Ask the Expert: Preeclampsia prevention for a healthier pregnancy
Globally, preeclampsia and other hypertensive disorders of pregnancy are one of the leading causes of maternal and infant illness and death. Around 4% of pregnant females in the U.S are diagnosed with preeclampsia. Worldwide, it accounts for roughly 76,000 maternal and 500,000 infant deaths each year. Some of these deaths could be potentially prevented by increasing awareness about preeclampsia, which may help in early detection and optimal treatment.
What is preeclampsia?
Preeclampsia is a type of hypertensive disorder exclusively seen in pregnancy and is defined as new-onset hypertension and the presence of proteins (in most cases) in the urine. Preeclampsia can occur any time after 20 weeks and up to six weeks after delivery. The usual parameters for initial identification of preeclampsia are specifically defined as a systolic blood pressure of 140 mm Hg or more or diastolic blood pressure of 90 mm Hg or more on two occasions at least 4 hours apart. The other symptoms suggestive of preeclampsia are:
Low platelet count
Elevated liver enzymes
Headache not explained by any other cause
Blurred vision
Breathing difficulty because of fluids in lungs (pulmonary edema)
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Who is at risk of preeclampsia?
Although any pregnant woman can develop preeclampsia, certain risk factors may further increase the risk of preeclampsia. Some of these risk factors are:
History of preeclampsia in a previous pregnancy
Medical conditions, such as pre-existing hypertension before pregnancy, obesity/overweight, diabetes, auto-immune disorders like lupus, and chronic kidney disease
Twin or other multi-fetal pregnancy
First pregnancy
Family history of preeclampsia
Advanced maternal age
Pregnancy achieved through the use of assisted reproductive technology
How is preeclampsia prevented?
There are few measures that can be taken, especially for pregnant women with risk factors, to reduce the chances of developing preeclampsia. These include:
Maintaining weight in the normal range prior to pregnancy
Controlling blood pressure and blood sugar
Doing regular exercise
Getting enough sleep
Eating healthy foods along with low salt and caffeine consumption
Baby aspirin may also be prescribed by doctors (especially for women with higher risks for developing preeclampsia).
How does preeclampsia affect pregnant women?
Preeclampsia may lead to some serious complications including:
Seizure, when it is called “eclampsia”
Stroke
Fluid collection in lungs (pulmonary edema)
Heart failure
Blurred vision
Bleeding
HELLP Syndrome (which stands for hemolysis, elevated liver enzymes, and low platelets)
Placental abruption, which results from the separation of the placenta from the uterus resulting in significant maternal blood loss.
What is the impact of preeclampsia on babies?
Preeclampsia can reduce blood supply to the placenta which may cause the baby to be born small.
Preeclampsia is also one of the common causes of preterm birth, which may result in complications like hearing and vision problems, developmental delays, difficulty in walking or using limbs, seizure disorders, etc.
Maternal bleeding as a result of preeclampsia may jeopardize the health of the fetus and may also lead to fetal loss.
How is preeclampsia treated?
Treatment depends on the severity of preeclampsia and how far along the woman is in pregnancy. To avoid the complications of preterm birth, doctors will try to control preeclampsia with medications with the aim of delivering the baby close to the due date. However, some women may not respond well to treatment and delivering the baby, even if preterm, becomes the only option to prevent the complications of preeclampsia.
Women with less severe features of preeclampsia may be treated with:
Bed rest
Monitoring fetal heart rate and frequent ultrasounds
Medicines to control blood pressure
Steroid injections to help the baby's lungs mature faster
Magnesium to prevent seizures
Certain blood and urine tests
Mohammad Adnan, MD, FAAP, is a neonatologist and vice-chair of the department of pediatrics at IU Health Ball. Learn more at iuhealth.org/find-medical-services/high-risk-pregnancy.
This article originally appeared on Muncie Star Press: Ask the Expert: Preeclampsia prevention for a healthier pregnancy