What is preeclampsia and eclampsia in pregnancy?

Both preeclampsia and eclampsia are very critical conditions in pregnancy and can have extreme consequences if not treated on time. In both these conditions, the mother’s blood pressure rises to the extent that it can cause damage to her other organs, as well as the baby. It usually happens during the latter stages of pregnancy, due to an abnormal blood flow to the placenta. While both preeclampsia and eclampsia cannot be prevented, getting regularly checked by your doctor can help you detect and deal with these conditions on time. Early detection as well as regular monitoring can help you have a safe pregnancy, despite these conditions.

What is preeclampsia in pregnancy?

Preeclampsia is a serious complication that occurs during pregnancy, characterized by high blood pressure and damage to other organs, most often the liver and kidneys. This condition typically arises after the 20th week of pregnancy, even in women who previously had normal blood pressure, states this study, published by StatPearls. The exact cause of preeclampsia remains unclear, but it is believed to be related to the development of the placenta and abnormalities in blood flow to the organ,” explains gynaecologist and obstetrician Dr Rekha Ambegaokar. If left untreated, preeclampsia can lead to life-threatening complications for both the mother and the baby, including premature birth, placental abruption, and long-term health risks. Therefore, early detection and monitoring are crucial for managing the condition.

What is eclampsia in pregnancy?

Eclampsia is a more severe form of preeclampsia, which involves the onset of seizures in a pregnant woman with no previous history of neurological conditions. It is the result of untreated or poorly managed preeclampsia and can have devastating consequences if not immediately addressed. According to a study published in Cureus, eclampsia can also lead to the death of both mother and fetus if not properly diagnosed on time. Eclampsia can occur during pregnancy, labour, or postpartum, as well. In addition to the seizures, eclampsia can lead to loss of consciousness, severe headaches, and organ failure. The condition requires emergency medical intervention, typically leading to the early delivery of the baby to prevent further complications.

Causes of preeclampsia and eclampsia in pregnancy

The causes of preeclampsia and eclampsia are not entirely understood, but several contributing factors have been identified. For preeclampsia, one key cause is related to abnormalities in placental development, leading to insufficient blood flow to the placenta. A study published in Medscape, lists hypertension and connective tissue disorders as the causes. This can trigger high blood pressure and damage to the mother’s organs. “Another potential cause is immune system issues, where the body’s immune response to the placenta is abnormal, resulting in inflammation and high blood pressure,” says Dr Ambegaokar.

Genetics also play a role, as women with a family history of preeclampsia are more likely to develop the condition. Additionally, pre-existing health conditions like chronic hypertension, kidney disease, and autoimmune disorders (such as lupus) can increase the risk of preeclampsia.

For eclampsia, the exact cause is unknown, states the US’ MedlinePlus. It lists factors such as blood vessel problems, genetics, as well as diet and neurological factors that have an impact on the probability of eclampsia. “The primary cause is uncontrolled or severe preeclampsia that is left untreated. The factors that contribute to preeclampsia, such as placental abnormalities and pre-existing conditions, can also lead to eclampsia if the symptoms progress,” says Dr Ambegaokar. The condition is marked by sudden seizures, which occur due to the severe increase in blood pressure and the inability of the body to maintain proper blood flow to vital organs.

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Symptoms of preeclampsia and eclampsia in pregnancy

The symptoms of preeclampsia can vary, but the most common signs include:

• High blood pressure (above 140/90 mmHg)
• Severe headaches
• Vision changes, such as blurred vision or light sensitivity.
• Upper abdominal pain, particularly under the ribs on the right side,
• Nausea and vomiting.
• Decreased output of urine
• Shortness of breath
• Swelling in the face and hands and swelling of the lower limbs
• Sudden weight gain

Eclampsia presents with more severe symptoms, such as

• Seizures or convulsions
• Loss of consciousness
• Severe headaches
• Blurred vision
• Abdominal pain.

These signs indicate a medical emergency that requires immediate attention.

Risks associated with preeclampsia and eclampsia in pregnancy

Both preeclampsia and eclampsia carry significant risks for both the mother and the baby. For mothers, preeclampsia can lead to complications such as stroke, organ damage (especially to the kidneys and liver), and blood clotting disorders.

In extreme cases, untreated preeclampsia can be fatal. Eclampsia further increases the risk by causing seizures, which can result in brain damage or even maternal death.

For the baby, the risks include premature birth, which can lead to developmental challenges, low birth weight, and placental abruption, a condition where the placenta detaches from the uterus before delivery. In severe cases, stillbirth may occur. Long-term, women who have had preeclampsia are also at higher risk for cardiovascular diseases such as hypertension and heart disease later in life.

Can you prevent preeclampsia and eclampsia in pregnancy?

While there is no sure way to completely prevent preeclampsia and eclampsia, certain lifestyle changes and medical interventions can help reduce the risk.

Maintaining a healthy diet rich in fruits, vegetables, whole grains, and lean proteins, along with regular exercise, can help manage blood pressure and reduce the risk of developing preeclampsia. Make sure to avoid processed foods during pregnancy.

Regular prenatal care is crucial, as early detection of high blood pressure or other signs of preeclampsia can allow for timely interventions.

For women at higher risk, such as those with a history of preeclampsia or chronic hypertension, low-dose aspirin therapy after the 12th week of pregnancy may be recommended by a healthcare provider to lower the risk. Managing pre-existing conditions like diabetes, obesity, or kidney disease is important in reducing the likelihood of developing these complications. Check out other tips to ensure a safe pregnancy and delivery.

Who is more at risk of getting preeclampsia and eclampsia in pregnancy?

Certain groups of women are at a higher risk of developing preeclampsia and eclampsia. These include first-time mothers, who are more likely to develop the condition than women who have previously been pregnant. “Women with multiple pregnancies (carrying twins or triplets), those with chronic health conditions such as hypertension, kidney disease, or diabetes, and women with obesity are also at higher risk,” says Dr Ambegaokar.

Age can also be a factor, with women over the age of 35 being more prone to developing preeclampsia. Additionally, women with a family history of preeclampsia or those with autoimmune diseases like lupus are more likely to experience complications during pregnancy. African American women are also at a higher risk of developing preeclampsia compared to other racial groups.

How to treat preeclampsia and eclampsia in pregnancy?

The treatment for preeclampsia depends on the severity of the condition and how far along the pregnancy is. “Mild cases of preeclampsia may be managed with regular monitoring, bed rest, and medications to control blood pressure,” says Dr Ambegaokar, adding that women with more severe cases may need to be hospitalized so their blood pressure and the baby’s health can be closely monitored.

Steroids may be given to help speed up the baby’s lung development if early delivery becomes necessary. Ultimately, the only cure for preeclampsia is to deliver the baby. In cases where the condition becomes life-threatening, early delivery may be recommended to protect both the mother and baby.

For eclampsia, immediate treatment involves administering magnesium sulfate to prevent further seizures and stabilize the mother, says Dr Ambegaokar. In most cases of eclampsia, emergency delivery is required to ensure the safety of both the mother and the baby. Postpartum care is also essential, as preeclampsia can continue to affect the mother’s health after delivery, necessitating careful monitoring of blood pressure and organ function in the weeks following birth.