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Preeclampsia

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  3. Preeclampsia

Overview of Preeclampsia

Preeclampsia Meaning in Urdu

یہ بیماری حمل کے دوران عورتوں کو متاثر کرتی ہے۔ اس کی وجہ سے حاملہ خواتین کو ہائی بلڈ پریشر، پیشاب میں پروٹین، سوزش، سر درد، اور نظر کے دھندلے پ کا سامنا کرنا پڑتا ہے۔ کچھ حاملہ خواتین کو اس بیماری کی وجہ سے سردرد، پیٹ کے دائیں جانب درد، جِلد پر کالے دھبوں، اور سانس لینے میں مشکل بھی پیش آ سکتی ہے۔ پہلی مرتبہ حاملہ ہونے والی خواتین میں اس بیماری کے خطرات زیادہ ہوتے ہیں۔ تاہم کچھ عوامل جیسا کہ گردوں کی بیماریاں، ہائی بلڈ پریشر، ذیابیطس، مدافعتی نظام کی مسائل، اور موٹاپے کی وجہ سے بھی اس کے خطرات میں اضافہ ہو جاتا ہے۔

Definition

Preeclampsia is a pregnancy-related complication characterized by high blood pressure (hypertension) and organ damage, such as the liver and kidneys. It usually develops after 20 weeks of pregnancy and can lead to severe complications for the mother and baby if left untreated.

Prevalence of Preeclampsia

Globally, 2-8% of pregnancy-related complications happen due to preeclampsia, with 9-26% incidence of deaths.  

Signs and Symptoms of Preeclampsia

The symptoms of preeclampsia can vary in severity and may include:

  • High blood pressure (hypertension): Blood pressure readings consistently at or above 140/90 mmHg.
  • Proteinuria: Excessive protein in the urine (more than 300 milligrams in 24 hours).
  • Swelling: Edema or swelling, particularly in the face, hands, and feet.
  • Headaches: Persistent and severe headaches that don't go away with medication.
  • Visual changes: Blurred vision, sensitivity to light, and temporary loss of vision.
  • Nausea and vomiting: Especially if accompanied by severe headache and upper abdominal pain.
  • Upper abdominal pain: Pain in the upper right side of the abdomen, typically under the ribs.
  • Shortness of breath: Difficulty breathing, especially when lying down.
  • Decreased urine output: Less frequent urination or urine output of less than 500 ml in 24 hours.
  • Reduced fetal movements: Decreased fetal movements or activity compared to normal.

It's important to note that some women with preeclampsia may not experience any symptoms, and the condition may only be detected during routine prenatal care.

Types of Preeclampsia

There are several types of preeclampsia, including:

  • Mild Preeclampsia: Mild preeclampsia is characterized by high blood pressure and protein in the urine (proteinuria), along with mild symptoms such as headaches, swelling, and nausea.
  • Severe Preeclampsia: Severe preeclampsia is diagnosed when blood pressure levels are extremely high, and symptoms are more severe, including severe headaches, visual changes, abdominal pain, and shortness of breath. This type of preeclampsia may also lead to complications such as liver and kidney damage, low platelet count, and fluid in the lungs.
  • Early-onset Preeclampsia: This type of preeclampsia occurs before 34 weeks of gestation. It is often associated with more severe symptoms and complications.
  • Late-onset Preeclampsia: Late-onset preeclampsia occurs after 34 weeks of gestation. It is often less severe than early-onset preeclampsia.
  • Superimposed Preeclampsia: Superimposed preeclampsia occurs when a woman with pre-existing hypertension (high blood pressure) develops preeclampsia during pregnancy. This type of preeclampsia can be particularly dangerous and requires careful management.

Causes of Preeclampsia

The exact cause of preeclampsia is not fully understood, but it is believed to be related to problems with the blood vessels in the placenta, which can affect blood flow to the developing fetus. Some factors that may increase the risk of developing preeclampsia include:

  • First pregnancy: Women who are pregnant for the first time have a higher risk of developing preeclampsia.
  • Age: Women younger than 20 or older than 40 have a higher risk of developing preeclampsia.
  • Multiple gestations: Women carrying twins, triplets, or more have a higher risk of developing preeclampsia.
  • History of high blood pressure: Women who have high blood pressure before pregnancy or have a family history of hypertension are at increased risk of developing preeclampsia.
  • History of preeclampsia: Women who have had preeclampsia in a previous pregnancy are more likely to develop it in subsequent pregnancies.
  • Obesity: Women who are obese or overweight have an increased risk of developing preeclampsia.
  • Diabetes: Women with pre-existing diabetes or gestational diabetes are at higher risk of developing preeclampsia.
  • Autoimmune disorders: Women with autoimmune disorders such as lupus or rheumatoid arthritis have an increased risk of developing preeclampsia.
  • In vitro fertilization (IVF): Women who conceive through IVF have a slightly higher risk of developing preeclampsia.

It's worth noting that in many cases, preeclampsia causes are not known, and it can develop in women with no known risk factors.

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Risk Factors of Preeclampsia

Preeclampsia can cause a range of complications for both the mother and the developing fetus, including:

  • Eclampsia: Preeclampsia can progress to eclampsia, a serious condition that can cause seizures, coma, and even death if left untreated.
  • Placental abruption: Preeclampsia can cause the placenta to separate from the uterine wall, leading to heavy bleeding and a risk of fetal distress.
  • Fetal growth restriction: Preeclampsia can affect blood flow to the fetus, resulting in poor fetal growth and development.
  • Preterm birth: In some cases, preeclampsia may require delivery of the baby before full term, which can increase the risk of health problems for the baby.
  • HELLP syndrome: A severe form of preeclampsia, HELLP syndrome can cause liver and blood clotting problems and can be life-threatening for both the mother and baby.
  • Cardiovascular disease: Women who have had preeclampsia may be at increased risk of developing cardiovascular diseases later in life.
  • Stroke: Preeclampsia can increase the risk of stroke in the mother.
  • Kidney failure: In severe cases, preeclampsia can cause kidney damage or failure.
  • Pulmonary edema: Preeclampsia can cause fluid to accumulate in the lungs, making it difficult to breathe.

Pregnant women need regular prenatal care and monitoring to help detect and manage preeclampsia early to reduce the risk of complications.

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Prevention

Unfortunately, there is no known way to avoid preeclampsia, but there are some steps that women can take to lower their risk:

  • Attend regular prenatal care appointments: Regular prenatal care can help detect and manage preeclampsia early.
  • Control pre-existing medical conditions: If you have pre-existing medical conditions such as high blood pressure or diabetes, work with your healthcare provider to manage them before and during pregnancy.
  • Maintain a healthy weight: Women who are overweight or obese are at higher risk of developing preeclampsia, so it's important to maintain a healthy weight before and during pregnancy.
  • Exercise regularly: Regular physical activity, with your healthcare provider's approval, can help reduce the risk of preeclampsia.
  • Eat a healthy diet: A diet rich in fruits, vegetables, whole grains, and lean protein can help reduce the risk of preeclampsia.
  • Take low-dose aspirin: Women at high risk of preeclampsia may benefit from taking low-dose aspirin daily, as recommended by their healthcare provider.
  • Avoid smoking and alcohol: Smoking and alcohol use during pregnancy can increase the risk of preeclampsia and other complications.

It's important to note that these steps may not eliminate the risk of developing preeclampsia, but they can help lower the risk and improve overall health during pregnancy.

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Diagnosis

Preeclampsia is typically diagnosed through a combination of physical exams, blood tests, and monitoring of blood pressure and urine protein levels. Here are some of the diagnostic tools used:

  • Blood pressure monitoring: Preeclampsia is often associated with high blood pressure, so your healthcare provider will monitor your blood pressure throughout your pregnancy.
  • Urine protein test: Preeclampsia can cause protein to leak into your urine, so your gynecologist will monitor your urine protein levels through a simple urine test.
  • Blood tests: Your gynecologist may also order blood tests to monitor liver and kidney function and to check for low platelet count, which can be a sign of preeclampsia.
  • Fetal ultrasound: An ultrasound may be performed to monitor the growth and health of your baby.
  • Non-stress test: A non-stress test is a simple test that monitors your baby's heart rate and movements to ensure they are healthy and growing properly.

If your healthcare provider suspects you have preeclampsia, they may recommend more frequent monitoring and testing to ensure early detection and appropriate management of the condition.

Treatment of Preeclampsia | When to Consult a Doctor

The treatment for preeclampsia depends on the severity of the condition and the gestational age of the fetus. In general, the goal of treatment is to prevent the condition from getting worse and to manage any complications that may arise. Here are some of the treatment options:

  • Close monitoring: If you are diagnosed with mild preeclampsia, your gynecologist may recommend close monitoring of your blood pressure, urine protein levels, and fetal well-being.
  • Medications: If your blood pressure is high, your gynecologist may prescribe medications such as antihypertensives to lower it. In some cases, low-dose aspirin may be recommended to help prevent preeclampsia in women at high risk.
  • Delivery: The only cure for preeclampsia is delivery of the baby, so if you have severe preeclampsia or if your condition is not improving with treatment, your gynecologist may recommend delivery of the baby, even if it is before the due date.
  • Corticosteroids: If delivery is needed before 34 weeks, corticosteroids may be given to help accelerate fetal lung maturity and reduce the risk of complications.
  • Hospitalization: In some cases, hospitalization may be necessary to closely monitor you and your baby and to provide appropriate care.

The treatment plan will be tailored to your circumstances, so it's important to consult a renowned gynecologist to manage the condition and ensure the best possible outcome for you and your baby.

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