Preeclampsia - Symptoms, Causes, Treatments and Prevention
Preeclampsia (or pregnancy toxemia): definition and causes
Preeclampsia or toxemia of pregnancy is an illness during pregnancy that can have serious consequences for the mother and the fetus. What are the signs of preeclampsia? How to treat this illness?
Preeclampsia is a condition that affects approximately 3 to 4% of pregnancies. In 10% of cases, it can lead to serious complications that, in the short term, put the life of the mother and her future baby at risk .
Definition: What are the signs of preeclampsia? What is the expectant mother's blood pressure?
What is preeclampsia? When can it occur?
Preeclampsia is not detected early in pregnancy. It is caused by a malformation of the blood vesselsof the placenta . " Pre-eclampsia is a disease that can appear at the end of the second trimester of pregnancy (from 20 weeks of amenorrhea) and which combines high blood pressure ( blood pressure higher than 14/9) and proteinuria (protein in the urine higher than 0.3 g/24 h )".
How to detect preeclampsia in pregnant women? What are the associated symptoms?
Certain signs alert the health professional in charge of the mother-to-be's pregnancy, notes the specialist doctor: "We detect it during the monthly appointment with the gynecologists, in the event of high blood pressure or protein on the urine strip ."
Expectant mothers affected by this disease can have many clinical symptoms, she explains: “ Headaches , visual disturbances,tinnitus (ringing in the ears), phosphene (flies in front of the eyes) and epigastric bar (pain in the upper abdomen).”
Once the delivery has passed and, more specifically, after the expulsion of the placenta , preeclampsia will cease and the symptoms will disappear after a few days.
Causes: What are the causes of preeclampsia (pregnancy toxemia) during pregnancy?
This disease cannot be contracted,"it is an immunological disease. The main risk factors are: advanced maternal age, chronic high blood pressure, primiparity (first child), short exposure to paternal antigens or a family or personal history of preeclampsia". There is therefore a genetic predisposition: a mother can transmit preeclampsia to her daughter when she gives birth in turn.
What are the risks of preeclampsia?
The main risk is eclampsia , which causes potentially fatal seizures caused by the mother's intracranial high blood pressure .
How does an eclamptic crisis manifest itself?
In addition to these seizures , there can be many complications for the mother. " This can also cause a retroplacental hematoma (premature detachment of the placenta), a subcapsular hematoma of the liver, coagulation disorders and renal failure".
There are also, the specialist continues, fetal complications : " We most often see intrauterine growth retardation (IUGR) , induced prematurity (during, for example, an emergency premature delivery by cesarean section to save the mother), or in the worst case, fetal death in utero (FFIU) ."
How to treat preeclampsia? How to prevent eclampsia after childbirth?
Regular and appropriate monitoring can save the pregnant woman and the future baby. " If pre-eclampsia occurs, it is important to be monitored in a maternity ward with a level adapted to the term of pregnancy . For severe pre-eclampsia, it will be necessary to go to an establishment with a maternal resuscitation service," advises the practitioner.
Some pregnant women may need to be hospitalized during the end of their pregnancy. It all depends on the severity of the disease. The doctors in charge of the woman's pregnancy will have to check certain criteria to ensure that it is not severe preeclampsia. Such as:
- blood pressure (systolic pressure should not be equal to or greater than 160 mmHg and diastolic pressure should not be equal to or greater than 110 mmHg);
- proteinuria (which should not be more than 3 g per 24 hours), or decreased urine volume;
- increased blood levels of liver enzymes indicating a liver problem;
- blood platelets (cells that help blood to clot) which must not decrease;
- persistent or severe “bar” abdominal pain ;
- chest pain, shortness of breath, acute pulmonary edema (accumulation of fluid in the lung tissue);
- severe headaches that do not respond to treatment, persistent visual disturbances (phosphenes) or hearing disturbances (tinnitus)
When the mother-to-be is well supported, she recovers quickly and gives birth to a healthy baby.
The doctor or midwife in charge of the mother will have to give her appropriate treatment. " Antihypertensive treatment must be started to balance the blood pressure and regular monitoring of the mother (blood pressure, proteinuria, blood tests) and the future baby (ultrasound, fetal heart rate).
Magnesium sulfate may also be given to prevent eclampsia (seizures).
The patient who had a first pre-eclampsia has a lower risk of contracting it a second time for her next pregnancy with the same father, due to an immunological adaptation of the mother to the father's antigens . If it is a different second parent, she will run the same risks as for her previous pregnancy.
Postpartum: what are the long-term consequences of pre-eclampsia?
Mothers who have had preeclampsia during pregnancy have a higher risk than the general population of developing cardiovascular disease. The risk of hypertension is multiplied by four, that of a stroke or a myocardial infarction is multiplied by two. In addition, this syndrome multiplies by two the risks of post-pregnancy diabetes .
However, it is possible to slow down the onset of these diseases:
- by monitoring his blood pressure regularly;
- by regularly monitoring blood sugar levels;
- by adapting your diet (eating a balanced diet, sometimes without salt if necessary);
- by avoiding the consumption of alcohol or tobacco.
