What are early signs of preeclampsia

Preeclampsia - Symptoms and causes

Overview

Preeclampsia is a complication of pregnancy. With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range.

Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and baby.

Early delivery of the baby is often recommended. The timing of delivery depends on how severe the preeclampsia is and how many weeks pregnant you are. Before delivery, preeclampsia treatment includes careful monitoring and medications to lower blood pressure and manage complications.

Preeclampsia may develop after delivery of a baby, a condition known as postpartum preeclampsia.

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Symptoms

The defining feature of preeclampsia is high blood pressure, proteinuria, or other signs of damage to the kidneys or other organs. You may have no noticeable symptoms. The first signs of preeclampsia are often detected during routine prenatal visits with a health care provider.

Along with high blood pressure, preeclampsia signs and symptoms may include:

Excess protein in urine (proteinuria) or other signs of kidney problems
Decreased levels of platelets in blood (thrombocytopenia)
Increased liver enzymes that indicate liver problems
Severe headaches
Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
Shortness of breath, caused by fluid in the lungs
Pain in the upper belly, usually under the ribs on the right side
Nausea or vomiting

Weight gain and swelling (edema) are typical during healthy pregnancies. However, sudden weight gain or a sudden appearance of edema — particularly in your face and hands — may be a sign of preeclampsia.

When to see a doctor

Make sure you attend your prenatal visits so that your health care provider can monitor your blood pressure. Contact your provider immediately or go to an emergency room if you have severe headaches, blurred vision or other visual disturbances, severe belly pain, or severe shortness of breath.

Because headaches, nausea, and aches and pains are common pregnancy complaints, it's difficult to know when new symptoms are simply part of being pregnant and when they may indicate a serious problem — especially if it's your first pregnancy. If you're concerned about your symptoms, contact your doctor.

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Causes

The exact cause of preeclampsia likely involves several factors. Experts believe it begins in the placenta — the organ that nourishes the fetus throughout pregnancy. Early in a pregnancy, new blood vessels develop and evolve to supply oxygen and nutrients to the placenta.

In women with preeclampsia, these blood vessels don't seem to develop or work properly. Problems with how well blood circulates in the placenta may lead to the irregular regulation of blood pressure in the mother.

Other high blood pressure disorders during pregnancy

Preeclampsia is one high blood pressure (hypertension) disorder that can occur during pregnancy. Other disorders can happen, too:

Gestational hypertension is high blood pressure that begins after 20 weeks without problems in the kidneys or other organs. Some women with gestational hypertension may develop preeclampsia.
Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy. High blood pressure that continues more than three months after a pregnancy also is called chronic hypertension.
Chronic hypertension with superimposed preeclampsia occurs in women diagnosed with chronic high blood pressure before pregnancy, who then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy.

Risk factors

Conditions that are linked to a higher risk of preeclampsia include:

Preeclampsia in a previous pregnancy
Being pregnant with more than one baby
Chronic high blood pressure (hypertension)
Type 1 or type 2 diabetes before pregnancy
Kidney disease
Autoimmune disorders
Use of in vitro fertilization

Conditions that are associated with a moderate risk of developing preeclampsia include:

First pregnancy with current partner
Obesity
Family history of preeclampsia
Maternal age of 35 or older
Complications in a previous pregnancy
More than 10 years since previous pregnancy

Other risk factors

Several studies have shown a greater risk of preeclampsia among Black women compared with other women. There's also some evidence of an increased risk among indigenous women in North America.

A growing body of evidence suggests that these differences in risk may not necessarily be based on biology. A greater risk may be related to inequities in access to prenatal care and health care in general, as well as social inequities and chronic stressors that affect health and well-being.

Lower income also is associated with a greater risk of preeclampsia likely because of access to health care and social factors affecting health.

For the purposes of making decisions about prevention strategies, a Black woman or a woman with a low income has a moderately increased risk of developing preeclampsia.

Complications

Complications of preeclampsia may include:

Fetal growth restriction. Preeclampsia affects the arteries carrying blood to the placenta. If the placenta doesn't get enough blood, the baby may receive inadequate blood and oxygen and fewer nutrients. This can lead to slow growth known as fetal growth restriction.
Preterm birth. Preeclampsia may lead to an unplanned preterm birth — delivery before 37 weeks. Also, planned preterm birth is a primary treatment for preeclampsia. A baby born prematurely has increased risk of breathing and feeding difficulties, vision or hearing problems, developmental delays, and cerebral palsy. Treatments before preterm delivery may decrease some risks.
Placental abruption. Preeclampsia increases your risk of placental abruption. With this condition, the placenta separates from the inner wall of the uterus before delivery. Severe abruption can cause heavy bleeding, which can be life-threatening for both the mother and baby.
HELLP syndrome. HELLP stands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count. This severe form of preeclampsia affects several organ systems. HELLP syndrome is life-threatening to the mother and baby, and it may cause lifelong health problems for the mother.

Signs and symptoms include nausea and vomiting, headache, upper right belly pain, and a general feeling of illness or being unwell. Sometimes, it develops suddenly, even before high blood pressure is detected. It also may develop without any symptoms.
Eclampsia. Eclampsia is the onset of seizures or coma with signs or symptoms of preeclampsia. It is very difficult to predict whether a patient with preeclampsia will develop eclampsia. Eclampsia can happen without any previously observed signs or symptoms of preeclampsia.

Signs and symptoms that may appear before seizures include severe headaches, vision problems, mental confusion or altered behaviors. But, there are often no symptoms or warning signs. Eclampsia may occur before, during or after delivery.
Other organ damage. Preeclampsia may result in damage to the kidneys, liver, lung, heart, or eyes, and may cause a stroke or other brain injury. The amount of injury to other organs depends on how severe the preeclampsia is.
Cardiovascular disease. Having preeclampsia may increase your risk of future heart and blood vessel (cardiovascular) disease. The risk is even greater if you've had preeclampsia more than once or you've had a preterm delivery.

Prevention

Medication

The best clinical evidence for prevention of preeclampsia is the use of low-dose aspirin. Your primary care provider may recommend taking an 81-milligram aspirin tablet daily after 12 weeks of pregnancy if you have one high-risk factor for preeclampsia or more than one moderate-risk factor.

It's important that you talk with your provider before taking any medications, vitamins or supplements to make sure it's safe for you.

Lifestyle and healthy choices

Before you become pregnant, especially if you've had preeclampsia before, it's a good idea to be as healthy as you can be. Talk to your provider about managing any conditions that increase the risk of preeclampsia.

By Mayo Clinic Staff

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What Is Preeclampsia?

Preeclampsia, formerly called toxemia, is when pregnant women have high blood pressure, protein in their urine, and swelling in their legs, feet, and hands. It can range from mild to severe. It usually happens late in pregnancy, though it can come earlier or just after delivery.

Preeclampsia can lead to eclampsia, a serious condition that can have health risks for mom and baby and, in rare cases, cause death. If your preeclampsia leads to seizures, you have eclampsia.

The only cure for preeclampsia is to give birth. Even after delivery, symptoms of preeclampsia can last 6 weeks or more.

You can help protect yourself by learning the symptoms of preeclampsia and by seeing your doctor for regular prenatal care. Catching preeclampsia early may lower the chances of long-term problems for both mom and baby.

Preeclampsia Symptoms

In addition to swelling (also called edema), protein in the urine, and blood pressure over 140/90, preeclampsia symptoms include:

Weight gain over 1 or 2 days because of a large increase in bodily fluid
Shoulder pain
Belly pain, especially in the upper right side
Severe headaches
Change in reflexes or mental state
Peeing less or not at all
Dizziness
Trouble breathing
Severe vomiting and nausea
Vision changes like flashing lights, floaters, or blurry vision

Some women with preeclampsia don’t have any symptoms, so it’s important to see your doctor for regular blood pressure checks and urine tests.

When Do Symptoms Show Up?

Preeclampsia can happen as early as 20 weeks into pregnancy, but that’s rare. Symptoms often begin after 34 weeks. In a few cases, symptoms develop after birth, usually within 48 hours of delivery. They tend to go away on their own.

Preeclampsia Causes

Many experts think preeclampsia and eclampsia happen when a woman’s placenta doesn’t work the way it should, but they don’t know exactly why. Some think poor nutrition or high body fat might contribute. A lack of blood flow to the uterus could play a role. Genes are also a factor.

Other High Blood Pressure Disorders in Pregnancy

Preeclampsia is one of four blood pressure disorders in pregnant women. The other three are:

Gestational hypertension. This is high blood pressure that starts after the 20th week of pregnancy but doesn’t cause high amounts of protein in a woman’s urine. It usually goes away after delivery.
Chronic hypertension. This is high blood pressure that starts before a woman gets pregnant or before the 20th week of pregnancy.
Chronic hypertension with superimposed preeclampsia. This is chronic high blood pressure that gets worse as pregnancy goes on, causing more protein in urine and other complications.

Preeclampsia Risk Factors

Things that can increase your chance of getting preeclampsia include:

Being a teen or woman over 40
Being African American
Being pregnant for the first time
Having babies less than 2 years apart or more than 10 years apart
Pregnancy with a new partner instead of the father of your previous children
High blood pressure before getting pregnant
A history of preeclampsia
A mother or sister who had preeclampsia
A history of obesity
Carrying more than one baby
In-vitro fertilization
A history of diabetes, kidney disease, lupus, or rheumatoid arthritis

Preeclampsia Complications

Preeclampsia can keep your placenta from getting enough blood, which can cause your baby to be born very small. This is called fetal growth restriction.

It’s also one of the most common causes of premature births and the complications that can follow, including learning disabilities, epilepsy, cerebral palsy, and hearing and vision problems.

Preeclampsia can cause rare but serious complications that include:

Stroke
Seizure
Fluid buildup in your chest
Heart failure
Reversible blindness
Bleeding from your liver
Bleeding after you've given birth

When preeclampsia or eclampsia damages your liver and blood cells, you can get a complication called HELLP syndrome. That stands for:

Hemolysis. This is when the red blood cells that carry oxygen through your body break down.
Elevated liver enzymes. High levels of these chemicals in your blood mean liver problems.
Low platelet counts. This is when you don’t have enough platelets, so your blood doesn’t clot the way it should.

HELLP syndrome is a medical emergency. Call 911 or go to the emergency room if you have symptoms including:

Blurry vision
Chest or belly pain
Headache
Fatigue
Upset stomach or vomiting
Swelling in your face or hands
Bleeding from your gums or nose

Preeclampsia can also cause your placenta to suddenly separate from your uterus, which is called placental abruption. This can lead to stillbirth.

Preeclampsia Diagnosis

You have preeclampsia if you have high blood pressure and at least one of these other signs:

Too much protein in your urine
Not enough platelets in your blood
High levels of kidney-related chemicals in your blood
High levels of liver-related chemicals in your blood
Fluid in your lungs
A new headache that doesn’t go away when you take medication

To confirm a diagnosis, your doctor might give you tests including:

Blood tests to check your platelets and to look for kidney or liver chemicals
Urine tests to measure proteins
Ultrasounds, nonstress tests, or biophysical profiles to see how your baby is growing

Preeclampsia Treatment

The only cure for preeclampsia and eclampsia is to give birth. Your doctor will talk with you about when to deliver based on how far along your baby is, how well your baby is doing in your womb, and the severity of your preeclampsia.

If your baby has developed well, usually by 37 weeks or later, your doctor may want to induce labor or do a cesarean section. This will keep preeclampsia from getting worse.

If your baby isn’t close to term, you and your doctor may be able to treat mild preeclampsia until your baby has developed enough to be safely delivered. The closer the birth is to your due date, the better it is for your baby.

If you have mild preeclampsia, also known as preeclampsia without severe features, your doctor may prescribe:

Bed rest, either at home or in the hospital; resting mostly on your left side
Careful monitoring with a fetal heart rate monitor and frequent ultrasounds
Medicines to lower your blood pressure
Blood and urine tests

Your doctor also may tell you to stay in the hospital so they can watch you closely. In the hospital, you might get:

Medicine to help prevent seizures, lower your blood pressure, and prevent other problems
Steroid injections to help your baby's lungs develop faster

Other treatments include:

Injections of magnesium to prevent eclampsia-related seizures
Hydralazine or another blood pressure drug

For severe preeclampsia, your doctor may need to deliver your baby right away, even if you're not close to term. Afterward, symptoms of preeclampsia should go away within 1 to 6 weeks but could last longer.

Preeclampsia Prevention

If you have a greater chance of getting preeclampsia, talk to your doctor about making lifestyle changes that can help keep you healthy. You might need to:

Lose some weight if you’re overweight
Stop smoking
Exercise regularly
Get your blood pressure or blood sugar under control

Your doctor might also tell you to take a low-dose (81 milligram) aspirin each day. But don’t take any medications, vitamins, or supplements without talking to them first.

9 early signs of pre-eclampsia - a deadly complication of pregnancy

Every twentieth pregnant woman, or 5% of all mothers-to-be, faces this life-threatening disease.

Vera Ermakova

Pre-eclampsia is a serious complication that occurs in 5-8% of all pregnant women. If measures are not taken in time, it may well develop into full-scale eclampsia, which in turn can lead to the death of the mother and child. For this reason, it is important to know the early signs of preeclampsia and consult a doctor at the slightest suspicion.

Contents of the article

Increased blood pressure

Monitor your blood pressure throughout your pregnancy - and be sure to tell your doctor if you notice an increase. It is important to know your normal pressure in order to notice a change in this indicator in time - and to attract the attention of a doctor if it rises.

Protein in the urine

One of the classic symptoms of preeclampsia is increased protein in the urine. As doctors explain, this can happen due to damage to the blood vessels in the kidneys caused by high blood pressure. However, it is important to remember that although this is a common, but not an obligatory symptom: enough cases have been identified when preeclampsia developed, and the protein level remained the same.

Decreased frequency of urination

Another warning sign is infrequent or more scanty urination. If you go to the toilet less often, or if you notice that the volume of urination has decreased, this may be a sign of impaired kidney function and preeclampsia.

Puffiness

Most often, preeclampsia develops in the third trimester of pregnancy, when expectant mothers are especially prone to edema. But there is one sign that will help distinguish dangerous swelling caused by preeclampsia: during this disease, excess fluid accumulates in the face and hands. If you notice something similar in yourself, it is important to immediately consult a doctor.

Severe headaches

Another symptom that can be confused with pregnancy is severe headaches. But doctors advise paying attention to those migraines that last a long time or return after a short (less than a day) break. In any case, if you suffer from headaches, you should pay attention to the rest of the symptoms of preeclampsia and immediately consult a doctor if you have the slightest suspicion.

Nausea and vomiting

Toxicosis of pregnancy usually resolves in the second trimester. If you feel nausea or vomiting at a later date, you should tell your doctor about it and check for signs of pre-exlampsia: a study conducted in Norway confirmed the connection between this disease and toxicosis that continued into the second and third trimesters of pregnancy.

Weight gain

Rapid weight gain during pregnancy is often associated with the development of edema - which, as mentioned above, can be a sign of preeclampsia. You should consult a doctor if the weight gain was abrupt - for example, adding a kilogram over two to three days.

Impaired vision

Up to 50% of patients with pre-eclampsia reported some form of vision related symptoms: blurry vision, spots or flashes, increased photosensitivity. This may be due to developing swelling of the optic nerve, which in turn can warn of developing cerebral edema. Be sure to see a doctor!

Pain in the upper abdomen

Persistent pain localized in the upper right abdomen is a reason to immediately consult a doctor. This symptom may indicate a severe form of preeclampsia, in which swelling of the liver occurs. If measures are not taken in time, this organ may rupture. sometimes pains radiate to the lower back and even the shoulder - and it is important to take action as soon as possible and consult a doctor.

Preeclampsia and pregnancy | Ida-Tallinna Keskhaigla

The purpose of this leaflet is to provide the patient with information about the nature, occurrence, risk factors, symptoms and treatment of preeclampsia.

What is preeclampsia?

Pre-eclampsia is a disease that occurs during pregnancy and is characterized by high blood pressure and protein in the urine. Preeclampsia is one of the most common complications of pregnancy. Epilepsy-like seizures occur in severe preeclampsia and are life-threatening.

What symptoms may indicate the development of preeclampsia?

High blood pressure - blood pressure values are 140/90 mmHg. Art. or higher. If systolic (upper) or diastolic (lower) blood pressure rises by 30 mm Hg. Art. or more, then such an increase cannot be ignored.

Protein in urine - 300 mg in urine collected over 24 hours, or +1 value on a rapid test.

Swelling of the arms, legs or face , especially under the eyes or if the swelling leaves a depression in the skin when pressed. Edema can occur in all pregnant women and is generally harmless, but rapidly developing edema should be taken into account.

Headache that does not improve after taking pain medication.

Visual disturbances - double vision or blurred vision, dots or flashes before the eyes, auras.

Nausea or pain in the upper abdomen - These symptoms are often mistaken for indigestion or gallbladder pain. Nausea in the second half of pregnancy is not normal.

Sudden weight gain - 2 kg or more per week.

As a rule, there is a mild course of the disease that occurs at the end of pregnancy and has a good prognosis. Sometimes, preeclampsia can worsen quickly and be dangerous to both mother and fetus. In such cases, rapid diagnosis and careful monitoring of the mother and child are of paramount importance.

Unfortunately, most women develop symptoms in the final stages of the disease. If you experience any of the above symptoms, you should contact your midwife, gynecologist, or the Women's Clinic emergency department.

Is preeclampsia called toxemia of pregnancy?

Previously, pre-eclampsia was really called toxicosis, or toxemia, since it was believed that the cause of the disease was toxins, that is, poisons in the blood of a pregnant woman.

What is the difference between preeclampsia and gestational hypertension?

Pregnancy hypertension is an increase in blood pressure above normal after the 20th week of pregnancy. With hypertension of pregnant women, protein in the urine is not observed.

What is HELLP syndrome?

HELLP syndrome is one of the most severe forms of preeclampsia. HELLP syndrome is rare and sometimes develops before symptoms of preeclampsia appear. Sometimes the syndrome is difficult to diagnose, as the symptoms resemble gallbladder colic or a cold.

When does preeclampsia occur?

Preeclampsia usually occurs after the 20th week of pregnancy. As a rule, preeclampsia goes away after delivery, but complications can occur up to six weeks after delivery, during which careful monitoring of the condition is necessary. If by the sixth week after birth, blood pressure does not return to normal, then you need to contact a cardiologist, who will begin treatment against hypertension.

What is the cause of preeclampsia?

The causes of the disease are still not clear, there are only unproven hypotheses.

How does the disease affect pregnant women and pregnancy?

Most preeclamptic pregnancies have a favorable outcome and a healthy baby is born. However, the disease is very serious and is one of the most common causes of death of the child and mother. Preeclampsia affects a woman's kidneys, liver, and other vital organs, and if left untreated, it can cause seizures (eclampsia), cerebral hemorrhage, multiple organ failure, and death.

How does the disease affect the fetus?

In preeclampsia, the fetus does not receive enough oxygen and nutrients to grow, and intrauterine growth retardation may occur. In addition, the placenta may separate from the uterine wall before the baby is born. Since the only treatment for preeclampsia is childbirth, sometimes a pregnancy has to be terminated prematurely. Until the 34th week of pregnancy, the lungs of the fetus have not yet matured, and steroid hormones are administered intravenously to the pregnant woman to prepare her lungs. In addition to the immaturity of the lungs, the health of a premature baby is threatened by many other diseases.

Who is at risk for preeclampsia?

Pre-eclampsia occurs in approximately 8% of pregnant women, many of whom have no known risk factors.

What are the risk factors for preeclampsia?

Patient-related risk factors

First pregnancy
Pre-eclampsia during a previous pregnancy
Age over 40 or under 18
High blood pressure before pregnancy
Diabetes before or during pregnancy
Multiple pregnancy
Overweight (BMI> 30)
Systemic lupus erythematosus or other autoimmune disease
Polycystic ovary syndrome
Long interval between two pregnancies

Risk factors associated with the patient's family

What is the prevention and treatment of preeclampsia

During the first trimester screening, or Oscar test, in addition to the most common chromosomal diseases, the risk of preeclampsia is also calculated. In case of high risk, pregnant women are advised to take aspirin (acetylsalicylic acid) at a dose of 150 mg in the evenings until the 36th week of pregnancy. This helps reduce the chance of preeclampsia by the 34th week of pregnancy by up to 80%.

Childbirth is the only treatment for preeclampsia. Sometimes a child can be born naturally, but sometimes, if the disease is very acute, an emergency caesarean section is necessary. The best time to have a baby is after the 37th week of pregnancy. Bed rest, medications, and, if necessary, hospitalization can sometimes help bring the condition under control and prolong the pregnancy. Often, a doctor will refer a woman with preeclampsia to the hospital for observation, as the condition of the fetus and pregnant woman may suddenly worsen.

Does bed rest help?

Sometimes bed rest is enough to bring mild preeclampsia under control. In this case, the patient often visits a doctor who measures blood pressure, does blood and urine tests, and monitors the course of the disease. The condition of the fetus is also often examined using a cardiotocogram (CTG) and ultrasound.

Are medications used to treat preeclampsia?

High blood pressure sometimes requires medication. The medications used have few side effects, the drugs prescribed do not have much effect on the fetus, but are very important in the treatment of maternal high blood pressure.

Seizures are a rare but very serious complication of preeclampsia. Magnesium sulfate is sometimes given intravenously to prevent seizures in a pregnant woman with preeclampsia both during and after childbirth. It is safe for the fetus, but the mother may experience side effects such as hot flashes, sweating, thirst, visual disturbances, mild confusion, muscle weakness, and shortness of breath.

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