February 6, 2024
Pre-eclampsia is a complication of pregnancy that usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal, but it may develop after delivery of a baby, a condition known as post-partum pre-eclampsia.
A. According to the American Heart Association a normal blood pressure reading is 120\80mmHg and below. Readings below 90\60mmHg indicate low blood pressure. Readings above 140\90 mmHg indicate high blood pressure.
Beware that increases in blood pressure of more than 30mmHg systolic pressure or a rise in diastolic pressure of more than 15mmHg over blood pressure values taken at a first visit may indicate the development of hypertension, even if the blood pressure is not yet in the hypertensive range.
A. Not all pregnant women suffer from pre-eclampsia, but there are higher risk profiles:
A. The cause of pre-eclampsia is unknown; however, the placenta plays a key role in pre-eclampsia. Early in a pregnancy new blood vessels develop and evolve to supply oxygen and nutrients to the placenta. In women with pre-eclampsia these blood vessels do not seem to develop or work properly. Problems with how well blood circulates in the placenta may lead to the irregular regulation of blood pressure in the mother.
A. The following may help to reduce the chance of getting pre-eclampsia:
A. The only cure for pre-eclampsia is the delivery of the baby and placenta. In some cases, the baby must be delivered immediately, regardless of the gestational age to save the mothers or baby’s life.
It is imperative that mothers continue to monitor their health for at least 6 weeks after delivery as they are still at risk of experiencing post-partum pre-eclampsia.
A. Many factors influence the health care provider’s decision about how to manage pre-eclampsia including the gestational age and health of the baby, overall health, and age of the mother and careful assessments of how the disease is progressing.
Antihypertensive drugs (methyl dopa 250mg-500mg) orally 3 times a day is prescribed.
The healthcare provider will watch for signs of instability in the mother including very high blood pressure that is not responding to antihypertensives.
If less than 38 weeks and the blood pressure is controlled, delivery is delayed to up to 38 weeks. If the blood pressure is not controlled with medications and treatment, and the baby or mother’s life is at risk, the mother may be given steroids to aid the maturation of the infant’s lungs prior to delivering the baby.
A. If your blood pressure remains within target levels, you should be able to have a natural vaginal birth. At 38 weeks gestation, you will be admitted in the hospital where labour will be induced. The blood pressure is monitored every hour during labour.
A. Pre-eclampsia causes your blood pressure to rise and put you at risk of brain injury. It can impair your kidney and liver function and can cause blood clotting problems, pulmonary edema (fluid in the lungs), seizures and in severe forms or left untreated, maternal, and infant death.
Pre-eclampsia affects the blood flow to the placenta often leading to smaller or premature born babies. The effects of being born early can vary, some babies may spend only a day or two under close observation while others may spend months in a neonatal intensive care unit. Some babies may also have lifelong problems such as learning disorders, cerebral palsy, blindness, and deafness.
Having a premature baby can also mean a great deal of emotional and financial stress for the family.
Intrauterine growth restriction: because of reduced flow to the placenta, this restricts the supply of food to her unborn baby thus the baby becomes malnourished and is small for gestational age.
Death: Infant death is one of the most devastating consequences of pre-eclampsia.
In conclusion: pre-eclampsia is a hypertensive disorder to pregnancy responsible for significant maternal mortality. Most deaths related to pre-eclampsia could be avoided with timely and effective care.
Sr Khumbuzile Hlatshwayo
Acting Maternity and Paediatric Unit Manager