Preeclampsia

One in 20 women in their first pregnancies will develop a condition called preeclampsia. If left untreated, it can be deadly and in fact is the leading cause of maternal death, according to the National Institute of Child Health and Human Development (NICHD). The rate in second pregnancies is lower, between 1 and 2 percent, but it can be just as dangerous, striking without warning.

What is preeclampsia?

The exact reasons and the cause of preeclampsia are still under investigation. The results of the condition however are well known. The Preeclampsia Foundation (PF) says it occurs typically in the late second or third trimesters (Read about "Stages of Pregnancy") and results in high blood pressure (Read about "Hypertension: High Blood Pressure") and protein in the urine. (Read about "The Urinary System") It only occurs in pregnant women. The American Medical Association (AMA) points out that not all high blood pressure during pregnancy indicates preeclampsia but it should still be treated appropriately. The American Academy of Family Physicians (AAFP) says teenage mothers, women over 40 and women carrying multiple babies are at a greater risk of developing preeclampsia. Women with high blood pressure or kidney disease (Read about "Kidney Disease") before pregnancy are also at greater risk.

Symptoms

The major symptoms as already mentioned are high blood pressure and protein in the urine. Prenatal care (Read about "Prenatal Care") is crucial in spotting the condition in its early stages when it can be treated. The American College of Obstetrics and Gynecology (ACOG) says women without prenatal care are seven times more likely to die from preeclampsia and its complications. Symptoms according to ACOG, AMA and PF can include:

• high blood pressure
• proteinuria (protein in the urine)
• increased reflexes (hyperreflexia)
• swelling in the ankles, lower legs, hands or face
• sudden weight gain
• headaches
• vision problems
• abdominal pain, often under the right-side ribs
• right shoulder pain
• nausea or vomiting
• liver changes (Read about "The Liver")
• decreased urine output or dark brown urine

If not treated, the condition can progress to life-threatening convulsions (Read about "Seizures"), and the condition is then called eclampsia.

Dangers for the baby

The March of Dines says preeclampsia can constrict the blood vessels in the uterus that supply the fetus with oxygen and nutrients. This eventually can slow the fetus's growth. AMA says that low birth weight, premature birth and even stillbirth can result. NICHD says preeclampsia can also cause what is called abruptio placentae, when the placenta detaches from the uterine wall. (Read about "Placental Complications") This can lead to heavy bleeding. In severe cases, abruptio placentae can result in maternal shock and/or death to the fetus.

Treatment

There is no cure for preeclampsia, according to NICHD, aside from delivery of the baby. This may not be possible, however, because the baby may be too immature or premature to survive outside the womb. In that case, AAFP says steps can be taken to manage the condition. They include, lowering blood pressure, with drugs if required and bed rest. Your doctor will want to monitor closely your condition during this time. In some cases, hospitalization is required.

HELLP Syndrome

HELLP syndrome is a rare, but serious liver disorder. The Preeclampsia Foundation calls it a variant of preeclampsia that is found in tandem with preeclampsia. It is sometimes a forerunner of preeclampsia, with blood chemistry showing the signs of HELLP before the signs of preeclampsia, such as high blood pressure appear. The American Academy of Family Physicians (AAFP) says that it usually develops in the third trimester, and often very quickly.

HELLP is diagnosed in pregnant women who have:

• H - hemolysis - destruction of red blood cells
• EL - elevated liver enzymes - indicates liver damage
• LP - low platelet count - clotting cells found in the blood that control bleeding

According to AAFP, women with the HELLP syndrome may experience bleeding problems, liver problems and blood pressure problems that could harm the mother and the baby. The causes of HELLP are unknown. However, AAFP lists some women who may be at increased risk of developing it.

• white women over 25
• high blood pressure conditions
• previous pregnancies
• previous history of HELLP

HELLP syndrome often occurs without warning and can be difficult to recognize. The Preeclampsia Foundation lists these symptoms:

• pain in the upper right abdomen (liver)
• headaches
• nausea or vomiting
• swelling, especially in the face and hands

Delivery is the only known way to reverse HELLP syndrome, even if the birth is premature. (Read about "Preterm Labor") If you aren't too sick, AAFP says your doctor may try to wait a short period before delivering the bay to allow it to develop more - a good reason to monitor your health if you are at risk.

Related Information:

    Pregnancy Resource Center

    Healthy Pregnancy

    Women and Blood Pressure

    Thrombophilia

    Pregnancy Terms Glossary

    Woman's Health Terms Glossary