What Is Preeclampsia?
Preeclampsia is a type of hypertensive (ie, high blood pressure) disorder that affects 2-8% of pregnancies.1 Preeclampsia usually occurs later in the pregnancy and is diagnosed when a pregnant woman >20 weeks of gestation has a new-onset hypertension defined as a systolic blood pressure of >140 mm Hg and/or a diastolic blood pressure of >90 mm Hg along with one or more of the following new-onset symptoms:2
- Proteinuria (ie, elevated levels of protein in urine)
- Dysfunction of end-organs such as acute kidney injury, liver injury, fluid build-up in the lungs, neurological complications (eg, severe headache), blood count complications (eg, low platelet count)
- Dysfunction of the uterus or placenta (eg, placental abruption, fetal growth restriction)
What Are the Symptoms of Preeclampsia?
Pregnant women with preeclampsia often present with clear symptoms that should prompt health care professionals for further diagnostic testing.3 Here are some common symptoms of preeclampsia:
- Sudden onset of headache with or without visual changes that does not respond to medications
- Stomach pain
- Nausea or vomiting
- Shortness of breath
- Increased swelling
Who Is at Risk for Preeclampsia?
Women with chronic hypertension and those who have had preeclampsia during a prior pregnancy are considered to be at the highest risk of developing preeclampsia.2 Other risk factors include:
- Pre-pregnancy body mass index >30 kg/m2
- Maternal age >40 years
- Current pregnancy assisted by fertility treatments
- Currently pregnant with more than one child (eg, twins, triplets)
- Never given birth or been pregnant prior to current pregnancy
- Prior placental abruption, stillbirth, fetal growth restriction
- Preexisting diabetes mellitus
- Chronic kidney disease
- Autoimmune conditions such as systemic lupus erythematosus
How Do You Prevent and Manage Preeclampsia?
Preeclampsia can lead to severe complications if left untreated.3 Eclampsia (ie, convulsive seizures with hypertension, headaches, and blurry vision), HELLP syndrome (ie, life-threatening complication marked by hemolysis, elevated liver enzymes, and low platelets), heart attack, stroke, and fetal or maternal death are some of the serious consequences of preeclampsia.
The best way to avoid preeclampsia and its serious complications is prevention. Unless otherwise discouraged by their health care team, all pregnant women are encouraged to exercise and take calcium supplements of at least 500 mg/d if their dietary calcium intake is low.2 In women considered to be at risk, guidelines strongly suggest taking a low-dose aspirin every night, from before 16 weeks of gestation until 36 weeks of gestation. No treatment has been shown to prevent preeclampsia completely, but the above recommendations have been shown to reduce the risk.
In women diagnosed with preeclampsia, management options should be weighed to optimize both maternal and fetal health.1 Treatment options such as corticosteroids and magnesium sulfate aim at reducing the risk of adverse fetal outcome associated with premature birth. Corticosteroid reduces the risk of respiratory distress syndrome and death of infant while magnesium sulfate reduces the risk of cerebral palsy in infants while preventing seizures in pregnant women. Ultimately, the only true treatment for preeclampsia is delivery.3 In women who are at full-term (>37 weeks of gestation), delivery is often recommended.
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