Preeclampsia – What is it and should I be concerned?

Posted by | January 05, 2018 | LENS, Lifestyle, Pregnancy Medicine | No Comments
preeclampsia

You’re young, maybe even a little scared, but overall you are excited about this new addition but something just doesn’t seem right?  Maybe you’re gaining weight too quickly or your feet and legs appear to be swelling much more than you had expected.  Or, maybe your vision is blurry and you’re experiencing more headaches than before.  Any one of these symptoms could be a sign of Preeclampsia.  Preeclampsia occurs in 5% – 8% of all pregnancies.  This rapidly progressive condition typically occurs after your 20th week and has been known to occur up to 6 weeks after birth.  In cases where the disease has advanced rapidly, you may experience very few symptoms or may not notice anything at all.  This is why early and proper prenatal care is crucial in diagnosing and managing this disease.  You and your doctor will work together to ensure a safe and healthy delivery for both you and your beautiful new addition.

So what does this disease do exactly?  Preeclampsia can affect you in various ways.  It causes a rise in your blood pressure which can put your brain at risk of being injured. It can also affect your kidney and liver functions, cause blood clotting problems, fluid on the lungs and even seizures. Because preeclampsia affects the flow of blood to the placenta, it can often lead to small or premature babies.  In cases when seizures are also present, the condition is called Eclampsia, which is the second leading cause of maternal death in the U.S. and is also known to be one of the leading causes of fetal complications.  Both of these diseases if not treated early through proper prenatal care could result in low birth weight, premature birth, and even death of both mother and infant.  Although death due to Preeclampsia is less common in developed nations, it is one of the leading causes of death globally for mothers and infants.

As mentioned earlier, some women experience few or no symptoms at all.  Preeclampsia may be diagnosed unexpectedly during your routine prenatal visit through blood pressure and/or urine tests. If this occurs later in pregnancy your doctor may recommend delivery of your baby.

If the disorder occurs earlier in your pregnancy or if you were diagnosed with high blood pressure prior to your pregnancy, the impact is more critical.  Your doctor may encourage you to take time off work, stay in bed and keep off your feet, and sometimes even hospitalization to monitor and manage your blood pressure. As long as your baby continues to develop normally, your doctor may advise you to carry your little one for as long as possible with very close monitoring.

You are probably wondering what types of tests will my doctor do, how will he/she know if I have this disease.  There are many factors your doctor must consider to determine the best way to diagnose and manage your condition. Some of these could include the gestational age and health of your baby, your overall health and age, and determining how the disease is progressing. Your doctor will monitor your blood pressure and may request blood tests to determine if your kidneys and liver are functioning properly. Your doctor will also watch closely for any sign or indication that you may have a seizure or a stroke.  If he/she determines that you may be at risk for a seizure you may be treated with magnesium sulfate. If your blood pressure is increased enough to put you at risk for a stroke an antihypertensive medication to decrease your blood pressure may also be prescribed by your doctor.

Unfortunately, the only “cure” for this disease is to deliver your baby and placenta.  In some instances pre-mature delivery is the best course of action for both you and your baby’s health.  For example, if you are less than 34 weeks gestational age and your blood pressure cannot be managed with medication and conservative treatments your doctor may recommend that your baby be delivered. They will also recommend that you be given steroids to help your baby’s lungs mature before he/she is delivered.  Sometimes pre-mature delivery is the best course of action for both you and your baby’s health.

So, you’ve delivered a beautiful baby now and you are ready to take your little bundle of joy home but you may be wondering if you are still at risk.  In some instances, preeclampsia does not appear until during delivery or even up to 48-hours after the delivery.  There are cases where it has been known to occur up to six weeks post-partum. While post-partum preeclampsia is obviously not dangerous for your baby, it is still critical for you. A significant number of women who have died from Preeclampsia have died post-partum. It is easy to miss the signs of post-partum Preeclampsia.  After all, you just got home with your little wonder, your experiencing sleepless nights, possibly post-partum depression and all of your attention is on the your new baby.  All of these things, although they may seem normal and expected, could also be signs or symptoms of post-partum Preeclampsia and you should immediately contact your doctor so that they can closely monitor you.  You need to be at your best to care for that new baby of yours!!!

If you delivered a preemie due to Preeclampsia, you may be asking yourself if there are any complications your baby will face being born prematurely. Preemies come with the risk of long hospitalizations and smaller gestational size.  In addition, with your baby in the hospital being cared for, this also interrupts that valuable bonding time for you and your family. Unfortunately, Preeclampsia has been linked to many lifelong challenges for babies born prematurely.  These include learning disorders, cerebral palsy, epilepsy, blindness and deafness. Just remember, that early and proper prenatal care will give you the best advantage for a safe delivery and a beautiful and healthy baby.

So talk to your doctor about your risks and what steps you can take to minimize them.  Even though there are no definitive answers to the cause or causes of preeclampsia, early diagnosis, simple screening measures, and early prenatal care can predict and/or delay many of these adverse outcomes.  Prompt treatment could save you and your baby’s life.

Dr. Gareth Forde

About Dr. Gareth Forde

An obstetrician-gynecologist, a clinical professor, a researcher, and a father of five—and he delivered them all! He speaks and publishes extensively on maternal and child health issues, where he emphasizes the role of a healthy maternal lifestyle, good nutrition, and breastfeeding on infant development. He chose the field of obstetrics because it is a celebration of life, a happy and exciting profession. “Children are a blessing and they bring joy and laughter to the world,” he says. “I cherish my work, as a doctor and a dad.” The study of genetic imprinting is a major focus of both Dr. Forde’s research and medical practice. This looks at what happens in the womb, how the genes a baby inherits are expressed (turned on and off), and how this influences the child’s health after birth. “This field holds great promise, shedding light on many unsolved mysteries in health and disease from infancy to adulthood,” he adds. Dr. Forde grew up in London, England and Orlando, Florida. He received his medical degree from the University of Minnesota Medical School and is currently pursuing a fellowship in gynecologic oncology at the University of California, Irvine. Prior to this, he practiced with Grand Rapids Medical Education Partners, a consortium of Saint Mary’s Health Care, Spectrum Health, Grand Valley State University, and Michigan State University College of Human Medicine—where he was a clinical professor of obstetrics, gynecology, and reproductive biology. He also has a master’s in molecular and cellular biology from Florida Agricultural & Mechanical University; a Ph.D. in environmental science (computational chemistry) from Jackson State University; and a post-doctoral fellowship in biophysics from Mount Sinai School of Medicine, in New York.”