Pregnant or planning to have a baby?

Here's what you should know about pre-eclampsia.

A medical condition which affects roughly 10% of pregnant women, pre-eclampsia is a growing concern for doctors. Pre-eclampsia is a medical condition of high blood pressure and excess proteins in the urine of a pregnant woman after 20 weeks of pregnancy.

What is Pre-eclampsia?
Gynaecologist Dr Suman Bijlani says that it is a multi-systemic disorder, which affects most of the major organ systems, such as the kidneys, liver, brain, heart, lungs and clotting mechanism. The basic problem is the narrowing of blood vessels due to oxidative stress.

Adds gynaecologist and infertility specialist Dr Rishma Pai, "Pre-eclampsia usually develops in the second half of pregnancy and is more common in a woman who is pregnant for the first time. It is seen in about seven to 10% of pregnant women. This is the earlier stage of eclampsia, which is characterised by convulsions in a patient with high blood pressure. If blood pressure increases over 130 / 90 after 20 weeks of pregnancy along with the presence of protein in the urine and oedema or swelling on the feet and body, it confirms the diagnosis of pre-eclampsia."

Symptoms usually include swelling on the feet and hands, puffiness of the face and, in severe cases, headaches, upper abdominal pain, blurring of vision, giddiness, reduced passage of urine or vaginal bleeding. If you're pregnant, regularly check your blood pressure and test your urine for proteins. Most of the time, the condition presents no symptoms. Some women may experience excessive weight gain.

Unfortunately, pre-eclampsia cannot be 'cured'. It can be 'managed' and 'controlled'. The only cure is delivery of the foetus. Once the foetus is delivered, the maternal systems return to their original state within a few hours to days. "The challenge is that the baby cannot be delivered before he/ she is mature enough to survive outside the womb. Hence, we have to manage the pregnancy till the foetus reaches a mature stage. Untreated pre-eclampsia can lead to poor foetal growth and reduced fluid in the uterus due to narrowing of the blood vessels, which supply the placenta and foetus. In severe pre-eclampsia, the mother is at a risk of haemorrhage (bleeding) in various organs such as the liver, lungs, placenta or brain or convulsions (fits). So, the obstetrician will try to maintain the foetal circulation and prevent growth restriction, detect complications early and deliver the baby before things go out of hand. In mild cases, a doctor will control the blood pressure and keep a close watch on the foetal growth and mother's blood pressure and other systems. Monitoring is the most important aspect of management of pre-eclampsia. As soon as the foetus becomes mature, delivery is carried out," explains Dr Bijlani. If the condition worsens, the foetus is delivered irrespective of maturity. Many of these premature or low birth weight babies need neonatal intensive care.

Preventing pre-eclampsia
Unfortunately, there is no preventive method or drug for pre-eclampsia. Low dose aspirin started early in pregnancy may reduce the risk. However, it has to be taken under medical supervision only. According to Dr Bijlani, women deficient in calcium, vitamin D, folic acid and vitamin B12 are at a higher risk. Regular antenatal visits are the surest way to improve pregnancy outcome in women predisposed to pre-eclampsia.

"A history of high blood pressure in a previous pregnancy increases the risk of pre-eclampsia in the second pregnancy. Also, obese women and those with multiple pregnancies should have regular blood pressure checks. There are no reliable tests to ascertain pre-eclampsia," says Dr Pai.

Occurrence in Mumbai

While there are no specific studies, which have investigated the trends of pre-eclampsia in Mumbai, experts have noted an increased incidence over the last few years. "It is more common in a very young or much older mother. Since women are delaying motherhood, particularly working women in Mumbai, there is an increase in numbers. Also, women who are smokers, obese, diabetic or already suffering from high blood pressure are more at risk. There is a much higher incidence of twins nowadays due to increased fertility treatments such as IUI and IVF. Twin pregnancies are at higher risk for developing pre-eclampsia," says Dr Pai.

Celebrities who reportedly battled Pre-eclampsia

Angelina Jolie
Adriana Lima
Jennifer Lopez
Faith Hill
Marcia Cross
Lisa Marie Presley
Jenna Jameson
Debra Messing
Jane Seymour



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