Preeclampsia in pregnancy: symptoms, causes and treatments

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Marie-Ange Demory
@marie-angedemory
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Contents

  • 1 What is preeclampsia
  • 2 Causes and risk factors of preeclampsia
  • 3 Incidence of preeclampsia in the country
  • 4 Symptoms of Preeclampsia
  • 5 Risks of preeclampsia
  • 6 Preventing Preeclampsia in Pregnancy
  • 7 How preeclampsia is treated
  • 8 When does blood pressure return to normal?
  • 9 What kind of childbirth is done with preeclampsia
  • 10 Preeclampsia and eclampsia

When you are pregnant, you always hope that everything goes smoothly and that, apart from the classic symptoms that can disturb a little in the first trimester, the rest of the pregnancy will go on smoothly. Unfortunately this does not always happen and suddenly we are faced with some small or large complication. One of these is preeclampsia, also known as gestosis. A pathology that absolutely must not be taken lightly. 



What is preeclampsia

Preeclampsia (or "gestosis") is a typical condition of pregnancy that can appear, generally suddenly, around the 20th week and in any case starting from the second trimester onwards and is related to the increase in blood pressure and proteins in the mother's urine.

Arterial pressure values ​​- the force exerted by the circulating blood on the elastic walls of vessels and arteries - are considered high if greater than 140 millimeters of mercury (mm Hg) for the "maximum" (systolic pressure), and / or 90 mm Hg of "minimum" (diastolic pressure). Coronary heart disease, stroke, heart failure and renal failure are linked to this trend in values.

High blood pressure in pregnancy can be dangerous for the mother and fetus. Women with pre-existing or chronic hypertension (high blood pressure) are more likely to have complications although, in many cases, the pressure "increases" only during the gestation period. 



Causes and risk factors of preeclampsia

There is no clear cause of preeclampsia. The only certain thing is that there are specific risk factors that increase the possibility of getting sick: 

  • obesity;
  • familiarity with preeclampsia;
  • diseases prior to pregnancy (diabetes, high blood pressure, kidney disease);
  • age (the higher it is, the greater the risk of undergoing gestosis);
  • autoimmune diseases;
  • preeclampsia in a previous gestation;
  • thrombophilia. 

Incidence of preeclampsia in the country

Fortunately, in Del Paese, the incidence of preeclampsia is relatively low. Obesity, which is a high risk factor for the disease, is not as common as in the United States (underlying hypertension is associated with severe excess weight). In our country, on the other hand, gestosis is often linked to the mother's thrombophilia, a defective congenital mechanism of blood coagulation that is sometimes at the basis of spontaneous abortions.

Symptoms of preeclampsia

Very often preeclampsia does not present itself in a definite way: the woman who is affected does not feel particular sensations or specific disorders that herald it. In addition to above-normal blood pressure and the presence of protein in the urine (proteinuria), symptoms such as: 

  • persistent headache; 
  • severe pain in the stomach or abdomen;
  • visions of dark or bright spots;
  • blurred vision;
  • sudden weight gain (over 5 kilos in a week); 
  • nausea and vomit;
  • low amount of urine;
  • swelling (often on suddenly and affecting the hands, feet, ankles and sometimes the face).

Risks of preeclampsia

Preeclampsia can affect both the mother and the fetus. You may experience placental abruption or liver changes. The disease affects the placenta with various consequences: it produces "bad" substances that damage circulation and does not allow the transfer of oxygen and nutrients to the fetus. This in turn leads to poor fetal growth. 



Preventing preeclampsia in pregnancy

Precisely for this subtle dimension of the disease it is necessary to be monitored regularly. It is very useful, for example, to measure blood pressure at specific intervals: once a month in the first months of pregnancy, three times a month after 20-22 weeks and every week starting from the third trimester. Do not underestimate the urine test which is best done monthly first and, at the end of the course, even several times.

If routine checks are desirable for all pregnant women, some recent international scientific researches recommend, for subjects at risk, the preventive intake of low-dose aspirin and Doppler flowmetry of the uterine arteries, useful in evaluating the uterine arteries. adequate formation and function of the placenta. But of course it will be your gynecologist who will evaluate the opportunity.

Prevention also consists in modifying some risk factors, for example being overweight or familiar with gestosis. Proper nutrition is also very important and includes, among other things, a reduction in the quality of daily salt (also essential to counteract water retention, a frequent problem in pregnancy). 

How preeclampsia is treated

When a diagnosis of gestosis is made, the expectant mother is kept under close medical supervision to try to carry on the pregnancy for as long as possible, at least up to 37 weeks when the birth is now considered complete and the risks for the baby are really reduced. 

In fact, childbirth is the only way to effectively treat preeclampsia. However, if the disease has manifested itself early, giving birth can be risky for the health of the unborn child who is not yet "ready". In this case, an attempt is made to counteract the progression of the disease to allow the fetus to develop. 


If the only symptom of gestosis is high blood pressure, in general, the woman can be treated at home by checking the values ​​several times a day. In some cases, antihypertensive drugs may be prescribed. If, on the other hand, the disturbances are important, hospitalization is required during which:


  • pressure will be monitored.
  • Repeated urine tests will be performed to check the level of protein, and blood tests to ascertain liver and kidney function.
  • The state of health and growth of the baby will be checked with ultrasound or cardiotocographs (the tracings that are made at the end of pregnancy).

When does blood pressure return to normal?

Typically, blood pressure is within normal ranges within 6 weeks of delivery. However, it is advisable to monitor it a little longer to evaluate its progress. 

What kind of childbirth is done with preeclampsia

In the case of a diagnosis of preeclampsia, the type of birth depends on the general condition of the woman and obviously on the week in which it is decided to give birth. If overall she is fine and there is no indication for a cesarean, natural delivery is usually recommended.  

Preeclampsia ed eclampsia

We speak of eclampsia when the disease evolves and causes seizures, convulsions, loss of consciousness and, in some cases, brain haemorrhages: a very common condition in the United States with often dramatic outcomes. Preeclampsia in the US is also one of the main causes of fetal complications (low birth weight of the baby, premature birth and death of the fetus).

Text updated on 9 August 2022

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