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Ayrshire Maternity
Unit
Pre-eclampsia
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Review Date March 2009
ACH05/51
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Can I prevent pre-eclampsia?
Often women feel that pre-eclampsia is somehow
their fault, that they have been doing too much or
not looking after themselves properly. Pre-eclampsia
is not caused by stress, hard work or worry. It is a
disease of pregnancy and there is little that can be
done to prevent it. Some women who have had it
before may benefit from medication during their
next pregnancy and you may discuss this with
your doctor.
Useful telephone numbers:
Midwife.........................................................................
Family doctor (GP).............................................
Ayrshire Maternity Unit
Crosshouse Hospital
Telephone: 01563 521133
Page 8
Blood pressure in pregnancy
Every pregnant woman has her blood pressure and
urine checked at each antenatal visit. Raised blood
pressure and protein in the urine can be signs of
pre-eclampsia. This is a condition which occurs
only during pregnancy and is common, affecting
approximately one in ten pregnant women. Most
cases of pre-eclampsia are mild, but occasionally
pre-eclampsia can be more severe, making you
and your baby unwell if it is not noticed early and
monitored closely.
Your midwife or doctor has noticed a slight increase
in your blood pressure and is arranging for you to
have extra antenatal appointments to ensure that any
trend towards higher blood pressure or protein in
your urine can be detected, since this could be a sign
of severe pre-eclampsia. This leaflet answers many
questions you may have about pre-eclampsia, and
has been written to give you more information about
the condition.
Page 1
What is blood pressure?
Blood pressure, sometimes written in your notes as
‘BP’, is the force of blood pumping round your body.
It is written as two numbers, the first and highest
being measured during a heart beat, the second
lower figure being measured between heartbeats.
A blood pressure of 120 / 80 is average for most
women but many women have blood pressure
higher or lower and are still perfectly healthy.
How is blood pressure measured?
A cuff is wrapped round your upper arm and inflated
until it feels quite tight. The air is then let out of the
cuff and the midwife or doctor listens to the blood
flowing back into your arm with a stethoscope.
Sometimes an automatic machine is used, which
is easier if several readings have to be taken.
What happens to blood pressure
during pregnancy?
We will have checked your blood pressure at your
first antenatal visit and written in your notes. It is
normal for blood pressure to fall a little around the
middle of your pregnancy and then to go up again
towards the end. If blood pressure rises too much,
we will check it more often.
Page 2
how your baby is growing, and will be made by your
consultant obstetrician after discussing it with you.
Drugs may be used to control your blood pressure
during or after pregnancy. These drugs do not cure
pre-eclampsia but do protect you from some of the
effects of high blood pressure. You should take them
as prescribed and not stop them without speaking to
your doctor.
Is there anything I should watch out for?
Many women feel well with pre-eclampsia, but if you
feel ill this may be a sign of the disease developing
or getting worse. You should watch out for:
headaches which do not go away
blurred vision or flashing lights or spots in front
of the eyes
pain just below the ribs, especially on the right
side
vomiting
sudden swelling of the hands, feet or face
These symptoms do not always mean pre-eclampsia
but you should get them checked out by telephoning
your midwife or hospital.
Page 7
How will pre-eclampsia be monitored for
the rest of my pregnancy?
You will need more frequent antenatal checks, either
at the antenatal clinic or at the Maternity Outpatient /
Daycare Monitoring department. This may involve
blood tests to check on liver, kidneys and the blood
clotting system. You may be asked to collect urine
over 24 hours in a special container so that the
amount of protein in the urine can be measured.
You may also need to have a regular ultrasound
scan in order to check on your baby's growth.
If there are signs that the disease is becoming
severe, you may need to be admitted to hospital
for closer examination.
What is the treatment for pre-eclampsia?
The only cure for pre-eclampsia is to deliver the baby
and placenta. Once this is done, the illness gets
better. If pre-eclampsia develops in the last few
weeks of pregnancy it may be necessary to induce
labour early. If pre-eclampsia develops earlier on in
the pregnancy, the decision is more difficult as the
baby may have to be delivered prematurely, often by
Caesarean section. The decision to deliver early
depends on a number of things, including the
severity of the disease, how you are feeling and
Page 6
When is blood pressure too high?
Blood pressure can be raised by things such as
worry, stress or activity. Generally this type of high
blood pressure will settle with rest and often if it is
re-checked after a while, it will have returned to
normal. If blood pressure is greater than 140/90 over
several readings, your midwife or doctor will want to
keep a closer eye on it to make sure you do not
develop pre-eclampsia.
What is pre-eclampsia?
Pre-eclampsia is an illness which affects women
only when they are pregnant or shortly after the
baby is born. The exact cause is not known, but
pre-eclampsia seems to be caused by problems with
the placenta (afterbirth). This is why pre-eclampsia
usually gets better after the baby is born.
Some women are more prone to develop it than
others. This includes women who are pregnant for
the first time or for the first time with a new partner,
women who have close relatives who have had
pre-eclampsia, women expecting twins or triplets,
women who have high blood pressure before their
pregnancy and women with diabetes or kidney
disease.
Page 3
Most women who get pre-eclampsia, get it in the last
few weeks of pregnancy but it can start earlier,
sometimes as early as 20 weeks.
How can my midwife tell if I have
pre-eclampsia?
There is no single test to detect pre-eclampsia.
Signs that it may be developing are persistently
raised blood pressure and protein in the urine. This
is why you will be asked to bring a fresh specimen
of urine with you to each visit.
How is the urine checked for protein?
A paper strip (dipstick) is dipped into your urine
sample. This shows whether or not there is protein
there. A small amount is noted as a trace and is
usually nothing to worry about. Larger amounts of
protein are noted as + signs, up to four at most.
What else can cause protein in the urine?
Protein in the urine may be because of vaginal
discharge or urine infection. You should tell
your midwife if you have had either of these.
Sometimes protein in the urine can be as a result
of kidney disease, but this is rare.
Page 4
How does pre-eclampsia affect me?
Pre-eclampsia causes blood vessels all over the
body to constrict (tighten). This causes blood
pressure to rise and protein to leak out of the
kidneys into the urine. Water also leaks out of the
blood vessels leading to tissue swelling (oedema).
This is especially noticeable around the ankles and
in the fingers.
Severe cases of pre-eclampsia can cause problems
in the lungs, liver, brain and blood clotting system.
If there are any signs of these problems developing,
the safest place to be is in hospital, where we can
keep a very close eye on you.
Less severe cases may need extra visits to the
antenatal clinics or to the Maternity Outpatient /
Daycare Monitoring department to make sure the
illness is not becoming worse.
How does pre-eclampsia affect my baby?
Blood vessels supplying the placenta may constrict,
limiting the amount of blood going to the placenta.
This means that some (not all) babies may not grow
so well. The growth of the baby is monitored by
checking the size of the uterus (womb) or by
ultrasound scans which measure your baby's
growth.
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