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Preeclampsia Risk Factors, Symptoms. Diagnosis & Treatment

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Preeclampsia Risk Factors, Symptoms. Diagnosis & Treatment

Preeclampsia is a serious medical condition that occurs after the first 20 weeks of pregnancy and is characterized by hypertension, edema (of the feet) and proteinuria (that is leak of proteins in urine). Preeclampsia is a complication that occurs during pregnancy and can progress to eclampsia, which is a life-threatening condition. It seems that preeclampsia is more common in women with multiple pregnancies or those who have never born.

It is not known exactly what mechanism underlies this disease although several theories have been questioned over time. It seems that hypertension is caused by damage to the endothelium of blood vessels in the placenta and a maternal immune system imbalance. Vasoconstriction of the blood vessels in the placenta has consequences not only on the mother, but also on the fetus. These complications include fetal growth retardation, death in utero or fetal distress in the first days after birth.

Pregnany

Pregnany

Risk factors for preeclampsia

Statistics show that about 5-10% of pregnant women suffer from this disorder. Risk factors that predispose to this disease include age over 35 years, chronic hypertension, obesity, diabetes, multiple pregnancies, clotting disorders, kidney disease, collagen diseases (lupus, scleroderma disease), antiphospholipid syndrome.

Symptoms and signs

Preeclampsia symptoms are due to hypertension, that is headache, tinnitus (ringing in the ears), blurred vision (diplopia, that is double vision). Besides these symptoms, epigastric abdominal pain, nausea, vomiting, weight gain due to edema may appear. The main complication is eclampsia, which is characterized by tonic-clonic seizures. It should be noted that seizures can occur not only during pregnancy but also postpartum (especially in the first week after birth). Other possible complications are cerebral edema, acute renal failure, pulmonary edema and bleeding disorders (disseminated intravascular coagulation). HELLP syndrome is another complication and is characterized by hemolysis, elevated liver enzymes, low platelets.

Diagnosis

The diagnosis of preeclampsia include high blood pressure: 140/90 mmHg, proteinuria (protein in the urine over 300mh per 24 hours).  Blood pressure should be measured twice every 6 hours in order to be relevant.

Treatment

The treatment of preeclampsia is medical ( antihypertensives) but in eclampsia the only cure is Cesarean section (among other medical care). Antihypertensives that are used in preeclampsia are calcium blockers (eg nifedipine) and alpha-beta adrenergic blockers such as labetolol. Treatment is adapted to the level of hypertension and the patient’s condition. In some cases intravenous magnesium sulfate is used to prevent the onset of seizures.

Besides pharmacological treatment, bed rest and strict supervision are required.