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PreeclampsiaPreeclampsia is a form of high blood pressure which is related to pregnancy. The cause of it is unclear, and no-one is sure why it occurs most in those who are to become a mom for the first time. Some suggest that preeclampsia may be linked to poor nutrition, and that low dosages of aspirin can lower the risk. Others believe that a high dose of calcium can help prevent it. In women who have developed the condition preeclampsia, toxic substances are found to be present in the blood. When these substances are put in test tubes with human cells, they are shown to damage the endothelial cells (which line blood vessels), which is why they are harmful. One theory as to why these toxins are produced is as a defensive or immune reaction to the presence of the baby who is seen as a foreign intruder by it. Normally there is a mechanism that prevents this from happening, but sometimes it can be absent, or fails during pregnancy. More research into this hypothesis might be able to lead to humans finding a way to deal with preeclampsia more effectively than we are currently doing so. Before finding a cure, a sure-fire way to identify the condition needs to be established. Currently, there are a few signs and symptoms which help to identify whether a mom-to-be is suffering from preeclampsia. Two possible symptoms are both related to the retention of water. These are swelling (especially in hand and face regions), and a rapid increase in weight. Blood pressure can skyrocket to 140/90 and above, even in those who have never suffered from high blood pressure problems previously. Unfortunately, preeclampsia can very quickly elevate to a severe condition with many more symptoms. Blood pressure rises even higher, 160/110 or more is common, and blurry vision, bad headaches, irritability, itchiness all over the body is all characteristic symptoms. If the condition is left without treatment, women suffering from preeclampsia can end up with severe gastric pain, abnormal functioning of kidneys and liver. If left for long enough, it can transform into eclampsia, which can leave the sufferer in a coma or having severe convulsions. Between 5-10% of pregnant women can be suffering from preeclampsia, and it can lead to damage of the nervous system, blood vessels and kidneys. It doesn’t just affect the mother, it can also promote growth retardation (caused by a reduction in blood supply), and result in the baby being deprived of oxygen. Those who seek medical care after noticing symptoms early on, can easily avoid damage to themselves or their baby. Sadly, sometimes preeclampsia doesn’t show any signs and symptoms until the time of delivery, or even later. If a rapid blood pressure boost occurs or high protein levels in urine is observed in women who have just delivered their baby, they are usually put under observation and watched extremely carefully to see if any other symptoms of preeclampsia develop. The treatment of preeclampsia varies according to how severe each individuals condition is (both mother and baby). The length of pregnancy is taken into account, and the doctor will make an informed decision on how to treat the disease. In mild cases, where the women is nearly at the end of her pregnancy term and she has a cervix which has softened and thinned out in preparation for the birth, pregnancy can be induced without a delay. In these cases, being confined to constant bed rest is unusual and observation/treatment normally doesn’t require the use of diuretics, medication to treat high blood pressure or any diet restrictions. Occasionally, the sufferer is permitted to go home and rest virtually straight away, as long as they have regular checkups (both by a nurse coming to the house, and going down the local doctors). Information to sufferers, even those who suffer mild cases is provided, in case the condition gets to a point where it worsens instead of lessens. Those who suffer should be taught what the danger signs are: really bad headaches, pain in the abdomen or vision problems. If any of these occur, expert medical attention should be sought out immediately, in an emergency situation. It won’t just be the mother who is assessed and her condition that is monitored once medical examiners have determined that the condition suffered is indeed preeclampsia. The baby is monitored just as regularly, movements of the fetus will be assessed, stress tests will be performed and many other types of observational tests if they are deemed appropriate. If the condition of the mother is seen to be affecting the baby, and it has been decided that the baby needs to be delivered, different delivery modes will then be assessed. As long as the cervix is in the correct condition and the baby isn’t suffering from an acute form of stress, then normal induced delivery is the best option. If the baby is suffering acutely, or conditions aren’t favourable for a normal delivery, a cesarian is the normally recommended option. Women with preeclampsia aren’t allowed to pass the 40th week of pregnancy, hence the need for induced labour or caesareans. This is because after 40 weeks, the condition inside the uterus will degrade rapidly. Fortunately, mild sufferers of preeclampsia have a very good prognosis and even after induced labour, the condition of mother and child is similar to that of mothers who have a normal blood pressure level. For women who have more severe cases of preeclampsia or if the mild cases progressively worsens, the treatment is more aggressive. Magnesium sulfate is promptly administered intravenously as this is known to prevent the mother from having convulsions which is one of the more serious symptoms of the disease. Similarly to those with mild cases, if it near the end of the pregnancy term and the baby seems capable of being able to survive outside, induced delivery occurs. If it is not near the end of the term, but it is past the 28 week mark, some doctors prefer to deliver the baby since they feel that this helps normalise blood pressure and that intensive care will provide a better environment for the baby than the mother’s uterus. When treating severe cases, some doctors, prefer to administer bed rest in hospital, medication, and close observations of the mother and baby, in order allow the fetus to have as much time to develop inside the uterus as possible. Others prescribe steroids and have them administered to the baby in order to speed up lung maturity so that it can breathe by itself. If blood pressure levels are too high, or deterioration occurs then labour is favourably induced. If the baby is within the 24-28 development period, conservative methods e.g. bed rest, is tried before labour is induced as a last resort. Thankfully, severe preeclampsia is uncommon before 24 weeks. Before 24 weeks of age, the fetus is deemed unable to live by itself and chances of survival are slim. Prompt delivery of an extremely premature baby can be necessary so that the condition of the mother can get better. There is a high chance of a favourable outcome for both the mother and baby if the appropriate medical treatment is administered as soon as possible - up to 97% of women suffering from preeclampsia have their blood pressure return to normal and symptoms subside. The condition usually disappears within 24 hours of an effective delivery, but it can take up to a week. If symptoms have not disappeared after 6 weeks, the likelihood is that it is another disease that is affecting the mother. Pregnancy Week To Week 1- 40
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