It is thought that preeclampsia actually begins very early in the pregnancy, before any symptoms appear. The first symptom of preeclampsia is the onset of high blood pressure, usually a reading of 140/90 mm Hg or an increase of 30 mm Hg systolic (top number) and 15 mm Hg diastolic (bottom number) in your normal blood pressure reading. Another common symptom of preeclampsia is protein in urine. It is because of this disease that women routinely get their blood pressure and urine checked at prenatal visits.
The exact cause of preeclampsia is unknown but many doctors suspect it has to do with a placental default. It appears that preeclampsia may begin when the placenta doesn’t implant in the uterus wall properly and fails to develop the proper amount of blood vessels. This causes decreased blood flow to the placenta, which can lead to blood vessel constriction, damage to vessel walls and problems with blood clotting. The constriction causes the high blood pressure and the vessel wall damage causes protein in the urine. Other possible causes for preeclampsia are family history of preeclampsia, vitamin/mineral deficiencies, pre-existing diabetes or high blood pressure, an imbalance in the hormones that regulate blood vessels and an immune system reaction. If a woman in her family had preeclampsia, a pregnant woman’s risk factor increases, especially if her mother developed preeclampsia while pregnant with her. A similar link has been shown between the baby’s father and preeclampsia; if his mother developed preeclampsia while pregnant with him, the pregnant woman will have an increased risk of preeclampsia.
Preeclampsia is more common with first pregnancies, teenage mothers, women over 40 and carrying multiple fetuses, but any pregnant woman can develop it. It usually develops late in the pregnancy (after 37 weeks) but can occur any time from 20 weeks to two weeks after delivery. Delivery of the baby is usually the best choice to prevent any complications, but if the mother is diagnosed with mild preeclampsia prior to 37 weeks, her doctor may choose not to induce and put her on bed rest with blood pressure medications to bring it down. If the mother is diagnosed with severe preeclampsia and is past 32 weeks, labor may be induced or she may be scheduled for a cesarean delivery. Severe preeclampsia prior to 32 weeks is often cause of hospitalization.
Mild preeclampsia usually has no noticeable symptoms and is only found when a pregnant woman goes in for her normal prenatal visit and her doctor discovers elevated protein in the urine and high blood pressure. The difference between mild and severe preeclampsia is only 20 mm Hg systolic and 10 mm Hg diastolic. Severe preeclampsia may or may not have noticeable symptoms. The possible physical symptoms of severe preeclampsia include persistent headaches, blurred vision, pain in the upper right area of the abdomen usually directly under the ribs, nausea/vomiting, unexplained anxiety, dizziness and a decrease in urination. Because preeclampsia can make a sudden appearance, it is important for pregnant women to know these symptoms and warning signs so they can call their doctor’s office or go to the emergency room immediately. Rapid treatment of preeclampsia symptoms can prevent complications and ensure safe delivery of the baby.
Preeclampsia complications are usually worse for the mother than the infant, but not always. Common maternal complications are eclampsia and HELLP syndrome. Eclampsia is preeclampsia with seizures. HELLP stands for hemolysis (destruction of red blood cells), elevated liver enzymes and low platelet count. Up to 12% of preeclampsia patients develop HELLP and it can become life-threatening. This syndrome can be particularly dangerous because you don’t have to have preeclampsia to develop HELLP. A complication that is potentially dangerous for both mother and infant is placental abruption, where the placenta separates from the uterus before delivery. This can cause uncontrolled bleeding and shock in the mother and, in severe cases, can cause disability or even death for the infant. The most common infant complications are low birth weight and premature birth. In severe preeclampsia cases, the infant can develop acidosis due to using energy reserves with no way to remove the waste product (lactic acid), these cases require immediate delivery. The infant may even die from untreated severe preeclampsia. Preeclampsia causes 15% of all premature births and 30% of premature births with known causes.
Michael RussellYour Independent guide to Blood Pressure
