What is preeclampsia?

Preeclampsia, is called as toxemia of pregnancy and also a worldwide problem in pregnant mother. It is a disorder that occurs only during pregnancy and the postpartum period. It can lead to serious complications for both mother and baby. It is a serious, multisystem complication of pregnancy with an unclear etiology, affecting at least 5-8% of all pregnancies. 

It is a rapidly progressive condition characterized by high blood pressure and the presence of protein in urine and also may be associated with myriad other signs and symptoms, such as pitting edema, visual disturbances, headache, and epigastric pain.

Preeclampsia is a condition that typically starts after 20th weeks’ gestation, but can also present up to 4-6 weeks post-partum. It affects the placenta and it can affect the mother’s kidney, liver and brain. Preeclampsia is also a leading cause of fetal complications, which includes low birth weight, premature birth and stillbirth. Preeclampsia, often asymptomatic, comes before the fatal condition “Eclampsia” appears, which is characterized by the appearance of tonic clonic seizures or convulsions in preeclamptic patients.

Preeclampsia can be classified as mild and severe:

Mild pre-eclampsia:
  • Pregnancy is greater than 20 weeks of gestation.
  • Sustained rise in blood pressure (greater than 140 systolic or 90 diastolic but less than 160 systolic or 110 diastolic).
  • 0.3 gm (300 mg) of protein is collected in a 24-hour urine sample or persistent 1+ protein measurement on urine dipstick.
  • There are no other signs of problems with the mother or the baby.
Severe preeclampsia:
  • Rise in blood pressure (greater than 160 systolic or 110 diastolic).
  • Proteinuria - Greater than 5 gm (5000 mg) of protein in a 24-hour sample or 3+ or greater on urine dipstick on two random urine sample collected at least 4 hours apart .
  • Thrombocytopenia (low platelet count <50,000/μL).
  • Very low urine output (less than 500 mL in 24 hours).
  • Reflecting pulmonary edema.
  • Signs of central nervous system problems (a severe headache, blurry vision, altered mental status).
  • Liver problems (nausea and/or vomiting with abdominal pain).
  • HELLP syndrome (a form of severe preeclampsia).
  • Signs of respiratory problems (pulmonary edema, bluish tint to the skin).
  • Severe fetal growth restriction.
  • At least twice the normal measurements of certain liver enzymes on a blood test.

Preeclampsia sign and symptoms:

Preeclampsia sometime develops without any symptoms. The main symptoms of preeclampsia are:

  • Severe headaches
  • Visual disturbances
  • Epigastric discomfort
  • Edema and rapid weight gain
  • Nausea or vomiting
  • Decreased urine output

      During a physical examination, the doctor may find your blood pressure is 140/90 or higher, presence of protein in urine ( Proteinuria), abnormal liver enzyme, low platelet level. Preeclampsia can happen as 20 weeks into pregnancy, but that’s rare. Symptoms often begins after 34 weeks. In few cases, symptoms develops after birth usually within 48 hours of delivery.

   Causes of preeclampsia:

The precise cause of preeclampsia is unknown, but some potential causes are:

  • Genetic factors
  • Autoimmune disorder

 Risk factors for preeclampsia include:

  • Having history of high blood pressure.
  • Having history of endocrine disorder; renal disorder; autoimmune disorder.
  • Multi-fetal gestation.
  • Maternal age is greater than 35 years.
  • Pre‐pregnancy obesity BMI ≥ 30.
  • A first pregnancy.

 There is no treatment for preeclampsia. Doctor may recommend to take vitamin D because it influences vascular structure and functions and regulates blood pressure. Also, calcium may prevent preeclampsia among women with low baseline calcium intake.

Early prenatal care, therefore, is vital to the prevention of the onset of the disease.