Pre-eclampsia
Am I at increased risk for pre-eclampsia?
Pre-eclampsia can occur in any pregnancy. About 3–4% of all pregnant women in Australia and New Zealand develop preeclampsia. You are more likely to develop pre-eclampsia if you:
- Have chronic hypertension
- Had pre-eclampsia in a previous pregnancy
- Have other medical problems, such as kidney disease, diabetes or an autoimmune disease
- Are having your first baby
- Are aged 40 years or more
- Are expecting twins or triplets
- Have a family history of pre-eclampsia (i.e. your mother had pre-eclampsia)
- Are very overweight at the beginning of pregnancy (BMI 35 or more)
- Have had a gap of 10 years or more since your last pregnancy
- Conceived with in vitro fertilisation (IVF)
Women at increased risk of pre-eclampsia may be advised to take low-dose aspirin, with or without calcium, to help reduce the risk. It is important to understand that no medication completely prevents pre-eclampsia, so close monitoring is still required for all women at increased risk.
What are the signs and symptoms of pre-eclampsia?
Most women with pre-eclampsia do not have any symptoms. Pre-eclampsia is usually detected during a routine antenatal appointment. However, women with severe pre-eclampsia will have high blood pressure and may experience:
- Sudden swelling of the face, hands or feet
- Headache that doesn’t go away with simple painkillers
- Problems with vision, such as blurring, flashes of light and dots before the eyes
- Severe pain just below the ribs
- Heartburn that doesn’t go away with antacids
- Generally feeling very unwell
It is very important that you contact your doctor, midwife or maternity hospital if you experience any of these symptoms.
How is pre-eclampsia treated?
When you are diagnosed with pre-eclampsia, you may be admitted to hospital and have a number of tests including:
- Regular blood pressure measurements
- Blood and urine tests – these tests assess how well your liver and kidneys are functioning and how well your blood is clotting
- Thorough physical examination, including tests of your leg reflexes
- Heart rate monitoring of your baby using a cardiotocograph (CTG) machine
- Ultrasound scan to assess your baby’s growth and well-being
While high blood pressure can usually be controlled with medication, the only complete cure for pre-eclampsia is the birth of your baby. The management of pre-eclampsia therefore depends on how far along you are in pregnancy and how seriously you and your baby are affected by the condition.
If you are 37 weeks pregnant or more, your doctor may recommend that you have an earlier-than-planned birth to avoid any decline in your health due to pre-eclampsia.
If you are less than 37 weeks pregnant, you will be regularly monitored to ensure that you are well enough to continue the pregnancy until 37 weeks or more. This may be done on an outpatient basis if you have mild pre-eclampsia, or as an inpatient if your condition is more severe.
If your blood pressure becomes very difficult to control, your organs are showing signs of worsening damage or there are concerns regarding your baby’s well-being, your doctor may recommend that your baby is born prematurely (before 37 weeks). Each pregnancy is unique and the exact timing will depend on your own particular situation, including your gestation, your baby’s size, and the severity of your illness. Your doctor may also need to consider transferring you to a larger maternity hospital with facilities to provide advanced care for you and your baby.