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Pre-eclampsiaPublished by BUPA's health information team, healthinfo@bupa.com, August 2007. This factsheet is for women who have pre-eclampsia, or people who would like information about it. Pre-eclampsia affects about one in 10 pregnancies. Most cases of pre-eclampsia are mild and occur close to the end of pregnancy.
What is pre-eclampsia?Pre-eclampsia is a condition that occurs during pregnancy. It causes high blood pressure and can affect the kidneys, liver, brain and placenta. It can also harm your baby. As well as pre-eclampsia, there are two other main causes of high blood pressure in pregnancy. Firstly, it may be caused by longstanding high blood pressure (chronic hypertension), which isn't caused by pregnancy but is sometimes diagnosed for the first time during the check-ups made when you are pregnant. It is important to diagnose chronic hypertension because there is an increased risk of developing pre-eclampsia. It can also damage organs including the heart and kidneys. The other type of high blood pressure during pregnancy is known as pregnancy-induced hypertension (PIH). In this case, the other typical signs of pre-eclampsia don't occur and blood pressure returns to normal soon after delivery. PIH doesn't carry the same high risk for the baby as pre-eclampsia. SymptomsDuring a normal pregnancy, your blood pressure will gradually fall until around the 14th week of pregnancy and then slowly returns to normal by the end. With pre-eclampsia, high blood pressure can develop any time after the 20th week of pregnancy and remain high, but it's most common towards the end of pregnancy. If you develop mild pre-eclampsia you won't have any symptoms and it's often first found when your blood pressure and urine are checked during a routine antenatal visit. If the condition is more advanced, symptoms may include:
Pre-eclampsia often develops over the course of a few weeks, but because it may not be noticed for some time, it has usually reached an advanced stage by the time symptoms start. It's important to seek the advice of your midwife or doctor if you have any of these symptoms. How pre-eclampsia affects the motherPre-eclampsia affects more than just blood pressure - if it's very severe it can lead to kidney failure, liver problems, or even stroke. It's known as pre-eclampsia because if left untreated it may result in eclampsia. This is when a seizure (fit) occurs and is a sign of severe disease. Fortunately, because pre-eclampsia can be treated once it's been diagnosed, eclampsia is rare, affecting only around one in 100 women with pre-eclampsia. However, around three to five women die each year from the condition in the UK. How pre-eclampsia affects the babyThe placenta is the organ that joins your growing baby to you. Problems with the placenta and high blood pressure reduce the blood flow to the baby and can lead to reduced growth, a condition called intra-uterine growth restriction. Often this is not easy to detect, but it may be picked up if the womb (uterus) is found to be smaller than expected for the stage of pregnancy. If pre-eclampisa is diagnosed, the growth of the baby will be checked using an ultrasound scanning machine. Occasionally, in severe pre-eclampsia, the baby can become distressed and may need to be delivered immediately. If this happens the baby may be premature. Premature babies are at risk of complications because many of their organs (especially the heart and lungs) may not be ready to work outside the womb. The earlier the premature baby is delivered, the greater the risk of serious medical complications. CausesThe cause of pre-eclampsia is unknown. However, research has found that the cause of the high blood pressure in pre-eclampsia is related to the placenta. In pre-eclampsia the placenta has not fully developed and the blood supply is reduced. There may also be small blood clots in the placenta, which further reduce blood flow to the baby. Genetics is a factor in pre-eclampsia. If your mother had pre-eclampsia, there is a two in 10 chance that you may also develop pre-eclampsia during pregnancy. You are more likely to get pre-eclampsia if you:
DiagnosisDoctors usually diagnose pre-eclampsia if your blood pressure is greater than 140/90mmHg, and protein shows up in urine tests. When pre-eclampsia is suspected you will usually be admitted into hospital. The following tests will be carried out.
Sometimes not all of these tests may be needed immediately. If you are told you have pre-eclampsia, you may need to stay in hospital for the remainder of your pregnancy. TreatmentChronic hypertension and PIHVisits from the midwife, or to the antenatal day care unit are usually increased to monitor chronic hypertension and PIH. Pre-eclampsiaPre-eclampsia can only be cured by delivery of the baby. Once it has been diagnosed, the doctors will weigh up the risk to both you and your baby, which depend on the severity of the condition and the stage of pregnancy. If blood tests show that your condition is stable, it's usually preferable to wait for labour to start normally because an induced labour is more likely to be long or result in an emergency caesarean. If pre-eclampsia develops earlier in your pregnancy, it's best to wait as long as possible before delivering the baby. If the condition is severe, the baby may need to be delivered immediately. This will often be by caesarean section. If the pregnancy is premature, you may be given a steroid injection 24 to 48 hours before delivery. This encourages the baby's lungs to develop and reduces the risk of breathing difficulties. Severe high blood pressure is treated with medicines to reduce the risk of complications. However, once the blood pressure is controlled, your doctor or midwife may consider delivery. If you develop eclampsia, this can be treated with a medicine called magnesium sulphate, which will also prevent further fits. You will then be monitored closely until delivery. This will usually be by caesarean section, and will need to be within a matter of hours. You will be closely monitored after delivery as you are still at risk of fitting. PreventionA number of medicines, diets and supplements have been suggested to reduce the risk of pre-eclampsia, though for many there is limited scientific evidence that they work. Aspirin can reduce the risk of pre-eclampsia in women who are already at high risk of the disease. Women who have previously had a severely affected pregnancy, resulting in premature birth, may benefit from a low dose of daily aspirin (up to 75mg). This should only be started on the advice of your doctor, as it may cause complications, such as bleeding during pregnancy. Daily calcium supplements of at least 1g have been found to reduce the risk of pre-eclampsia in high risk women and in those who have dietary deficiency of calcium. Vitamin C and E supplements may also provide some benefits. These should only be started on the advice of your doctor or midwife. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: August 2007. Expected review date: August 2009.
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