Every mother wants her pregnancy to be normal and healthy. But the fear of pre-eclampsia can darken the joy.
What is pre-eclampsia?
Pre-eclampsia is a potentially life-threatening multiorgan condition that occurs during pregnancy and is characterized by elevated maternal blood pressure and protein in the urine or, in the absence of protein, impaired functioning of other organ systems. This can affect both you and your unborn child. If the risk of pre-eclampsia is known in advance, it can be prevented.
How common is pre-eclampsia?
Most women have a normal pregnancy. At the same time, pre-eclampsia is a relatively common condition during pregnancy, occurring in Estonia in two women out of one hundred.
When does pre-eclampsia occur?
Pre-eclampsia occurs after the 20th week of pregnancy or up to six weeks after delivery. Pre-eclampsia most often occurs between the 32nd and 36th weeks of pregnancy. The earlier in pregnancy the condition occurs, the more severe its course and the more dangerous it is for the mother and the baby.
What causes pre-eclampsia?
The exact causes of pre-eclampsia are unknown, but they are thought to be due to a disruption in the attachment of the developing placenta to the uterus, so there is no reliable connection between the circulatory systems of the mother and the baby. In this case, the rapidly developing fetus requires oxygen and nutrients for its growth from the maternal circulatory system. If the developing placenta lacks oxygen, toxic substances are released into the maternal circulatory system, which harms the mucous membrane lining the maternal blood vessels. In this way, systemic damage to the internal organs of the mother is formed. In order to save the lives of the mother and child, the baby must be born. If it happens at a very early stage of pregnancy, the born child is not yet ready for extrauterine life.
How will it affect me?
Mostly there is a mild form of the disease, which occurs at the end of pregnancy and for which the prognosis is good. But sometimes pre-eclampsia can worsen very quickly and begin to threaten the lives of mother and child. Pre-eclampsia disease also has a long-term effect on a woman’s health, as it doubles the incidence of cardiovascular disease later in life. Most women with pre-eclampsia are hospitalized, and often their babies have to be born prematurely. If the health of the mother or child is at risk, labor is induced or a cesarean section is performed.
How will this affect my baby?
Most babies stay healthy even when their mothers have severe pre-eclampsia. But sometimes pre-eclampsia can threaten the life and health of both the fetus and the newborn. Preeclampsia in the mother doubles the risk of cerebral palsy, that is, brain damage, the consequence of which is delayed physical and sometimes mental development. In addition, surviving children are more likely to develop cardiovascular disease, obesity, and diabetes later in life. In pre-eclampsia, there is not enough oxygen and nutrients for the fetus to grow, and intrauterine developmental delay occurs. Because the only treatment for pre-eclampsia is delivery, sometimes the pregnancy has to be terminated. Before the 34th week of pregnancy, the fetal lungs are not yet fully developed, and steroid injections are given to stimulate them.
How to recognize preeclampsia?
Unfortunately, the symptoms of the disease do not appear in most women until they are at an advanced stage.
- A persistent headache that does not respond to painkillers
- Severe nausea and vomiting
- Tinnitus and visual disturbances
- Pain in the right hypochondrium
- Feeling short of breath
- Infrequent need to urinate (less than 500 ml per day)
- Swelling of the hands, face, and eyelids
- Rapid weight gain (more than 1 kg per week)
- If you have any of the above symptoms, you should contact your obstetrician, gynecologist, or on-call physician.
At what stage of pregnancy is the screening performed?
Pre-eclampsia screening can be done in all three trimesters.
In the first trimester, at 11-13 +6 weeks (as part of the OSCAR test)
Second trimester, 19-21+6 weeks (FNA screening).
Third trimester, 34-36 weeks (fetal growth and growth study).
The three-step screening test for pre-eclampsia provides an opportunity to prevent its occurrence or to shift it to a later stage of pregnancy.