Pre-eclampsia

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Also known as: Toxemia; Pregnancy-induced Hypertension

What is pre-eclampsia?

Pre-eclampsia is one of the most serious conditions affecting pregnant women. It is diagnosed when a woman develops high blood pressure (hypertension), protein in her urine (proteinuria), and/or swelling of the hands, feet and/or face during pregnancy. In severe cases, there may be evidence of damage to the kidneys or liver, accumulation of fluid in the lungs, or disturbances of the central nervous system. About 3 to 7 percent of pregnant women develop pre-eclampsia, which can occur after week 20 of pregnancy.

Untreated pre-eclampsia is dangerous because it can harm the mother's organs and lead to seizures. If these seizures, called eclampsia, aren't treated right away, they are usually fatal for a woman and her baby. Pre-eclampsia or eclampsia can also lead to low birth weight in the baby, premature delivery, which can cause health problems in the baby, or placental abruption, in which the placenta comes loose from the uterus before the baby is born, causing bleeding.

Pre-eclampsia can also progress to HELLP syndrome, another life-threatening condition. It is called HELLP because it is defined by the breakdown of red blood cells (Haemolysis), Elevated Liver enzymes and a Low Platelet count.

One out of every 200 women with untreated pre-eclampsia progresses to eclampsia. Most cases of eclampsia occur in the third trimester of pregnancy or within 4 days after delivery. Rarely, it may develop up to 6 weeks after delivery.

Pre-eclampsia sometimes causes symptoms that are very similar to those of normal pregnancy. Some women with pre-eclampsia may have no symptoms at all. That is why it is important to regularly attend all antenatal appointments. During the checkup, the healthcare professional will perform a physical examination and perform laboratory tests to look for the "silent" signs of pre-eclampsia, like high blood pressure and protein in the urine.

Risk
Researchers are still trying to establish the exact cause of pre-eclampsia. However, it is associated with certain risk factors. These include:

  • A past pregnancy with pre-eclampsia
  • A family history of pre-eclampsia
  • Being pregnant for the first time
  • Being older than age 35 at the time of pregnancy
  • Obesity
  • Carrying multiple babies
  • A history of other conditions, including chronic high blood pressure, migraine headaches, type 1 or type 2 diabetes, kidney disease, a hypercoagulable state (increased tendency for blood to clot), antiphospholipid syndrome, or lupus.

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