Preeclampsia
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| Preeclampsia |
Preeclampsia (or pregnancy toxemia): definition and causes
Preeclampsia, or toxemia of pregnancy, is a condition during pregnancy that can have serious consequences for both the mother and the fetus. What are the signs of preeclampsia? How is this condition treated?
Preeclampsia is a condition that affects approximately 3 to 4% of pregnancies. In 10% of cases, it can lead to serious complications that , in the short term, threaten the life of the mother and her unborn baby.
What are the signs of preeclampsia? What is the expectant mother's blood pressure?
What is preeclampsia? When can it occur?
Preeclampsia is not detected early in pregnancy. It is caused by a malformation of the blood vessels.of the placenta . Preeclampsia is a condition that can appear at the end of the second trimester of pregnancy (from 20 weeks of amenorrhea) and which combines high blood pressure (blood pressure higher than 14/9) and proteinuria (protein in the urine higher than 0.3 g/24 h ).
How to detect preeclampsia in pregnant women? What are the associated symptoms?
Certain signs alert the health professional in charge of the mother-to-be's pregnancy, notes the specialist doctor: "It is detected during the monthly appointment with the gynecologist, in the event of high blood pressure or protein on the urine strip ."
Expectant mothers affected by this disease can have many clinical symptoms, she explains: “ Headaches , visual disturbances,tinnitus (ringing in the ears), phosphene (flies in front of the eyes) and epigastric bar (pain in the upper abdomen).”
Once the delivery is over, and more specifically, after the placenta has been expelled , preeclampsia will cease and the symptoms will disappear after a few days.
Causes: What causes preeclampsia (pregnancy toxemia) during pregnancy?
This disease cannot be contracted, explains Lauren Sebbag: " it is an immunological disease. The main risk factors are: advanced maternal age, chronic high blood pressure , primiparity (first child), short exposure to paternal antigens (such as in the context of sperm donation ) or a family or personal history of pre-eclampsia ." There is therefore a genetic predisposition: a mother can transmit pre-eclampsia to her daughter when she gives birth in turn.
What are the risks of preeclampsia?
The main risk is eclampsia , which causes convulsive seizures that can be fatal and are caused by the mother's intracranial hypertension .
How does an eclamptic crisis manifest itself?
In addition to these seizures , there can be many complications for the mother. This can also cause a retroplacental hematoma (premature detachment of the placenta), a subcapsular hematoma of the liver, coagulation disorders and kidney failure.
There are also, fetal complications : " We most often see intrauterine growth retardation (IUGR) , induced prematurity (during, for example, an emergency premature delivery by caesarean section for maternal rescue), or in the worst case, fetal death in utero (FUIM)".
How to treat preeclampsia? How to prevent eclampsia after childbirth?
Regular and appropriate monitoring can save the pregnant woman and the unborn baby. If pre-eclampsia occurs, it is important to be monitored in a maternity ward with a level adapted to the gestational age . For severe pre-eclampsia, you will need to go to an establishment with a maternal intensive care unit.
Some pregnant women may need to be hospitalized toward the end of their pregnancy. It all depends on the severity of the condition. The doctors in charge of the woman's pregnancy will need to check certain criteria to ensure that the condition is not severe preeclampsia. Such as:
- blood pressure (systolic pressure should not be equal to or greater than 160 mmHg and diastolic pressure should not be equal to or greater than 110 mmHg);
- proteinuria (which should not be more than 3 g per 24 hours), or decreased urine volume;
- increased blood levels of liver enzymes indicating a liver problem;
- blood platelets (cells that participate in blood clotting) which must not decrease;
- persistent or severe “barrel-like” abdominal pain ;
- chest pain, shortness of breath, acute pulmonary edema (accumulation of fluid in the lung tissue);
- severe headaches not responding to treatment, persistent visual disturbances (phosphenes) or hearing disturbances (tinnitus)
When the expectant mother is well supported, she recovers quickly and gives birth to a healthy baby.
The doctor or midwife in charge of the mother will need to prescribe appropriate treatment. Antihypertensive treatment is needed to balance blood pressure and regular monitoring of the mother (blood pressure, proteinuria, blood tests) and the unborn baby (ultrasound, fetal heart rate).
Magnesium sulfate may also be given to prevent eclampsia (seizures).
A patient who has had pre-eclampsia for the first time is less likely to contract it a second time in her next pregnancy with the same father, due to the mother's immunological adaptation to the father's antigens . If it is a different second parent, she will run the same risks as in her previous pregnancy.
Postpartum: What are the long-term consequences of preeclampsia?
Mothers who have preeclampsia during pregnancy have a higher risk of developing cardiovascular disease than the general population. The risk of hypertension is quadrupled, and that of a stroke or myocardial infarction is doubled. Furthermore, this syndrome doubles the risk of post-pregnancy diabetes .
However, it is possible to slow down the onset of these diseases:
- by monitoring his blood pressure regularly;
- by regularly monitoring blood sugar levels;
- by adapting your diet (eating a balanced diet, sometimes without salt if necessary);
- by avoiding the consumption of alcohol or tobacco.
