Maternity Information Leaflet
Information about Pre Eclampsia
What is pre-eclampsia?
Pre-eclampsia is a common condition that only occurs during pregnancy,
affecting the mother, baby or both. It can develop from around 20 weeks of
pregnancy to as late as several days after delivery, the severity of which can
vary. In the mother, the condition causes high blood pressure and protein leaks
from the kidneys into the urine, other symptoms may develop and are mentioned
below. For the baby, growth may be slower than normal.
How common is it and how dangerous is it?
Pre-eclampsia affects around one in 14 pregnancies and is the most common
complication of pregnancy. Pre-eclampsia is usually mild but in one in every 100
pregnancies it is severe.
Who gets pre-eclampsia?
No one can predict who is at risk of developing pre-eclampsia. However, you are
at an increased risk of developing the condition if you have a strong family
history of pre-eclampsia, if you have had pre-eclampsia before or if you are
pregnant for the first time, or are pregnant for the first time by a new partner. Preexisting medical conditions may also increase the risk of pre-eclampsia
developing including high blood pressure prior to pregnancy, diabetes, systemic
lupus erythematosis, and kidney disease or if you have a raised BMI (Body Mass
Index).
What causes pre-eclampsia?
It is thought that the condition probably originates in the placenta; this is the
attachment between the baby and mother. It is thought that the blood vessels in
the placenta do not develop properly affecting the transfer of oxygen and
nutrients to the baby. It is also believed that genetic factors are involved, as
women whose mothers and sisters have suffered with pre-eclampsia are more
likely to get it themselves.
2
How is pre-eclampsia detected?
Pre-eclampsia can develop anytime after 20 weeks of pregnancy.
Most commonly pre-eclampsia is present if:
• Your blood pressure is high and
• You have an abnormal amount of protein in your urine
Serial blood pressure monitoring, detailed urine tests and blood tests will help
with the diagnosis of pre-eclampsia.
Is pre-eclampsia the same as high blood pressure of pregnancy?
No. many women develop high blood pressure. Most do not have pre-eclampsia.
With pre-eclampsia you have high blood pressure, plus protein in your urine, and
sometimes other symptoms listed below. About 1 in 5 women with high blood
pressure progress to pre-eclampsia.
Therefore, if you develop high blood pressure you will have regular ante-natal
checks which can detect pre-eclampsia, if it occurs, as early as possible.
What are the symptoms?
The severity of pre-eclampsia is usually (but not always) linked to the blood
pressure level. You may not have any symptoms at first; if pre-eclampsia
worsens one or more of the following symptoms may develop:
•
Headaches
•
Blurring of vision, or other visual problems.
•
Abdominal pain (generally in the upper part of the abdomen, under
the ribs.)
•
Vomiting
•
Just not feeling right
Swelling of your feet, face and hands (oedema) is also a symptom of preeclampsia although it is also common in normal pregnancy. Oedema may
become worse with pre-eclampsia therefore, if you notice a sudden increase in
the swelling in your feet, face and hands you should inform your midwife.
3
What is the treatment for pre-eclampsia?
Delivering the baby
The only complete cure for pre-eclampsia is to deliver the baby. At delivery the
placenta is also delivered, therefore, the cause of the condition is removed. After
the birth, the blood pressure and any other symptoms in the mother usually
settle quickly.
It is common practice to induce labour if pre-eclampsia occurs late in pregnancy.
The risk to the baby is small if he or she is born a few weeks early. The best time
to
deliver the baby has to balance several factors including:
•
The severity of the condition in the mother, and the risk of complications
occurring.
•
How the baby is affected.
•
The chance of a premature baby doing well. Generally, the later in
pregnancy the baby is born, the better. However some babies grow very
poorly if the placenta does not work well in severe pre-eclampsia. They
may do much
better if they are born, even if they are premature.
If pre-eclampsia is severe, then delivery sooner rather than later is best. If the
pre-eclampsia is not too severe, then postponing delivery until nearer full term
may be best.
Other treatments
Until the baby is delivered, other treatments that may be considered include:
•
Medication to reduce blood pressure: Medication to reduce blood
pressure may be an option for a while if pre-eclampsia is not too severe.
If the blood pressure is reduced it may help to allow the pregnancy to
progress further before delivering the baby.
•
Rest: Rest is often recommended although there is little evidence that
this makes much difference.
It is sometimes necessary to admit women with pre-eclampsia to hospital,
particularly if it is severe. This is not just for rest, but also to monitor the mother
and developing baby.
4
Can pre-eclampsia be prevented?
There is some evidence to suggest that regular low dose aspirin and calcium
supplements may help to prevent pre-eclampsia in some women. These are not
standard or routine treatments as the evidence for their benefit is not strong or
conclusive. However, one or other may be considered by a specialist if you have
a particularly high risk of developing pre-eclampsia.
Will pre-eclampsia develop in my next pregnancy?
If you had pre-eclampsia in your first pregnancy, you have about a 1 in 10
chance of it recurring in future pregnancies. There is no way of predicting if
it will happen again.
If you do not have pre-eclampsia in your first pregnancy, it is unusual to
develop it in future if you become pregnant again by the same partner.
5
Help and information
If you are concerned or have any questions please contact your
community midwife or
Labour Ward (St Richard’s Hospital 01243 788122 ext 2962)
Worthing Hospital 01903 285230)
Further sources for information and help
APEC (Action on Pre-Eclampsia)
Helpline: 020 8427 4217 (Weekdays 10am – 3pm)
Web: www.apec.org.uk
References
RCOG guideline (No. 10), Management of eclampsia, November 1996
APEC patient information leaflets
Pre-eclampsia patient information leaflet. www.patient.co.uk
6
Further Information
NHS Choices Website — www.nhs.uk
National Institute for Clinical Excellence — www.nice.org.uk
Contact details:
St Richard’s Hospital, Spitalfield Lane, Chichester,
West Sussex, PO19 6SE
Labour ward:
Antenatal Clinic:
01243 831433
01243 788122 ext. 2871
Worthing Hospital, Lyndhurst Road, Worthing
West Sussex, BN11 2DH
Labour Ward:
Antenatal Clinic:
01903 285138
01903 205111 ext. 84371
We are committed to making our publications as accessible
as possible. If you need this document in an alternative format,
for example, large print, Braille or a language other than
English, please contact the Communications Office by:
email: [email protected]
Or by calling 01903 205 111 ext 84038.
www.westernsussexhospitals.nhs.uk
Department:
Issue date:
Review date:
Author:
Maternity
Dec 2011
Oct 2014
Obstetric Registrar
7