Pre-eclampsia

Pre-eclampsia, sometimes also referred to as toxaemia, is a complication of pregnancy that affects approximately 2-3% of all expectant mothers. This early-onset pre-eclampsia in particular can be very dangerous for both mother and child.

Pre-eclampsia can develop into HELLP syndrome or eclampsia, with life-threatening complications for the mother ranging from organ damage to death if not treated quickly and competently.

Consequences for mother and child

Pre-eclampsia is one of the most common causes of preterm birth. It is also associated with a high risk of the baby being born too small and with a low birth weight, as the condition prevents the fetus from being adequately nourished. There is a possibility that the child may have problems with physical and intellectual development later in life, and be more likely to develop diabetes, heart and circulatory conditions and suffer from obesity.

Pre-eclampsia has also long-term health effects for the mother. Over 90% of women with severe preeclampsia develop chronic blood pressure 20 years after their pregnancy, and frequently suffer from cardiovascular disease. Competent continuing care of both mother and child by an expert and a healthy lifestyle (healthy diet, physical activity, avoiding stress) are particularly important in seeking to prevent them.

What are the risk factors?

A range of factors increase the risk of developing the disease. These include

  • pre-eclampsia or fetal growth restriction in a previous pregnancy or in the pregnancy of a relative
  • maternal age
  • pre-existing high blood pressure
  • kidney disease
  • diabetes
  • overweight
  • a first pregnancy
  • a pregnancy involving artificial insemination/egg donation
  • a multiple pregnancy or
  • increasing blood pressure 

Diagnosis

Pre-eclampsia is indicated by high blood pressure and increased protein excretion in the urine. Even if not recognisable from the outside, the disease originates already during the first trimester of pregnancy. The risk of developing pre-eclampsia should be detected as early as possible to start the treatment. The pregnancy is then considered high-risk and should be closely monitored.

Preeclampsia screening

A test between 11 and 13 weeks of pregnancy can determine the individual risk of developing pre-eclampsia. This involves checking the blood pressure, performing an ultrasound scan and taking a blood sample. Specific hormones can be measured in the blood; they indicate pre-eclampsia long before any clinical symptoms appear. If the test shows an increased risk, changes to the diet and lifestyle and a low-dose aspirin treatment as prescribed by the responsible specialist can help preventing this disease.  In particular the risk of developing the early and most serious form of pre-eclampsia can be decreased.

Treatment

Pre-eclampsia must always be treated by an expert, ideally in a hospital setting. Regular self-monitoring of the blood pressure and awareness for potential warning signals, such as headaches, impaired vision, rapid weight gain (more than 1 kg per week), marked water retention in your body, or restlessness are helpful.

Potential signs of pre-eclampsia can be determined by measuring the blood pressure and by examining the urine for particular proteins. Doppler ultrasound in the second trimester can help predict the development of pre-eclampsia.

Additionally, a blood test in the second and third trimester can predict the onset of pre-eclampsia but also of a fetal growth restriction. An individual risk evaluation is possible and the frequency of antenatal care visits can be scheduled accordingly.

The earlier the risk of developing pre-eclampsia is known, the more likely it is to continue the treatment in a specialised perinatal centre. Optimal treatment of pre-eclampsia always requires an interdisciplinary team of specialised and experienced obstetricians, midwives, internists, anaesthetists, psychologists and neonatologists.

Luckily a severe early-onset pre-eclampsia occurs very rarely. Even if high blood pressure and protein in the urine are discovered, complications are rare. The most important, however, is regular antenatal care to enable the detection of the disease as early as possible.


For more information on pre-eclampsia such as causes, prevention, and the diagnosis after week 20 of pregnancy, please dowonload our new factsheet that is currrently available in English and German (further languages in preparation):


Factsheet on pre-eclampsia (in English)

Informationsblatt Pr√§eklampsie (in German) 

 
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