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Alternative Names
pregnancy-induced hypertension (PIH), toxaemia

Preeclampsia is high blood pressure condition that develops during pregnancy. There is also swelling of the body and protein in the urine. The condition usually occurs after the 20th week of pregnancy. Preeclampsia can develop into eclampsia(seizures).

What is going on in the body?
Preeclampsia develops in 5-10% of pregnant women, usually in the first pregnancy. The cause is not known. Preeclampsia can be mild or severe. The disease can affect the brain, kidneys, liver, and lungs. The woman can have seizures. When preeclampsia develops, there may be serious problems for mother and baby.

What are the signs and symptoms of the disease?
The symptoms of preeclampsia may include:
  • sudden weight gain due to rapid development of oedema (fluid in tissues)
  • swelling of the face or hands
  • headaches
  • decreased urine output
  • nausea and vomiting
  • agitation
  • blurred vision
There may be no symptoms and the diagnosis made during a routine antenatal visit.

What are the causes and risks of the disease?
Factors that increase the risk of preeclampsia are:
  • a woman's first pregnancy or first pregnancy to a new partner
  • maternal age below 20 or over 35
  • low socioeconomic status
  • multiple gestation such as twins, triplets, etc.
  • hydatidiform mole, an abnormal condition that mimics a normal pregnancy, but is actually a type of tumour
  • too much amniotic fluid
  • diabetes
  • chronic high blood pressure
  • underlying kidney disease
What can be done to prevent the disease?
There are no known ways to prevent preeclampsia. All pregnant women should have early antenatal care. Blood pressure changes should be watched closely. Finding and treating the disease early can stop serious complications for mother and baby.

How is the disease diagnosed?
A healthcare professional will look for the following:
  • blood pressure greater than 140/90
  • swelling in the face and hands
  • protein in the urine
  • dropping level of platelets, one of the cells in the blood that is important for blood clotting
  • elevated liver function blood tests
  • high haemoglobin, or quantity of the pigment that gives red blood cells their colour. The doctor will also check the woman's percent of red blood cells in the blood.
  • anaemia, or low red blood cell counts
  • high levels of clotting breakdown products in the blood
What are the long-term effects of the disease?
Both mother and baby are at risk. Risks include:
  • premature delivery
  • increased risk of caesarean section
  • prematurity
  • foetal distress
  • intrapartum foetal distress, or abnormalities noted on the heart rate of the baby during labour
  • stillbirth
  • intrauterine growth retardation, a lack of normal growth of the baby within the womb
  • suffocation at birth, or asphyxia
  • development of eclampsia, which is potentially fatal for mother and child
What are the risks to others?
Though an affected mother and her baby are at risk, preeclampsia and eclampsia are not contagious.

What are the treatments for the disease?
Giving birth is the only cure for preeclampsia. The safety of the mother should be considered first. Delivering a healthy baby that does not need intensive long-term care should follow. Preeclampsia limits blood flow to the placenta and the foetus. If a woman has symptoms, flow may already be reduced by 50%. The doctor may decide to induce labour, or to wait for labour to occur naturally. The following factors will make the decision:
  • condition of the mother and foetus
  • foetal age
  • presence of labour
  • severity of the disease
  • dilation of the cervix
  • maternal desire
If the symptoms are mild, outpatient treatment is common. This includes bed rest at home and biweekly examinations in the doctor's office. If symptoms do not improve, hospitalisation may be needed. Tests for foetal maturity will help decide if early delivery is possible. Early delivery will prevent more serious problems. Serial ultrasounds are used to monitor growth and placental blood flow.

In severe cases, action is needed. Delivery may be induced if any of the following occur:
  • very high blood pressure for more than 24 hours
  • persistent and severe headache
  • pain in the right upper abdomen
  • elevated liver function tests
  • falling platelet count
  • signs of kidney failure
  • destruction of red blood cells, known as hemolysis
  • eclampsia, or seizures associated with preeclampsia
  • fluid in the lungs
  • foetal distress
  • failure of foetal growth by ultrasound monitoring
Delaying delivery when the foetus is mature causes problems for mother and baby.

Treating severe preeclampsia means controlling the woman's blood pressure. A surgical delivery may be needed if blood pressure is not controlled. Medications to prevent eclampsia include magnesium sulfate and other drugs to prevent seizures. In addition, medications may be prescribed to lower blood pressure.

What are the side effects of the treatments?
Side effects from magnesium sulfate include nausea, vomiting, respiratory depression, and respiratory arrest. These can be avoided with careful monitoring of serum magnesium levels. Other medications also have side effects, such as allergic reactions and stomach upset. Surgery carries a risk of infection, bleeding or even death.

What happens after treatment for the disease?
A woman may be at risk for developing eclampsia up to 6 weeks after delivery. The mother needs to be watched. Blood pressure, urine protein, serum platelet count, liver function tests, and other indicators may need to be checked. A premature baby will need hospital care.

How is the disease monitored?
Preeclampsia does not lead to chronic high blood pressure. The risk of preeclampsia in future pregnancies is roughly 33%.

Author: Eva Martin, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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