Pre-eclampsia

 

What is this?

This is a complicated condition of pregnancy, affecting different systems within the body, and characterised by two or more of the following symptoms: hypertension [raised blood pressure], oedema [generalised swelling], proteinurea [protein in the urine], headaches [often with visual disturbances], and epigastric pain [like heartburn, but does not resolve with indigestion remedies].
 
How will I know if I have it?

Some of the symptoms listed above are common in pregnancy, so it can be difficult to tell. You will be asked about oedema, your urine will be tested, and your blood pressure checked at every antenatal appointment. This is an important aspect of your care.

If your blood pressure is within normal limits at the start of pregnancy, but is found to be high at a subsequent visit, or appears to be creeping up gradually as the weeks go on, you will be referred for blood tests and other investigations to rule out pre-eclampsia, even if you dont have any of the other symptoms.

If the results are normal, but your symptoms persist, the tests will be repeated at regular intervals. Likewise, if your blood pressure is normal, but you have other features of pre-eclampsia, your midwife can refer you for diagnostic blood tests. If you have any symptoms you are worried about, always phone your maternity unit for advice. 
 
Is it dangerous?

It can be. There are risks involved in having pre-eclampsia, but it is much more risky if you dont know youve got it! Once the problem has been detected, it can be carefully monitored and treated appropriately, to make sure that you and your baby stay healthy throughout the rest of the pregnancy.

In some cases this may mean that you need to stay in hospital for a few days to ensure that your condition is stable. This can be frustrating, as you might feel perfectly well in yourself, but if pre-eclampsia is severe, it can damage your vital organs and also affect blood flow through the placenta to the baby. If your condition is worsening, the baby may need to be delivered early, either by induction of labour, or by caesarean section.

What happens next?

After the birth, your blood pressure should gradually settle down and all your other systems should return to normal. The time this takes varies from person to person, but if the pre-eclampsia was severe, you will need very close monitoring and observation for the first 24-48 hours after the birth, including regular blood tests.

When you go home, you will be followed up by your community midwife and GP. The medication you were taking to control your blood pressure in pregnancy will be reviewed, and sometimes the dose, or type of medication, will be changed, but usually it needs to be continued at least until the 6-week post-natal check up.