What is Preeclampsia?

Preeclampsia is a condition that can occur as a complication of pregnancy. It usually occurs after the 20th week of pregnancy and is characterized by high blood pressure and high levels of protein in the urine. While it's more common for preeclampsia to occur during pregnancy, it can also develop after the delivery of the baby which is called postpartum preeclampsia. Some other signs or symptoms that can point towards preeclampsia also include decreased levels of platelets, severe headaches, changes in vision, shortness of breath, or sudden appearance of edema.

Preeclampsia is known to be multifactorial. One of the biggest causes is the underdevelopment of the blood vessels that are supposed to form and evolve to supply oxygen and nutrients to the placenta. This leads to irregular circulation of the blood in the placenta which can cause a higher blood pressure in the mother. While having a high blood pressure is an important factor in the diagnosis of preeclampsia, it is important to differentiate between other high blood pressure disorders that also occur during pregnancy. For example, if a pregnant woman develops high blood pressure after 20 weeks and has no other signs of organ damage, then she is most likely to have gestational hypertension. If the high blood pressure occurs before 20 weeks, then it is termed chronic hypertension. If a woman is diagnosed with chronic hypertension prior to pregnancy and has worsening high blood pressure with proteinuria, she most likely can have chronic hypertension with superimposed preeclampsia.

Some risk factors that can predispose women to preeclampsia are having preeclampsia in a previous pregnancy, being pregnant with more than one baby, chronic hypertension, diabetes before pregnancy, kidney disease, first pregnancy, obesity, and maternal age of 35 years or older. Studies have also showed that African American women are at a greater risk of developing preeclampsia. There are also many complications of preeclampsia including fetal growth restriction, preterm birth, and placental abruption. It can also cause HELLP Syndrome which is characterized by the life-threatening condition of hemolysis, elevate liver enzymes, and low platelet count. Preeclampsia can also lead to eclampsia which is marked with the onset of seizures. Magnesium sulfate is commonly used as the treatment and prophylaxis.

Clinical evidence shows that the best way to prevent preeclampsia is the use of low dose aspirin. Studies have shown that taking an 81-mg aspirin tablet after the 12th week of pregnancy if a high-risk factor for preeclampsia is present may help with the prevention of the condition. The definite treatment of preeclampsia is delivery of the baby which is dependent on how severe the condition is the how far along the woman is pregnant.

References:

Fox, R., Kitt, J., Leeson, P., Aye, C. Y. L., & Lewandowski, A. J. (2019, October 4). Preeclampsia: Risk factors, diagnosis, management, and the cardiovascular impact on The offspring. Journal of clinical medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6832549/

March of Dimes. (2023). Preeclampsia. March of Dimes. https://www.marchofdimes.org/find-support/topics/pregnancy/preeclampsia

Mayo Clinic. (2023). Preeclampsia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745