Preeclampsia

Causes and risk factors

During pregnancy new blood vessels are formed in order to send blood to the placenta that nourishes the foetus. In preeclampsia, these blood vessels are not formed properly. They are narrower than normal vessels and restrict the blood flow within them giving rise to high blood pressure. The following increase the risk of hypertension in a pregnant woman-Gestational age below 20 years or above 35 years, first pregnancy [primi gravida], multiple pregnancies, prolonged interval between pregnancies. Patient having previous history of pre-eclampsia, family history of gestational hypertension, placental abnormalities may suffer from this condition. Underweight or overweight female, obesity, are also associated with higher risk of developing pre-eclampsia. Preeclampsia can occur as a primary disorder or a secondary disorder due to pre-existing pathology like chronic hypertension, chronic renal disease etc.

Clinical presentation

Patient with preeclampsia has following signs and symptoms- Systolic blood pressure higher than 140 mm Hg and Diastolic blood pressure higher than 90 mm Hg in a pregnant woman after 20 weeks of gestation, Proteinuria – passing excessive protein in your urine, reduced urine output. Oedema and swelling over hands and face, sudden weight gain, more than 1 kg per week can be seen. Patient experiences pain in the right upper portion of the abdomen, nausea, vomiting. Severe headaches, visual changes like temporary loss of vision, blurring of vision, photophobia etc. can also be observed. Preeclampsia may present with gestational hypertension, superimposed preeclampsia to chronic hypertension.

Investigation

Medical history by the patient and Clinical examination by the gynaecologist helps in diagnosis. Checking of blood pressure, patient’s weight and foetal heart sound at every ANC visit is essential. Periodic urine analysis is helpful in diagnosis of proteinuria. Routine blood test to monitor platelet count, Blood test including liver function tests, kidney function tests will help in diagnosis.  Foetal ultrasound, non stress test [NST] will also help in the assessment.

Treatment

Delivery of the baby will put an end to pre-eclampsia. Hence, if the due date is near enough, induction of labour or a C-section may be considered. Medications such as methyl dopa, corticosteroids,sedatives, anti convulsants etc. may be prescribed. Lifestyle changes like restricted salt and fluid intake, adequate amount of protein in diet and sufficient bed rest will also help in managing preeclampsia.

Other Modes of treatment

The other modes of treatment can also be effective in treating preeclampsia. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating preeclampsia.

Recent update

Research work has been published on sFLT-1, a protein related to development of blood vessel in early pregnancy and its relation to vascular dysfunction associated with preeclampsia.