The Pre-eclampsia

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The pre-eclampsia

What is pre-eclampsia?

Pre-eclampsia is a potentially dangerous complication that can occur during pregnancy and affects about 2% of pregnant women. The exact causes are not known, but it could be caused by a malformation in the placenta that releases toxic substances into the mother’s bloodstream, leading to high blood pressure and higher levels of protein in the urine.

What are the symptoms?

The symptoms vary from woman to woman and do not necessarily all occur simultaneously:

• Very high blood pressure
• Oedemas (or swelling) of the feet and ankles, hands or face as well as sudden, rapid weight gain.
• Severe, unusual and/or persistent headaches.
• Dizziness
• Tinnitus
• Severe lower abdominal pain or heartburn
• Nausea and/or vomiting
• Sleepiness
• Impairment of vision and hearing

These symptoms may occur starting from the 20th week of pregnancy and up to 4 weeks after birth.

Complications

Pre-eclampsia may lead to serious complications for the mother and child. 
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For the mother: The complications may take on various forms depending on the severity and the affected organs (brain, kidneys, liver). There are two main types of complications:

• ​​​​​​​ The HELLP syndrome is characterized by liver damage; it occurs in 5 to 20% of cases of pre-eclampsia, most commonly in the 3rd trimester of pregnancy. The symptoms are bruising, headaches, oliguria (low output of urine) and oedema. The mother needs to be given more intensive monitoring with medical treatment. In extreme cases it may result in premature childbirth. 

• ​​​​​​​ ​​​​​​​Eclampsia is a generalised seizure. It usually occurs as the main complication of pre-eclampsia. This is a life-threatening emergency for the woman and the unborn child. In this case labour is induced as quickly as possible.

For the child: One of the main characteristics of pre-eclampsia is the reduction of blood flow from the mother to the placenta, which results in an insufficient supply of oxygen and nutrients to the foetus. This can lead to premature birth, low birth weight, an increased risk of cardiovascular disease in later life or even to death.

How great is my risk of developing pre-eclampsia?

Pre-eclampsia occurs in the first pregnancy in 70 to 75% of cases. This does not preclude its occurrence in subsequent pregnancies, however. The disease is caused by multiple factors (e.g. pre-eclampsia in a previous pregnancy, type 1 or 2 diabetes, obesity, etc.) but it appears that a genetic predisposition contributes to up to 50% of occurrences of pre-eclampsia.

There is a screening test that accounts for all of these risk factors and combines them with a bio-chemical test (the PLGF protein) in the 1st trimester. This statistical calculation makes it possible to determine an increased risk and, in that case, to start prophylactic treatment. That can lower your risk of developing pre-eclampsia later in the pregnancy.

Can pre-eclampsia be treated?

At the moment the only promising treatment consists of giving birth. But the first symptoms can start long before the end of the pregnancy. In these cases the treatment aims to lower blood pressure in order to delay a premature birth as much as possible. Treatments are also performed to help the baby’s lungs mature. In any case, pre-eclampsia entails intensive medical monitoring and treatment. Talk to your doctor.

Can pre-eclampsia be prevented?

Most patients who are diagnosed early and treated correctly give birth to a healthy child and recover quickly.