Pre-eclampsia explained

Midwife Anne Richley explores the potentially serious pregnancy illness, pre-eclampsia

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What is it?

Pre-eclampsia, also known as pre-eclamptic toxaemia (or PET), is an illness that only exists in pregnancy. PET is caused by a defect in the placenta, the source of an unborn baby’s oxygen and nutrients. It can affect both you and your unborn baby, and occurs at any time from around 20 weeks of pregnancy until a few days after delivery.

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“It’s the main reason for having regular checkups throughout your pregnancy”, says midwife Anne Richley “Many mums-to-be in my antenatal the classes don’t really know what this condition is, but knowing about it is important when you’re expecting.”

Who does it affect most – mum or baby?

If undetected and allowed to develop, pre-eclampsia could be life-threatening to you and your baby – hence the importance of checkups. It affects one in 10 pregnancies in some form, but affects one in 100 first pregnancies severely.

Can I tell if I’ll get it?

Pre-eclampsia can’t be predicted, but some women are more at risk. They are:

  • First-time mothers
  • Very overweight women
  • Women over 40
  • Women with a family history of pre-eclampsia
  • Mothers who’ve left a gap of 10 years or more between babies
  • Women with high blood pressure, diabetes or kidney disease
  • Women with multiple pregnancies
  • Women who’ve suffered from 
pre-eclampsia before

How is it diagnosed?

The condition can cause your blood pressure to rise, and protein to leak into your urine, which if undetected can lead to serious illness. Women sometimes get a lot of swelling (oedema), in their hands and feet, legs, abdomen and face. But remember that most pregnant women will experience some swelling, particularly towards the end of pregnancy – it’s normal.

If pre-eclampsia has been present for a while, you may start to have other symptoms such as upper abdominal pain, vomiting, severe headaches, and visual disturbances (such as ‘flashing lights’). There can be innocent reasons for these symptoms, but don’t ignore them – see your midwife or doctor for a check. If you’re unable to get an appointment with either of them, call the labour ward and speak to a midwife.

What if I have it?

If you have a significant rise in your blood pressure, particularly if you also have protein in your urine (proteinuria), you’ll need to see an obstetrician. Your midwife can take blood samples to check your kidneys and liver are working properly and that your blood clotting properties are not affected. The amount of urine you produce might also be measured to help check whether your kidneys are working properly.

Having high blood pressure does not, on its own, mean that you have pre-eclampsia. With rest it may settle, though you’ll still need to be closely monitored. 
Pre-eclampsia can cause the placenta to fail, so the wellbeing of your baby might be affected. If this is suspected, your labour may be induced early, or in severe cases, you might be advised to have a caesarean.

Is there a cure?

The root of the problem is the placenta, so the ‘cure’ is the delivery of the baby. In mild pre-eclampsia, as long as your baby is continuing to grow and the blood flow is not affected, then the doctors will aim to keep 
your pregnancy going for as long as possible.

However, dilemmas occur when delivery needs to be induced early. This would resolve your problems, but may put your baby at risk if they are born prematurely.

You may be prescribed medication to help reduce your blood pressure, and although this is not a cure, it may help to stabilise 
the condition until your baby is safely delivered. After the birth, your blood pressure may still take a while to come down and you will continue to be monitored closely.

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A mum’s viewpoint:

“I couldn’t believe it when two hours after my routine checkup I was admitted to hospital with suspected pre-eclampsia. I’d felt really well and kept thinking the midwife must have made a mistake!” Kate, mum to Georgia, aged 10 days

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