What is Preeclampsia?
Preeclampsia is a complication of pregnancy. Up to 8% of all births globally are complicated by it. Besides, preeclampsia accounts for 15% of preterm births in the United States (delivery before 37 weeks of pregnancy). It is a very serious medical condition that can occur about midway through pregnancy, after 20 weeks. Preeclampsia needs to be diagnosed and treated by a healthcare provider.
Here is what you can read about in this post:
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What is preeclampsia
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What causes preeclampsia
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Does preeclampsia affect the baby?
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How to prevent preclampsia
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Is stress related to preeclampsia
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Signs and symptoms of preeclampsia
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How is preeclampsia diagnosed which is the treatment for preeclampsia
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Is there a cure for preeclampsia?
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Does preeclampsia disappear after delivery or is it chronic?
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Complications of preeclampsia
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New treatment and research
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What exactly is preeclampsia?
It is characterized by a high blood pressure (higher than 140/90 mmHg). This high blood pressure, when prolonged in time, puts stress under the mothers heart and other organs, such the uterus, potentially causing serious complications. Sometimes it can even affect the placenta, reducing the blood supply to the baby. A common sign of preeclampsia is protein in the urine, which demonstrates that the kidney is suffering from this high blood pressure. Besides the kidney, other organs also suffer such as the liver and the lungs that can get fluid build up.
What causes preeclampsia?
No one is entirely sure. Preeclampsia is believed to come from a problem with the health of the placenta. However, it is still not known how a problem in the placenta can develop such a severe process in the mothers body. What we do know is that the blood supply to the placenta might be decreased in preeclampsia, and this can lead to problems with both the mother and the fetus.
Does preeclampsia affect the baby?
preeclampsia can cause preterm delivery so you may need to go into labor earlier than desired. This leads to a premature baby which is at increased risk for health complications like low birth weight and respiratory issues. However, with an early diagnosis and with the correct treatment there should not be a biggest problem.
Can I do something to prevent it?
There is not clear data about what exactly causes preeclampsia but there are some steps that can be taken prior to or during a pregnancy to lower the charge of developing preeclampsia:
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- Losing weight if you have obesity or are overweight
- Controlling your sugar levels if you are diabetic
- Maintaining a regular exercise routine
- Getting enough sleep and eating healthy for lowering the salt and avoiding caffeine.
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Additionally, there are some factors that may put you at a higher risk:
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- History of blood pressure, kidney disease or diabetes
- Expecting multiples
- Family history of preeclampsia
- Autoimmune conditions like lupus
- Obesity
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It has been scientifically demonstrated that for these people that have some risk factors for preeclampsia, taking a baby aspirin daily decreases the risk of developing preeclampsia by approximately 15%. However, this should be commented on and recommended by a doctor, you should never medicate yourself. We also encourage getting information from other trusted sites like Pubmed.
Does stress cause preeclampsia?
Stress should be avoided during pregnancy for so many reasons that the scientific community does not even know where to start. However, preeclampsia is not one of them, even though it might increase the blood pressure, stress is not one of the direct causes of preeclampsia.
And how do I know if I have preeclampsia? Which are the symptoms?
The thing is that many people with preeclampsia do not have any symptoms. However, for those that do, some of the first signs of preeclampsia are high blood pressure, protein in the urine and retaining water leading to swelling. Other less common signs of preeclampsia may include headaches, blurry vision, light sensitivity, shortness of breath, swelling in face and hands between others.
The fact that preeclampsia does not have a clear diagnosis nor clear symptoms put into sight the importance of sharing all of the pregnancy symptoms with your healthcare provider.
Some people do not get diagnosed until the severe preeclampsia symptoms come to the surface including a blood pressure higher than 160/110 mmHg that leads to hospitalization, decreased liver or kidney function, fluid in the lungs or decreased urine production.
How is it diagnosed?
Preeclampsia is frequently discovered when he healthcare professional examines the weight growth, blood pressure, and urine during standard prenatal visits.When preeclampsia is suspected there are usually some test to run:
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- Specific blood test to check kidney and liver functions.
- 24 hours urine collection to detect protein.
- Fetal ultrasound and other fetal monitoring to look at the size of the fetus and the amniotic fluid volume.
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What is the treatment for preeclampsia?
The ideal course of treatment for preeclampsia will be recommended by the healthcare practitioner. The severity of your preeclampsia and the stage of your pregnancy will largely determine the course of treatment.
The baby will likely be born early if you are nearly at full term (37 weeks or more). You can still give birth vaginally, although a Cesarean section (C-section) may be advised in some cases. In addition, the doctor may prescribe medicine to lower your blood pressure and aid with the development of the fetus’s lungs until the baby can be born. Sometimes it is safer to deliver the child sooner than to take the chance of having a longer pregnancy.
Women are usually closely watched if preeclampsia appears early in pregnancy in an effort to keep the pregnancy longer and give the fetus more time to grow and develop. More prenatal checkups will be scheduled, including ultrasounds, urine tests, and blood tests. Nevertheless, if preeclampsia is identified as severe, some womens are asked to stay in the hospital until their baby is born.
Is there a cure for preeclampsia?
Sadly no, there is not a cure for preeclampsia. The only “cure” of preeclampsia is delivery. However, there is something that is usually given during labor and after delivery to women that have suffered preeclampsia to stop the development of eclampsia.
Wait a minute, what is eclampsia?
It is the name given to the seizures that occur after delivery in women that had suffered preeclampsia. Some time ago they were very mortal but they are not anymore. There are very few women that suffer from eclampsia nowadays.
Does preeclampsia disappear after delivery or is it chronic?
Yes, following delivery, preeclampsia normally disappears within a few days to weeks. The blood pressure may occasionally be elevated for a few weeks after delivery, necessitating pharmaceutical treatment. Preeclampsia patients are more likely to develop hypertension and heart problems later in life, especially if the condition manifests early in pregnancy. With this knowledge, such people can work with their primary care physician to take precautions to lower these risks.
Which are the most common complications of preeclampsia?
Yes, of course, even though most of the time preeclampsia does not lead to severe conditions, this is not always the case. Preeclampsia has the potential to be lethal to both the mother and the fetus if neglected. The most frequent issues prior to delivery are preterm birth, low birth weight, or placental abruption.
On top of that. HELLP (hemolysis, elevated liver enzymes and lower platelet count syndrome) syndrome can be brought on by preeclampsia. This occurs as a result of preeclampsia’s effects on your liver, red blood cells, and blood clotting. Other symptoms of HELLP syndrome include blurred vision, headaches, nosebleeds, and chest discomfort that even though usually go away with delivery, in those women that suffer HELLP syndrome needs to be treated.
Finally, the most common complication of preeclampsia is preeclampsia in subsequent pregnancies where it will be stronger and more difficult to treat.
New insights on preeclampsia, the latest published information
According to the latest reviews of preeclampsia (1), preeclampsia is familial. Genetic analyses suggest that one or more common alleles may act as “preeclampsia susceptibility genes.” The authors speculate that genes involved in blood pressure control, volume regulation, placental health, vascular disease, and vascular remodeling, underlie familial susceptibility to preeclampsia. Several candidate genes have been examined.
These data suggest that a common mutation in the angiotensinogen promoter, A(-6), leads to elevated expression of this gene and pleiotropic effects, including abnormal spiral artery remodeling and failed hypervolemia of pregnancy. The factor V. Leiden mutation, which predisposes women to thromboembolic disorders during pregnancy, has been implicated as another preeclampsia susceptibility gene. New insights into the genetics of preeclampsia will contribute to the understanding of this disease and should ultimately lead to improved diagnosis and treatment.
In addition, another study (2) complements this information stating that preeclampsia does not only have susceptibility genes but also there are some genes that are associated with complications of preeclampsia. University of Miami Miller School researchers, led by Shathiyah Kulandavelu, Ph.D., and Joshua Hare, M.D., have shown that mutations in a single gene, called GSNOR, can cause many of the complications associated with preeclampsia, a life-threatening condition affecting pregnant women. These findings could lead to new diagnostics and treatments, as well as sparking continuing research.
- Morgan T, Ward K. New insights into the genetics of preeclampsia. Semin Perinatol. 1999 Feb;23(1):14-23. doi: 10.1016/s0146-0005(99)80056-1. PMID: 10102167.
- Kulandavelu S, Dulce RA, Murray CI, Bellio MA, Fritsch J, Kanashiro-Takeuchi R, Arora H, Paulino E, Soetkamp D, Balkan W, Van Eyk JE, Hare JM. S-Nitrosoglutathione Reductase Deficiency Causes Aberrant Placental S-Nitrosylation and Preeclampsia. J Am Heart Assoc. 2022 Mar;11(5):e024008. doi: 10.1161/JAHA.121.024008. Epub 2022 Feb 22. PMID: 35191317; PMCID: PMC9075059.
Future treatments being studied
Scientists have proposed a new therapy, tested in two rodent models, that corrects the defects identified in placental cells, and restores placental and fetal weight. The treatment successfully lowers blood pressure in the mother and resolves the characteristic preeclampsia symptoms of excess protein in urine and cardiovascular abnormalities.
There is a genetic component: the first gene to be identified as being implicated in the genetic forms of preeclampsia was the STOX1 transcription factor, which controls the expression of thousands of genes, especially those involved in the production of nitric oxide (NO). In a transgenic mouse model, high accumulation of STOX1 in the placenta induced a preeclampsia-like syndrome. In preeclampsia, nitric oxide, a powerful vasodilator that dilates blood vessels to promote blood flow to the placenta, is mobilized to produce potentially toxic molecules (nitrosative stress) and its levels become insufficient in the placental vascular network, affecting trophoblast function and the vascular network and destabilizing other reactive species. This creates a vicious circle and causes uncontrollable oxidative/nitrosative stress with multiple complications, also affecting maternal blood vessel cells, with potentially fatal consequences. NO is produced by a family of enzymes known as nitric oxide synthases (NOSs). Finding a way of restoring
NO production in the placenta via NOSs could represent an effective new therapy to treat preeclampsia.
This research (3) is the first step towards the development of a therapy for preeclampsia.
3. Laurent Chatre, Aurélien Ducat, Frank T. Spradley, Ana C. Palei, Christiane Chéreau, Betty Couderc, Kamryn C. Thomas, Anna R. Wilson, Lorena M. Amaral, Irène Gaillard, Céline Méhats, Isabelle Lagoutte, Sébastien Jacques, Francisco Miralles, Frédéric Batteux, Joey P. Granger, Miria Ricchetti, Daniel Vaiman. Increased NOS coupling by the metabolite tetrahydrobiopterin (BH4) reduces preeclampsia/IUGR consequences. Redox Biology, 2022; 55: 102406 DOI: 10.1016/j.redox.2022.102406
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