Pre-eclampsia: a guide

Check out our guide to pre-eclampsia for all the information you need to know about pre-eclampsia.

Pre-eclampsia is a condition that can develop when you’re pregnant. It can potentially cause serious problems for both you and your baby. It’s understandable that you might feel worried about conditions such as pre-eclampsia. But by being aware of the symptoms and getting checked at antenatal appointments, you can find out if you have the condition early. You can then get the right support and treatment.

What is pre-eclampsia?

Pre-eclampsia, also called toxaemia, is a problem that starts in your placenta: the organ that joins you to your baby. You can get it any time after 20 weeks of pregnancy and even after you give birth.

The placenta supplies your baby with the blood and nutrients they need to grow and develop. If you have pre-eclampsia, your placenta doesn’t provide enough blood to your baby, which can affect how well they grow. 

Pre-eclampsia causes your blood pressure to rise (hypertension). It also affects how well your kidneys work, resulting in protein leaking into your urine. Pre-eclampsia can cause fluid to build up, leading to sudden, excessive swelling of the face , hands and feet. 

It’s important to remember that you can have high blood pressure while you’re pregnant without having pre-eclampsia. This is called gestational hypertension and it can happen after 20 weeks of being pregnant. Having gestational hypertension can increase your risk of developing pre-eclampsia later in your pregnancy.  

Symptoms of pre-eclampsia

If you have pre-eclampsia, you might not have any symptoms. It’s often picked up at routine antenatal checkups, which is why it’s so important to attend these so you can be monitored for any changes. 

As pre-eclampsia becomes more advanced, the symptoms can include:

  • headaches, which are not relieved by painkillers
  • problems with your sight, such as seeing flashing lights and getting blurred vision
  • pain in your tummy (abdomen), usually on the right, just below your ribs
  • nausea and vomiting
  • difficulty breathing
  • feeling generally unwell
  • dizziness
  • not going to the toilet much (to wee)

If you have any of these symptoms, contact your GP or midwife or straightaway, or go to the maternity unit at your local hospital.

Complications of pre-eclampsia

Serious complications can develop if pre-eclampsia isn’t diagnosed and monitored. Pre-eclampsia can lead to seizures (eclampsia), organ damage, kidney failure, liver failure, clotting problems, stroke and even death. 

Diagnosis of pre-eclampsia

As it’s possible to have pre-eclampsia and not notice any symptoms yourself, it’s essential you attend your antenatal appointments. During these checks, your doctor or midwife will do tests that can pick up pre-eclampsia, including blood pressure measures, urine tests and blood tests. 

If your blood pressure goes over 140/90mmHg after 20 weeks of being pregnant, and you have protein in your urine, you’ll be referred to a hospital maternity unit. Even if you have high blood pressure without protein in your urine, you will still be referred to a maternal unit. Your doctor or midwife can also do blood tests to check how well your liver and kidneys are working, and how well your blood is clotting.  

You may also have an ultrasound to check the growth of your baby, and an assessment of your baby's heart rate and movement called a cardiotocograph (CTG). This involves sitting in a chair for about 30 minutes with a soft belt around your tummy, which picks up your baby's heartbeat. 

Pregnant woman sitting down with her feet up

Treatments for pre-eclampsia

Treatment for pre-eclampsia depends on how severe your condition is, which includes your health, your baby’s health, and how many weeks pregnant you are. The only way to cure pre-eclampsia is giving birth, but until that time, pre-eclampsia can be managed. 

When you are first diagnosed with pre-eclampsia, you will generally be admitted to hospital. After assessment in hospital, some women can go home and receive care  outside of the hospital. Many women with pre-eclampsia will have to remain in hospital until their baby is delivered.  

For the rest of you pregnancy, you will be closely monitored to check that you can carry on with your pregnancy safely. You might need to collect your urine over 24 hours so your doctor can measure the exact amount of protein in it. Your midwife and doctor will check your blood pressure regularly, and you’ll have regular blood tests to check your liver, kidneys and how well your blood is clotting. Your baby’s health will also be monitored with ultrasound scans for checks on their heart rate and movement.

Medicines 

Your doctor may prescribe you medicines, such as a beta-blocker tablet called labetalol to help reduce your blood pressure. These can’t cure pre-eclampsia, but they may prevent your blood pressure becoming very high, which can cause serious health problems. You might be able to take tablets, but if your blood pressure is very high, you may need medicines through a drip.

If your pre-eclampsia is very severe, your doctor may also give you medicines to prevent seizures. An example is a medicine called magnesium sulphate, which is usually given through a drip.

Giving birth

The only way to cure pre-eclampsia is by giving birth, although it sometimes gets worse for a while before it gets better. Pre-eclampsia can develop for the first time after you’ve given birth, so your midwife will continue to measure your blood pressure after you’ve had your baby. 

Everyone is different – the decision on when you should have your baby will be made based on your health and circumstances. In some cases, your pre-eclampsia may become so severe that you need to have your baby early. And you might need to have a caesarean delivery.

Your doctor and midwife will talk this through with you and make a plan. Ask them if you’re unsure about anything or have questions.

Causes of pre-eclampsia

Doctors don't know the exact reasons why some women get pre-eclampsia. But it seems to start with a problem with the placenta. It doesn’t develop properly, which means there’s a reduced blood supply to it. 

Some things are thought to increase your risk of getting pre-eclampsia. You might be more likely to get pre-eclampsia if

  • this is your first baby
  • you have a close family history of pre-eclampsia – if your mother or sister had pre-eclampsia, you’re more likely to develop it
  • it’s been 10 years or more since you last had a baby
  • you're having more than one baby (twins or triplets for example)
  • you're under 18  or over 35 years of age
  • you have other health conditions, such as high blood pressure, diabetes and kidney disease
  • you're very overweight.

You’re also more likely to get pre-eclampsia if you’ve had it in a previous pregnancy, however many women who have had pre-eclampsia before go on to have a normal, healthy pregnancy. Let your midwife and GP know if you’ve had pre-eclampsia before, so that they can monitor you more closely.

Pre-eclampsia is a serious condition that can lead to complications, but it can be managed. If you are pregnant, ensure you attend all your antenatal appointments so you can get the right care. 

 
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