenatal appointments is to detect any early signs of pre-eclampsia.

There is some evidence to suggest that regular low-dose aspirin and calcium supplements before and in early pregnancy may help prevent pre-eclampsia in some women. Talk to your midwife or doctor if you are interested in these treatments.

If I get pre-eclampsia, how will it be treated?

If your blood pressure is moderately raised, you will be advised to have as much bed rest as possible, lying either on your left hand side because this improves the flow of blood to the placenta, or sitting well propped up. Your midwife will probably visit you on a daily basis to check your blood pressure.

If your blood pressure becomes very high, you might be admitted to hospital so that your condition can be monitored. Scans will be used to monitor your baby's growth and CTG (cardiotochograph) will be used to check your baby's heart rate and wellbeing. The aim is to prolong your pregnancy as long as possible, to give your baby the best chance.

You may also be given magnesium sulphate injections. A large research study published in 2002 found that if mothers with pre-eclampsia are given magnesium sulphate, it roughly halves their risk of developing eclampsia.

If your blood pressure cannot be controlled, your obstetrician may suggest that you have your labour induced or that you deliver your baby by caesarean section.

Pre-eclampsia will get better on its own once your baby is delivered. But you are still at risk of pre-eclampsia for up to four weeks after your baby is born, especially if your pre-eclampsia was severe or diagnosed when your pregnancy was 37 weeks or more.

What are the warning signs for pre-eclampsia?

Pre-eclampsia is a serious condition for you and your baby. Occasionally pre-eclampsia develops very quickly. Don't hesitate to call your doctor or midwife if you have any of the following symptoms in the second half of pregnancy or in the first few weeks after birth:

1. sudden swelling of the face, hands or feet
2. intense headaches accompanied by blurred vision or spots before the eyes
3. severe pain in the top of your abdomen
4. vomiting

Early detection and care can make a big difference in the course of pre-eclampsia.

Can pre-eclampsia lead to any other complications?

In rare cases it can lead to complications such as HELLP syndrome, which is a liver and blood clotting disorder. HELPP stands for haemolysis (H - breaking down of red blood cells), elevated liver enzymes (EL) and low platelet count (LP). It can develop before pre-eclampsia has been diagnosed. Symptoms of HELLP syndrome include headaches, nausea and pain in your upper abdomen.

source: http://www.babycentre.co.uk