Preeclampsia

Preeclampsia (pre-eclampsia) is a serious disorder that affects pregnant women. Therefore, it is mainly an issue of gynecologists and obstetricians.

Causes

The exact cause of preeclampsia is not known. It is assumed to be related to a failure of placenta, whose cells begin to produce many substances affecting blood vessels in various organs. There is decreased blood flow in the affected vessels and in addition, the blood walls’ permeability may be increased resulting in leakage of blood fluid into local tissues.

Symptoms

Pre-eclampsia has two major symptoms – repeatedly measured hypertension and protein present in urine. These symptoms may be accompanied by swelling of tissues due to the leaked blood fluid. The disruption of blood vessels may activate the clotting system with occurrence of small blood clots that further decrease local blood flow causing tissue ischemia. This condition can easily develop into the feared disseminated intravascular coagulopathy. The preeclampsia typically occurs after the 20th week of pregnancy and it may constitute a serious threat to life of both the mother and her child. The most sensitive organs to preeclampsia are kidneys and brain.

Diagnosis

The diagnosis is usually made by a gynecologist during regular examination of pregnant women. It is based on measurement of high blood pressure and urinalysis with positive confirmation of protein in urine.

Complications

Preeclampsia can progress into a very dangerous eclampsia, when the disrupted blood flow into the brain causes disorders of consciousness with muscle convulsions that may resemble epileptic seizures.

Treatment

In case of preeclampsia, bed rest is necessary. In addition, there are prescribed some antihypertensive drugs. However, the selection of drugs is limited as many antihypertensives may harm the fetus (such as the ACE-inhibitors). Magnesium compounds may be given to prevent muscle convulsions. The ultimate solution is termination of pregnancy (whether artificially induced childbirth through the birth canal or the Caesarean section). The premature newborn is naturally more vulnerable, but on the other hand, there is no other option. However, it is appropriate to repeatedly emphasize that the primary problem is the placenta and not the fetal tissue.