The main symptoms of pre-eclampsia are high blood pressure and a simultaneous loss of protein in the urine, known as proteinuria.
High blood pressure is particularly dangerous in pre-eclampsia. It can take on life-threatening proportions for the pregnant woman and the unborn child within a very short time.
If pre-eclampsia is diagnosed, the course of the pregnancy should be monitored as closely as possible. It may be necessary to induce the birth of the child at an early stage so as not to endanger the lives of mother and child.
Pre-eclampsia is therefore the most common reason for the premature birth of a child.
Worldwide, between five and eight percent of pregnant women are affected by pre-eclampsia. In Germany, around two percent of pregnant women suffer from pre-eclampsia.
In the past, pre-eclampsia was also referred to as EPH gestosis or pregnancy poisoning. Today, however, medicine is moving away from these outdated terms. The assumption that pre-eclampsia is a poisoning of the body has not been confirmed.
The possible symptoms of pre-eclampsia include
- Pain in the upper abdomen,
- high blood pressure
- severe inner restlessness,
- large accumulations of water in the body,
- rapid weight gain (sometimes more than one kilogram per week),
- visual disturbances and
- severe headaches.
In pre-eclampsia, pregnant women often suffer from severely increased blood pressure © interstid | AdobeStock
Pre-eclampsia can take different courses and forms. In medicine, a distinction is made between two different forms of pre-eclampsia:
- early pre-eclampsia, which occurs before the 34th week of pregnancy, and
- late pre-eclampsia, which occurs after the 37th week of pregnancy.
Mild pre-eclampsia is only associated with the excretion of protein in the urine and high blood pressure. Eclampsia and HELLP syndrome, on the other hand, are among the more severe forms.
Eclampsia
If pre-eclampsia is not treated, it can lead to seizures. This affects less than one percent of women who suffer from severe pre-eclampsia.
The risk of severe progression is particularly high in early pre-eclampsia, but is low overall.
If pre-eclampsia only occurs later in pregnancy, it almost always takes a mild course. Serious complications such as HELLP syndrome or eclampsia are then not to be expected.
HELLP syndrome
Around one or two in ten women who suffer from severe pre-eclampsia and eclampsia are affected by HELLP syndrome. HELLP syndrome is characterized by these symptoms:
- Hemolysis (increased breakdown of red blood cells),
- increased levels of liver enzymes (this indicates damage to the liver ) and
- a reduced number of platelets, which leads to poor blood clotting. This means that the mother has a higher risk of heavier bleeding during and after delivery.
Medicine speaks of pre-eclampsia when the pregnant woman
- repeatedly has a blood pressure of more than 140/90 or
- a blood pressure of more than 160/100 is detected once.
At the same time, more than 0.3 grams of protein must have been found in a 24-hour urine sample.
The risk of pre-eclampsia can be precisely determined for every pregnant woman even before the symptoms mentioned appear. To do this, the test for pre-eclampsia must be carried out between the 12th and 14th week of pregnancy. This test is also known as pre-eclampsia screening. It is carried out by the gynecologist.
This screening includes
- An ultrasound scan,
- a blood pressure measurement and
- a blood test for certain hormones.
This allows the risk of pre-eclampsia to be detected before it breaks out and prevents it in more than 80 percent of cases.
To date, the exact causes of pre-eclampsia have not been conclusively clarified. It is therefore still unclear to medicine why pre-eclampsia can occur.
However, various factors are known to increase the risk of pre-eclampsia. These include
- A very young or very old pregnant woman,
- high blood pressure even before pregnancy,
- genetic components, such as pre-eclampsia in the grandmother, mother or sister,
- kidney disease,
- overweight(obesity) or
- diabetes.
If one or more of these factors are present, the risk of developing pre-eclampsia during pregnancy increases.
Taking part in screening is considered the best way to prevent pre-eclampsia.
If the screening reveals an increased risk of pre-eclampsia, preventive treatment begins. The pregnant woman is given low-dose aspirin, which she should generally take until the 34th week of pregnancy. She must stop taking it by the 36th week of pregnancy at the latest.
This treatment must start before the 20th week of pregnancy and before the first symptoms appear. The onset of pre-eclampsia can then be avoided in more than 80 percent of cases.
The only known risk factor for pre-eclampsia that the pregnant woman herself can influence is being overweight. For this reason, it is important that women pay attention to a healthy diet before and during their pregnancy.
Do not eat "for two", but pay attention to your actual calorie requirements. Of course, this advice applies to every pregnant woman, regardless of pre-eclampsia, and should be heeded accordingly.
If symptoms of pre-eclampsia occur after the 20th week of pregnancy, it is important to closely monitor those affected throughout the pregnancy. This can be done as an inpatient in a maternity clinic or as an outpatient by the treating gynecologist.
The aim of this therapy is to enable the child to develop as far as possible in the mother's womb. Completed lung maturity from the 35th week of pregnancy would be a great advantage.
If the blood pressure rises too high during the course of the pregnancy, the birth must be induced prematurely.
