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  • Q&A with Australian Health Practitioners

    What are the signs for Pre-eclampsia?

    Related Topic
    Pregnancy & Breastfeeding
    What are the signs for Pre-eclampsia during pregnancy and is it possible to avoid this?
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  • Sachin Mishra

    HealthShare Member

    Thanks Oz,



    We going through our first pregnancy and it is very hard to locate helpful information.



    Will go through the sites you sent.

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    Thanks

    Dr Gary Sykes

    Obstetrician

    Dr Gary Sykes is a graduate Bachelor of Medicine and Bachelor of Surgery (M.B, B.S.) from Sydney University. He commenced his initial postgraduate training at … View Profile

    Preeclampsia is the most common serious medical disorder of pregnancy. It is much more likely to occur in the first ongoing pregnancy and can have as its manifestations in the mother high blood pressure (hypertension), protein leaking into the urine, abnormal liver function and impaired blood clotting. It can also impair the baby’s wellbeing and is associated with a fall-off in the baby’s growth, foetal distress and even foetal death in-utero

    There are no early signs or symptoms of preeclampsia. A woman is usually without symptoms until she is dangerously unwell. Very high blood pressure can lead to eclampsia or fitting. The outcome of eclampsia can be disastrous. I have personally met a teenager mother who had lost her vision as a consequence.

    Imminent eclampsia is heralded by a very severe headache or visual disturbance. When preeclampsia has significantly impaired kidney function she may notice a reduction of urine output and also very concentrated urine. Significant liver involvement can cause epigastric pain. Swelling (oedema) is a poor marker of preeclampsia. Most pregnant women with significant oedema don’t have preeclampsia, and I have seen very severe preeclampsia in women who don’t have oedema.

    An important reason for good antenatal care is the early detection of preeclampsia. Once detected then there can be close monitoring of mother and baby’s wellbeing. Antihypertensive medications are usually needed to control the mother’s hypertension.  But there is no cure. If it becomes too dangerous for mother or baby to continue the pregnancy or if the baby is sufficiently mature that there is no advantage to continuing the pregnancy, then the decision to deliver will be made.

    Sometimes preeclampsia is first manifest after delivery. Good postnatal care is important to detect this and so if detected there can be management as appropriate.

    It is reported that in Australia, mild preeclampsia occurs in 5-10% of pregnancies and severe preeclampsia in 1-2% of pregnancies. Preeclampsia and complications associated with this condition account for 15% of direct maternal mortality and 10% of perinatal mortality. Preeclampsia is the indication for 20% of labour inductions and 15% of Caesarean sections. It also accounts for 5-10% of preterm deliveries. Worldwide, preeclampsia and its complications kill many tens of thousands of women and their babies each year.

    There has been exciting work on assessing the risk of a woman getting preeclampsia when she has her nuchal translucency scan at 12 week pregnancy. If she is at high risk of developing preeclampsia then aspirin can be commenced at or before 16th week of pregnancy. This has been shown to result in a significant reduction the incidence of preterm preeclampsia.

    Besides first ongoing pregnancy known factors that make a woman more at risk of preeclampsia include diabetes mellitus, kidney disease, chronic hypertension, prior history of preeclampsia in the previous pregnancy,  >35 years old or <15 years old when pregnant, obesity, antiphospholipid antibody syndrome and twin pregnancy.

    Pre-pregnancy women should have a pregnancy planning check with her doctor, where her background risk for preeclampsia and other conditions can be identified and managed effectively before her embarks on pregnancy. This may include management of high blood pressure with drugs safe in pregnancy, optimal control of diabetes, smoking cessation (increases risk of getting preeclampsia) optimal diet and weigh reduction if overweight,. There no good evidence that either exercise or bed rest are effective preventative measures of preeclampsia.

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