Preeclampsia (toxemia) is a condition of pregnancy marked by high blood pressure, protein in the urine, and swelling of the feet and hands during pregnancy. Eclampsia is preeclampsia with the added symptom of a seizure and rarely death. Preeclampsia and eclampsia is seen after the 20th week of pregnancy. The following increase the risk of having preeclampsia and eclampsia: teenage pregnancy, previous history of preeclampsia, obesity, carrying more than one baby (twins, triplets), having high blood pressure, age greater than 35 during pregnancy, and being of African American descent.
During pregnancy, headache, upper abdominal pain, blurred vision, nausea, vomiting, leg swelling, hand swelling, sudden weight gain.
A history and physical exam will be performed. Blood pressure and urine protein is monitored very closely during pregnancy to detect this condition. If this condition occurs, blood tests are done to identify possible problems of high uric acid, elevated liver function tests, low platelets and renal failure.
Obstetrics and Gynecology
Treatment includes intravenous magnesium and blood pressure control with various medications. Delivery of the baby ends this condition, so cesarian section or induced labor can be used as a cure if the baby is old enough to be delivered safely.
Preeclampsia can begin as early as the 20th week of pregnancy, but it is more likely to develop during the last three months of pregnancy. It usually can be managed with treatment through the rest of pregnancy. If the condition worsens and threatens the health of the mother by causing eclampsia or other complications, the baby has to be delivered along with the placenta. Preeclampsia goes away after delivery.
Two studies published in October 2007 showed that careful management of the weight that you gain during pregnancy can lower your risk for preeclampsia. When researchers compared women who gained small, medium and large amounts of weight, the women who gained less than 15 pounds had fewer cases of preeclampsia. Women who gained more than 35 pounds had significantly higher rates of preeclampsia. These findings were true for women with a normal body mass index prior to their pregnancies as well as for women who were overweight or obese.
Calcium and low-dose aspirin, two treatments that were once thought to prevent preeclampsia, have been shown not to help prevent preeclampsia in large studies of healthy women. Some experts suspect that low-dose aspirin may provide slight protection to women who are at especially high risk of preeclampsia, even though the treatment have not been shown to work for women at average risk.
The complications of preeclampsia and eclampsia can be prevented with prenatal care. Prenatal care is a crucial and lifesaving step in preventing complications and deaths of both the mother and the fetus.
The likely course of this condition
The outlook for full recovery from preeclampsia is very good. Most women begin to improve within one to two days after delivery, and blood pressure returns to the normal pre-pregnancy range within the next 6 to 12 weeks. Prenatal care can dramatically reduce the complications and deaths of preeclampsia, because women who are diagnosed while preeclampsia is mild can receive treatment without any delay. Between 5% and 8% of pregnant women in the United States develop preeclampsia. Progress in treating eclampsia has saved the lives of both mothers and their newborns. In the United States and Britain, between 1% and 2% of women who developed eclampsia die and 3% of their babies die during or shortly after birth. The maternal death rate from eclampsia in locations where health care is not easily available can exceed 13%.
About one of every five women with preeclampsia during a first pregnancy will have preeclampsia during a second pregnancy.
Deciding when to call a professional
You should schedule your first prenatal care visit with a health care professional as soon as you become aware you are pregnant. If you have swelling, severe headache, changes in vision, abdominal or pelvic pain, or other symptoms of preeclampsia, see your doctor or midwife immediately.
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