Pregnancy and pressure

Keep a consistent watch on your blood pressure throughout pregnancy, advises  Dr Anubha Singh.

Pre-eclampsia is a hypertensive disorder that brings with it high-blood pressure and high protein levels in the urine (proteinuria) during pregnancy. According to data collected by the Federation of Obstetric and Gynaecological Societies of India (FOGSI), pregnancy-induced high blood pressure is responsible for 12% of maternal deaths in India, a leading cause of maternal mortality! Pre-eclampsia is common in Indian women, affecting between two to eight in 100 women during pregnancy. Around one in 200 women (0.5 per cent) develop severe pre-eclampsia during pregnancy. About 10% pregnant women are detected to be suffering from pre-eclampsia.

Headache, overall swelling and dizziness are common symptoms. However, not all pregnant women with these symptoms are pre-eclamptic.

When does it occur?

Pre-eclampsia usually appears during the second half of pregnancy, often in the latter part of the second or early third trimesters. However, it can occur earlier too. If this condition goes unnoticed, pre-eclampsia can lead to a more complicated condition called eclampsia that can put the mother and baby’s life at risk. In rare cases, pre-eclampsia can cause death. Women with pre-eclampsia that brings seizures are considered to have eclampsia.

How does it affect?

A pre-eclampsia pregnant woman’s body prevents the placenta from receiving enough blood, which can cause the baby to be born very tiny. It could also lead to premature birth, and the complications include learning disabilities, epilepsy, cerebral palsy, hearing and vision problems in the child. Also, women could (rarely) have serious complications that include stroke, seizure, water in the lungs, heart failure, reversible blindness, bleeding from the liver, severe vaginal bleeding after the delivery. In certain cases, pre-eclampsia can lead to the placenta suddenly separating from the uterus, which in medical terminology is called placental abruption, causing stillbirth.

What are the causes?

There is no exact cause of pre-eclampsia and the subsequent stage eclampsia. Although some researchers suspect poor nutrition, high body fat, or insufficient blood flow to the uterus as a few possible causes.

Genetics are also said to play a major role. Lifestyle changes as well as late pregnancies are said to contribute tremendously. Genetic diabetes, high BP, obesity, and family history of pre-eclampsia too can cause this medical condition. Lately, stress is also found to be a major factor, especially for working women in large metro cities.

Symptoms

Some signs and symptoms to watch out for include sudden obesity, sugar-level fluctuation, sudden hypertension, excessive weight gain, pedal swelling, headache, vomiting, decrease in urine output, and blurry vision.

[NOTE: However, it is not necessary that all the above mentioned symptoms be found in one patient.]

Who are at risk?

* Pregnant women over 40
*  Previous pregnancy accompanied by pre-eclampsia
*  Having a mother or sister who had pre-eclampsia
*  Obese pregnant women
*  Women carrying more than one baby
*  Diabetic women
*  Women with arthritis

Treatment

There is no way to treat the illness per say. Delivering the baby is usually the only cure. Usually this condition automatically gets treated in 10 days after delivery. In some cases the condition is also known to take six months after delivery. The fact that there is no way to cure pre-eclampsia makes this a rather scary condition. However, regular prenatal checkups can help diagnose pre-eclampsia early and help manage it easier.

(The writer is a gynaecologist)