Preeclampsia: pregnancy complication that can result in death.

JESSICA MAWU-KOENYA BANSAH

Madam Akua is a 37-year-old pregnant woman. She started experiencing severe headaches which would not go away even after taking strong painkillers. Her face, legs, and ankles began to swell but her mother said it was normal during pregnancy. Her condition worsened so her husband took her to the clinic. After some tests, she was diagnosed with a condition called preeclampsia. The doctor gave her medications and assured her that she will return to normal after delivery.

Her delivery was safe and she felt better for some time. After 2 weeks, she started experiencing severe symptoms again. She had a seizure and died alone at home.

Could that have been prevented? The answer is yes.

Preeclampsia

Preeclampsia is the new onset of hypertension (high blood pressure) or worsening of already existing hypertension during pregnancy coupled with a significant amount of protein in the urine. Hypertension is called a silent killer because the symptoms of hypertension are unnoticeable till it worsens. Due to this, preeclampsia may go unnoticed for a while because the symptoms which include swelling of the legs, ankles, and face may be normal during pregnancy.

Mostly, it goes away after delivery. In other cases, it may stay for about 4 to 6 weeks and develop into a deadly condition called eclampsia which can cause stroke, heart conditions, and more. It usually affects women late in pregnancy but sometimes it may occur early. In preeclampsia, the mother’s high blood pressure rate results in a reduction of blood supply to the fetus (developing baby). If left untreated, it can put both the mother and baby at risk.

At least, 1 in every 20 pregnancies will lead to preeclampsia globally. It is important to know about this condition to prevent it from worsening into eclampsia which may cause severe complications and death.

Symptoms of preeclampsia

Usually, preeclampsia is detected when mothers attend their routine ante-natal visit. It is characterized by a high blood pressure over 140/90mm Hg. A urine laboratory test with proteins present will confirm the diagnosis. Sometimes, the woman might detect it herself from symptoms such as:

· Swelling on the face, legs, and feet.

· Severe headache

· Blurred vision

· Upper abdominal pain on the right side

· Altered mental status such as confusion

· Decreased urine output

Complications from preeclampsia include:

The baby

· The growth of the fetus (baby) will be restricted because the condition prevents enough blood to be sent to the fetus.

· Placenta abruption- occurs when the placenta separates from the uterus.

The placenta is the organ that grows in the uterus. It connects the mother and baby by transferring oxygen and nutrients to the baby and removing waste from the baby to the mother.

The mother

· Cardiovascular disease.

· Seizures

· Stroke

· Bleeding after given birth

When this happens, the baby has to be delivered irrespective of how far along the pregnancy is. Hence, early detection may prevent these complications from occurring.

Causes of preeclampsia

The exact cause of preeclampsia is still under investigation. Many experts think it has to do with abnormal placentation. (Positioning of the placenta deeply into the uterine walls- womb).

There are several risk factors that can increase a person’s chance of getting preeclampsia. Below are a few:

1.      Chronic hypertension: Chronic hypertension refers to someone who is already hypertensive. Their blood pressure is usually above 140/90mmHg. Presenting with hypertension before getting pregnant will increase your chance of getting preeclampsia 5 times than a normal person. Hence, hypertensives must consult a doctor and control their condition before getting pregnant.

2.      Nulliparity-it refers to women who have not given birth before, hence first-timers. Epidemiological data suggest that first-timers are at an increased risk. This is because they have never come into contact with paternal antigens (proteins from the man/semen). Their chances of getting preeclampsia in their subsequent pregnancies are largely reduced.

3.      Advanced maternal age- statistics show that women above 40 years are at increased risk.

4.      Multifetal pregnancy- it refers to pregnancies involving twins, triplets, and other multiples.

5.     A person who has had preeclampsia previously might have it again during subsequent pregnancies.

6.     Having a family history of preeclampsia (a close relative with the condition) means you might also get it.

7.      Genetics

8.      Women who have medical conditions such as diabetes.

9.     Women who are overweight are at an increased risk.

10.  Use of advanced technology such as in-vitro fertilization.

Diagnosis and treatment

The ultimate way to detect preeclampsia as mentioned above is by having blood pressure over 140/90 mm Hg during pregnancy plus a high amount of protein in the urine. Other tests to check for urine or liver chemicals may be conducted.

Ultrasound may be recommended to check on the fetus(baby) health such as its movement, amniotic fluid, muscle tone, and so on.

Treatment

The most common way to treat preeclampsia is through birth. This depends on the severity of the condition and how far you are in your pregnancy.

During mild or early detections, the doctor will give you medications or recommend bed rest.

In severe conditions, you may be admitted. Careful monitoring via various laboratory tests. Medications that will prevent you from having a seizure and lower blood pressure as well as steroids injections that will help the baby’s lungs to grow faster.

After delivery, the blood pressure falls back to normal.  Your blood pressure must be monitored regularly. Regardless, your doctor or midwife will encourage you to look out for the symptoms and report to the clinic immediately after you experience them.

It is estimated that 63000 women die each year from preeclampsia and eclampsia. It is totally manageable and preventable.
Share this with all the women you know. You might save a life!

References

  1. UpToDate. Preeclampsia:Clinical features and diagnosis. Retrieved from https://www.uptodate.com/contents/preeclampsia-clinical-features-and-diagnosis
  2. WebMD. Retrieved from https://www.webmd.com/baby/preeclampsia-eclampsia
Health

JESSICA MAWU-KOENYA BANSAH

A young lady who is excited to influence the society and world with the knowledge she has acquired.