Preeclampsia Awareness Month!
May marks the start of Preeclampsia Awareness Month which maintains the purpose of informing and educating patients to reduce the incidence of complications associated with Preeclampsia, which in worst case scenarios can be fatal.
What is preeclampsia?
According to the American College of Obstetrics and Gynecologists (ACOG), preeclampsia typically occurs after the 20th week of pregnancy and occurs only during (and at times directly after) pregnancy. It is generally characterized by high blood pressure, presence of high levels of protein in the urine (proteinuria), substantial weight gain, swelling, headaches and changes in vision, although not all symptoms and signs must be present for its diagnosis.
The Preeclampsia Foundation estimates that this disorder affects 5-8% of all pregnancies which translates to 1 in 12 pregnancies worldwide. Although preeclampsia is a very serious and complex condition, most women recover and deliver healthy babies with the aid of quality care.
- High blood pressure is defined as 140/90 or higher by the ACOG.
- Your doctor can provide dipstick tests to test for elevated protein levels in your urine.
- Gaining more than 3-5 lbs. per week can signal increased fluid accumulation and retention.
What causes preeclampsia?
Preeclampsia is a very complex disorder that affects several organs and systems including your liver, kidneys, and vascular system, as well as your baby, which is why it is difficult to pin down the specific cause although doctors and specialists have many theories (e.g. a leading perspective revolves around the formation of the placenta). What most experts agree on is the increased risk for patients who*:
- are pregnant for the first time
- have had preeclampsia in a previous pregnancy or have a family history of preeclampsia
- have a history of chronic hypertension, kidney disease, or both
- are 40 years or older
- are carrying more than one baby
- have certain medical conditions such as diabetes mellitus, thrombophilia, or lupus
- are obese
- had in vitro fertilization
**For additional information on influencing factors of this disorder, refer to the chart below.
|Medical Description||Layperson’s Description|
|Uterine ischemia/ underperfusion||Insufficient blood flow to the uterus|
|Inflammation||Excessive maternal inflammatory response to pregnancy|
|Angiogenesis||Factors regulating the formation of new blood vessels in the placenta are overproduced which in turn affect the blood vessel health in the mother leading to hypertension and kidney damage.|
|Prostacyclin / thromboxane imbalance (ASA)||Disruption of the balance of hormones that maintain the diameter of the blood vessels.|
|Endothelial activation and dysfunction||Damage to the lining of the blood vessels that keeps fluid and protein inside the blood vessels, keeps blood from clotting, and regulates elasticity of the blood vessel.|
|Calcium deficiency||Calcium helps maintain blood vessels and normal blood pressure. A deficiency may lead to increased blood pressure.|
|Hemodynamic vascular injury||Injury to the blood vessels due to excessive blood flow or pressure. For example one might compare the condition to what would happen if a garden hose was hooked up to a fire hydrant.|
|Preexisting maternal conditions||The mother has undiagnosed high blood pressure or other preexisting problems such as diabetes, lupus, sickle cell disorder, hyperthyroidism, kidney disorder, etc.|
|Immunological Activation||The mother’s immune system mistakenly responds as if damage has occurred to the blood vessel and in trying to fix the “injury” actually makes the problem worse .|
|Nutritional Deficiencies||Insufficient protein, excessive protein, fish oil, vitamin D, and other diet factors .|
|Obesity||High body mass index (BMI) is linked to the genetic tendency for high blood pressure, diabetes and insulin resistance, and also to the effect of obesity on the inflammatory system .|
|Genetic Tendency||The hereditary transmission of inherited characteristics among family members.|
What can I do to prevent this disorder?
One of the most important active steps one can take is to ensure routine quality prenatal care and start a conversation with your doctor about any existing risk factors. Furthermore, listen to your body for the signs and symptoms described below.
Signs and symptoms:
- Swelling of face or hands
- A headache that will not go away
- Seeing spots or changes in eyesight
- Pain in the upper abdomen or shoulder
- Nausea and vomiting (in the second half of pregnancy)
- Sudden weight gain
- Difficulty breathing
- Proteinuria (abnormal amount of protein in urine)
- High blood pressure (140/90 or greater)