Preeclampsia can be life threatening to expectant mother
Preeclampsia, sometimes called toxemia, is pregnancy-induced high blood pressure. Left untreated, it can progress into eclampsia or even hemolysis, elevated liver enzymes, and low platelet count (HELLP), life-threatening conditions for both mother and baby. High blood pressure occurs in 6 to 8 percent of all pregnancies in the United States, with 70 percent of these being first pregnancies. Researchers say the rate of preeclampsia has risen in the past decade by nearly one-third because of an increase in the number of older mothers and multiple births.
According to the March of Dimes, you may be at risk for preeclampsia if:
– This is your first pregnancy.
– There is a long interval between pregnancies (10 years or more).
– You are expecting multiple babies (twins plus).
– You are younger than 20 or older than 35.
– You are heavier than normal.
– You have a personal history of preeclampsia.
The National Institutes of Health (NIH) adds to this list women with diabetes, kidney disease, rheumatoid arthritis, lupus, scleroderma or chronic hypertension.
A more recently discovered risk factor for preeclampsia are women who have conceived through assisted reproduction techniques. Irish researchers have also found that women who work past the latter part of the second trimester of pregnancy are five times more likely to develop the condition than those who do not work.
Some researchers are even looking for a connection to fetus gender.
Typically, preeclampsia occurs during the second and third trimesters. Many women have no symptoms, as the main signs are high blood pressure and protein in the urine. Others may experience swelling of the hands and feet, sudden weight gain (more than a pound a day), blurred vision, severe headaches, dizziness and stomach pain. Severe cases can result in seizures.
Most often, preeclampsia is detected during a routine prenatal exam. The American College of Obstetricians and Gynecologists reports that women who receive no prenatal care are more than seven times as likely to die from complications of preeclampsia and eclampsia as women who receive any prenatal care. It’s vital to the baby’s and mother’s health to keep those appointments.
If preeclampsia develops into eclampsia, you risk permanent damage to your kidneys, brain and liver. It can also be fatal to the baby. Warning signs of this condition are a severe headache, pain in the upper right side of your abdomen, vision problems such as seeing flashing lights and a change in your mental status – decreased alertness, etc.
The only effective treatment for preeclampsia is delivery of the baby, but depending on the length of gestation, this may not be an option. In mild cases, bed rest at home may be appropriate, as long as a support system of family and friends is in place to care for you. Frequent visits to the doctor will also be part of the routine.
More serious cases will necessitate hospital care so that both mother and baby can be constantly monitored. The inducement of early labor, or perhaps even a C-section, may be required. Medication will likely be prescribed.
Unfortunately, there is no known way to prevent preeclampsia, but researchers are finding outcomes that look promising. One British study indicates taking vitamins C and E throughout the second half of pregnancy may be beneficial. (High-risk women taking these vitamins reduced their chances of developing preeclampsia by 75 percent).
Another study, done at the University of Washington in Seattle, found that women who exercise regularly before pregnancy are at a lower risk.
The Birmingham Women’s Hospital in England found that treating high-risk women with daily low-dose aspirin reduces the incidence of preeclampsia. They further state that aspirin has been established to be safe during pregnancy.
What else can you do? The NIH recommends the following before becoming pregnant:
1. Keep your blood pressure under control. Watch your salt intake, exercise regularly and lose weight if needed.
2. Talk to your doctor about high blood pressure and what you can do.
3. If taking medication for hypertension, discuss with your doctor what changes will be necessary during pregnancy. Many experts now recommend avoiding the ACE inhibitors and Angiotensin II receptor antagonists while pregnant, but never stop or switch medications without your doctor’s input.
During pregnancy, obtain regular prenatal care, avoid alcohol and tobacco, and talk with your doctor before taking any over-the-counter medications.
Preeclampsia and other hypertensive disorders are estimated to be responsible for 76,000 deaths yearly. Don’t take chances.
(Jan Hawkins is a freelance health care journalist who resides in northern Kentucky.)