Better be aware

SIGNS

In India, hypertensive disorders such as pre-eclampsia affect around 15 per cent of pregnancies. Of these, pre-eclampsia commonly develops in women in their first pregnancy. Given that it catches many women unawares, it’s important to know more about this disorder.

So what is pre-eclampsia? It is a condition that can develop during pregnancy — usually during the third trimester. It is characterised by high blood pressure and protein in the urine (proteinuria). And if not treated in time, it can lead to eclampsia, which results in seizures. It has been reported that pre-eclampsia and eclampsia account for 24 per cent of maternal deaths in India.

Risk factors

But why does it occur? There are a number of factors as to why pre-eclampsia occurs. Some of the major factors that can contribute to the development of the condition and pose a risk are first pregnancy and if the mother is carrying multiple foetuses. Additionally, factors such as age (if the mother is older than 40 or is younger than 20), and her health condition (such as diabetes and hypertension) can also prove to be risk factors.

While the exact cause of pre-eclampsia is not known, if one experiences symptoms like severe headaches, upper abdominal pain, reappearance of nausea in the second or third trimester, changes in vision, decreased urine output, shortness of breath and a general feeling of being unwell, one must report it to their doctor.
However, it must be noted that pre-eclampsia can sometimes develop without any symptoms. So, it can be difficult to diagnose. However, if not treated in time, pre-eclampsia can complicate matters for both, the mother and her baby. It can lead to preterm delivery, perinatal mortality rate, low birth weight, birth asphyxia of the baby and respiratory distress of the mother, among other complications.

Latest developments

Initially, there was no single test that could diagnose or predict outcome of pre-eclampsia. However, of late, there has been some speculation on a protein released by the placenta, which can report placental problems early on.

These can be tracked using markers that begin to decrease 11 to nine weeks
before the onset of pre-eclampsia, and falling substantially during the five weeks before the onset of hypertension or proteinuria. The markers also tell the doctor about the risk of a pre-term delivery in a pre-eclampsia patient, thus allowing for a significant headstart in managing the condition.

So, apart from the regular urine protein or blood pressure checks, a 24-week placental growth factor (PlGF) check can not only establish the diagnosis of pre-eclampsia at an early stage, but also lead the gynecologist to institute therapy and remedial measures. Because it’s important to begin the treatment before it is too late.

(The author is president — research & innovation, mentor — molecular pathology & clinical research service, SRL Diagnostics)