What is preeclampsia?

Preeclampsia is a serious pregnancy complication that typically presents between 20 weeks of gestation up to 6 weeks after delivery. It is characterized by:

  • Raised blood pressure
  • Presence of protein in the urine (proteinuria)

The cause of preeclampsia is unknown.

Frequency

Preeclampsia is a frequent pregnancy complication that affects 5 out of 100 pregnant women. Usually it is mild; however in few cases it could become very serious and could be life-threatening for both the mother and the baby.

Symptoms

Preeclampsia could be completely asymptomatic at its initial stage and can be diagnosed during a routine blood pressure and urine test.

Symptoms of preeclampsia could present during pregnancy or within the first 6 weeks after delivery.

The commonest symptoms are:

  • Feeling generally very unwell
  • Acute and severe headache that does not improve with painkillers
  • Visual disturbances such as blurred vision
  • Shortness of breath
  • Severe heartburn pain that does not go away with antacids
  • Rapidly increasing swelling of the face, hands or feet

If a pregnant woman experiences any of these symptoms, she should immediately seek medical help.

In severe preeclampsia multiple organs, such as the liver or the kidneys, could be affected and seizures could occur before or after delivery (eclampsia). This is however rare and occurs in 1 out of 4000 pregnancies.

How is the fetus affected?

Preeclampsia is usually associated with poor placental development that causes intrauterine fetal growth restriction (IUGR) and reduced amniotic fluid. It is also associated with increased risk of iatrogenic preterm delivery, due to fetal or maternal complications.

Preeclampsia screening

The main cause of preeclampsia is poor placental development. This could be predicted as early as the first trimester at the 11-13 weeks nuchal scan by a combination of maternal characteristics, assessment of the blood flow in the maternal uterine arteries with Doppler studies, maternal blood pressure measurements and specific blood tests.

Factors that increase the risk of preeclampsia based on the maternal characteristics are:

  • Maternal history of hypertension before pregnancy
  • Past obstetric history of preeclampsia
  • First pregnancy
  • Multiple gestation
  • Pre-existing diabetes or gestational diabetes
  • Obesity
  • Age above 40 yrs

Dr Ioanna Tsoumpou has sub-specialized at Harris Birthright Centre of Fetal Medicine at King’s College Hospital in London and she is certified by the Fetal Medicine Foundation for the prediction of preeclampsia during the first trimester nuchal scan.

What can we do to reduce the risk of preeclampsia?

If the risk of developing preeclampsia is raised we recommend that the pregnant woman takes aspirin, based on the doctor’s instructions, provided that there are no contraindications. Furthermore, we recommended regular measurements of the maternal blood pressure and urine for proteinuria and regular fetal growth scans.

For more information you could visit the following websites:

www.fetalmedicine.org

www.rcog.org.uk