By Liz Wilkes, My Midwives
Pre-eclampsia is a condition that occurs from the 20th week of pregnancy and effects multiple organs in a woman’s body. It occurs in about 3% of pregnancies with the disorder ranging from a relatively mild problem to a very life-threatening condition.
Recent media around the death of a young woman with HELLP (hemolysis, elevates liver enzymes and low platelets) syndrome has put a spotlight on pre-eclampsia as a pre-cursor to HELLP syndrome. This has made many women scared about what this disorder is and how it is related to pregnancy.
The risk factors for developing pre-eclampsia are:
- First pregnancy
- Having had high blood pressure in a previous pregnancy
- Chronic (long term) high blood pressure
- Family history of pre-eclampsia
- Pre-existing diabetes
- Multiple pregnancy
- Women below 15 and over 40 years of age
- More than 10 years gap between pregnancies or a new partner
- Autoimmune diseases
- Renal disease
What if I have a risk factor, what do I need to look for?
If you are worried that you have a risk factor, the first thing you need to do is to speak to your pregnancy care provider and let them know that you have a risk factor for pre-eclampsia and that you want to know what they are checking at each visit.
Most care providers will check your blood pressure at each visit and will record and re-check elevations in blood pressure. They may also check your urine by taking a urine sample and testing it to see if you have protein present in your urine. There are also signs that you may notice – headaches, visual disturbances such as spots or stars or flashes in your vision, having to pass little to no urine, or that you have swelling in your hands, feet, face and generally all over. You may also notice upper abdominal pain. These symptoms listed can also be a range of other things, but do need to be mentioned to your care provider so that they can check that you are not at risk. For most women, the signs and symptoms mentioned do not have anything to do with pre-eclampsia or HELLP syndrome.
What happens if I have pre-eclampsia and what is HELLP syndrome?
Pre-eclampsia is a multisystem disorder so different women have very different experiences. For a few women they quite quickly develop symptoms which may escalate to seizures and, in rare cases, problems such as renal failure. It is rare that pre-eclampsia may lead to HELLP syndrome which can be fatal. As women may be very unwell this may lead to delivery of their baby (if baby is not born) prematurely, hospitalisation and very occasionally Intensive Care Unit treatment and other interventions such as renal dialysis.
At the other end of the scale of this disorder you may have an elevated blood pressure and a few changes in your urine which require monitoring but little to no ongoing treatment. Your stage of pregnancy and the level of systemic changes contribute to practitioners decisions about treatment options. Women may be prescribed medication, may be advised to rest more or cease work or may need additional ultrasound tests to monitor the baby’s growth. If you need this level of care then be in contact with a midwife who can provide additional support about your issues as they will be able to discuss and explain all interventions.
Is there anything I can do to prevent developing pre-eclampsia?
There is lots of research being undertaken about preventing pre-eclampsia. At the moment the best protection is to maintain a healthy weight, to get any pre-existing issues with your blood pressure and any renal or autoimmune problems under control and to communicate about your health and concerns with the person or people caring for you in your pregnancy. If you have had pre-eclampsia in a previous pregnancy talk to your GP or midwife prior to your next pregnancy or in early pregnancy.
I am really worried now – what should I do?
For most pregnant women, this is not something to be concerned about. Your pregnancy care provider is the best place to ask questions.
Find out more about My Midwives at http://www.mymidwives.com.au