Pre-eclampsia, or toxaemia, is a condition that can pose a serious risk to you and your baby. It’s widely screened for throughout pregnancy. You can be prepared by following our guide to the warning signs and making sure you attend all your antenatal checks.
Pre-eclampsia almost always occurs after week 20 and usually after week 30. Its main characteristics are high blood pressure and protein in urine and there are several other symptoms, including severe swelling in the hands, feet and face and bad headaches.
However, many women with pre-eclampsia can feel perfectly well, particularly in the early stages of the illness. This is unfortunate as if left untreated the condition can pose a serious risk to both you and your baby. A simple urine test can pick up the condition and proper antenatal care can prevent more serious complications developing.
What is pre-eclampsia?
Pre-eclampsia prevents the placenta from working properly, limiting the supply of food and oxygen to your baby and may also affect your kidneys, liver, lungs, brain and blood clotting system. As the name suggests, pre-eclampsia may develop into full eclampsia, leading to fits and coma, and may be fatal, but this is very rare.
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Before you start to panic, you should be aware that these days most women with pre-eclampsia go on to deliver healthy babies. The majority of cases occur in the final weeks of pregnancy and the more serious complications are avoided. The key to limiting the risks is in timely diagnosis and good health care.
What are the signs of pre-eclampsia?
As some women can experience no obvious symptoms of pre-eclampsia, it’s vital to go to your regular pregnancy health checks to have your blood pressure and urine checked. There are other reasons why you may have high blood pressure or protein in your urine, so having one of these symptoms doesn't mean that you have pre-eclampsia.
Up to 10% of pregnant women develop high blood pressure during pregnancy, which is known as gestational hypertension. If you’re diagnosed with high blood pressure then your GP should keep a close watch on you and conduct more frequent urine tests for protein.
Any one of many signs can be present without pre-eclampsia and, in particular, some swelling is to be expected during pregnancy and some pregnant women are more prone to headaches. Even so, it’s still sensible to report any of these symptoms to your GP or midwife as soon as you can.
How is it treated?
You and your baby will be closely monitored to see how the condition is affecting you both. Milder cases may be treatable from home. If you have mild pre-eclampsia, you’ll be advised to cut down your activities to a minimum. However, hospitalisation and complete bed-rest may also be necessary.
Drugs may be prescribed to control blood pressure but the only proper cure for pre-eclampsia is the birth of your baby. Depending on how serious the condition, an early delivery in the last weeks of pregnancy by induction or by caesarean could be likely. In a few cases where pre-eclampsia develops early and poses a significant risk to you and your baby, premature delivery may be the only option.
Following delivery all symptoms should disappear within two weeks.
What are the risks of getting pre-eclampsia again?
If you've had pre-eclampsia in an earlier pregnancy you do have a higher risk of developing the condition again, but there's also a very good chance that you'll have a healthy, uncomplicated pregnancy.
With each subsequent pre-eclampsia pregnancy the risk of a repeat in the next pregnancy is increased.
My ankles are swollen, have I got pre-eclampsia?
Probably not! Swollen ankles – that attractive pregnancy symptom - are caused by excess fluid, and are very common in pregnancy, especially in the third trimester.
“Typical symptoms of pre-eclampsia are unusual puffiness in the face and body, high blood pressure, excessive vomiting and nausea and dizziness” says pregnancy care expert Justina Perry of www.mamababybliss.com. “If you experience any of the above you must seek medical attention immediately.”
Pre-eclampsia, also known as pre-eclamptic toxaemia (or PET), is an illness that only exists in pregnancy. It affects one in 10 pregnancies in some form but one in 100 first-time mums have it severely.
Explain it to me!
PET is caused by a defect in the placenta, (the source of your unborn baby’s oxygen and nutrients.) It occurs at any time from around 20 weeks of pregnancy until a few days after delivery. High blood pressure can cause protein to leak into your urine, and lead to serious illness if it’s not spotted.
The trouble is, you don’t always show symptoms and that’s why it’s crucial to attend all your routine checkups, no matter how inconvenient.
"It's the main reason for having regular checkups throughout your pregnancy", says MFM midwife Anne Richley.
"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!" says Kate, mum to Georgia, aged 10 days.
“I had pre-eclampsia with my first,” says another MFM mum. “I ended up on blood pressure medication and being induced as it went downhill quite quickly - even though I actually felt fine! I was told by my consultant that assuming all factors remain the same (ie same father, no other health problems, not too much older) it was unlikely to reoccur.”
How will I know if it’s serious?
Feeling a bit wobbly is all part of being pregnant but whilst stomachache, vomiting, severe headaches, and visual disturbances can have an innocent cause they can also be a sign of the condition and you need to see a medic asap.
High blood pressure and having protein in your urine (proteinuria) means that things could be serious and you’ll need to see an obstetrician and further tests.
What’s HELLP? Is it the same as pre-eclampsia?
Sort of. HELLP Syndrome is a variant, or type of pre-eclampsia. Symptoms include headaches, sickness, indigestion with pain after eating, tummy or chest tenderness and upper right side pain, shoulder pain, swelling and vision problems. It’s very rare but if you do develop severe pre-eclampsia, doctors will be looking for the signs.
One mum says, “At 15 weeks pregnant I started with a pain in my lower chest just below my ribcage that felt like indigestion and heartburn and was uncomfortable to eat at times. They told me I had a urine infection. I spent the next 4 days still in pain and feeling unwell. By the Friday I had blood pressure that was through the roof and protein in my urine. I was referred to hospital where the next day I was diagnosed with hellp syndrome”.
If I get it what’s the treatment?
Rest! And more rest, sometimes in hospital. You may also be prescribed medication to reduce your blood pressure.
The root of pre-eclampsia is the placenta so the ‘cure’ is the delivery of the baby. With mild pre-eclampsia, as long as your baby’s growing and the blood flow isn’t affected, then the doctors will aim to keep your pregnancy going for as long as possible.
But the condition can cause the placenta to fail, which is serious. So if it looks as though this could happen your labour may be induced early, or in severe cases you might be advised to have a caesarean. You’ll still need to be monitored after birth, too.
teacup33 says, “I developed pre eclampsia at 31wks with ds, he was delivered at 32wks, i had no physical symptoms just high bp at a routine midwife check and some protein in urine. It all happened very quickly was admitted to hospital but everything turned out well in the end…”
Can doctors predict who is going to get it?
Maybe. Researchers at London’s Guys and St Thomas’ hospitals have developed a blood test that measures the amount placental growth factor in the blood (a protein found in the placenta).
They found that women with a low placental growth factor tend to get severe pre-eclampsia, meaning that their babies should be delivered within 14 days. Women with a high level of placental growth factor tend to only have a mild form, so they can probably safely carry their babies through to full term. The test accurately identified the severity of the condition 96% of the time. And whilst it’s still being trialled it could soon make a big difference.
What can I do to prevent it?
Having a healthy lifestyle helps - not smoking, being a healthy weight, and taking gentle exercise are important. And a recent study found that (hurrah) eating chocolate might actually offer some protection too.
In a study of 2,500 mums it was found that, “Women who reported regular chocolate consumption of more than three servings a week had a 50% or greater reduced risk of pre-eclampsia,” say researchers.
Will it affect me after my pregnancy?
Once you have pre-eclampsia there are certain conditions that may result from it- you might be more likely to suffer from a thyroid condition, so you should have post-natal thyroid checks but it’s easy to diagnose and treat.
There may also be a slightly increased risk of heart problems or stroke in later life, so regular check-ups are important, and if you have developed pre-eclampsia, take the recommended heart health measures of a healthy diet, exercise and stress-management.
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