PREGNANCY is an exciting time in a woman’s life, but it can also be one filled with uncertainty, anxiety and serious life-threatening complications.
One such complication is pre-eclampsia, which is a condition unique to pregnancy characterised by high blood pressure and systemic multiple organ dysfunction, such as of the liver and kidney, that develop after 20 weeks of pregnancy.
High blood pressure is dangerous during pregnancy because it may interfere with the placenta’s ability to deliver oxygen and nutrition to the foetus. The cause of pre-eclampsia is still unclear. Most theories focus on abnormal placental development, blood vessel disruption, immune system, or genetic factors.
Some of the risk factors for developing pre-eclampsia include: first pregnancy, a personal or family history of pre-eclampsia, a twin pregnancy, being part of the black race, aged under 20 or over age 35 at the time of pregnancy, pre-existing high blood pressure, kidney disease, autoimmune conditions, obesity or diabetes mellitus.
Therefore, if you have any of the above-mentioned risk factors, it is advisable to see your obstetrician as soon as you know that you are pregnant.
Pre-eclampsia complicates 2 to 8% of pregnancies globally and in Africa, more specifically sub-Saharan Africa and Asia, 9% of maternal deaths are attributed to pre-eclampsia.
The World Health Organisation (WHO) estimates the incidence of pre-eclampsia in developing countries to be seven times higher when compared to developed countries. A study conducted in Namibia in 2019 found that one in five women suffered from pregnancy-related life-threatening illness due to pre-eclampsia.
Once diagnosed, pre-eclampsia can only be cured by delivering the baby. Treatment for pre-eclampsia focuses on lowering blood pressure and managing the other symptoms.
It may be necessary to deliver the baby prematurely, as this is the only way to cure pre-eclampsia.
Pre-eclampsia is one of the major causes of perinatal death and serious illness for babies around the world.
Pre-eclampsia is unpredictable and may affect different organs within the pregnant woman, leading to serious complications such as seizures (known as eclampsia), strokes and even death if not well managed. It can also affect the baby’s growth and in severe cases lead to the death of the foetus inside the womb.
Delivering the baby early can reduce the risk of complications for the mother from pre-eclampsia.
On a positive note, aspirin started early during pregnancy, before 16 weeks in selected patients, may reduce the risk of pre-eclampsia by more than 60%. Therefore, see your obstetrician early in pregnancy to be screened for pre-eclampsia, and to determine if you will benefit from aspirin during pregnancy.
Although pre-eclampsia symptoms usually decrease soon after the baby is born, complications can sometimes develop a few days after delivery and may require medication to control high blood pressure. It is recommended that you see a doctor six weeks after delivery to check your progress and decide if any treatment needs to be continued.
Emerging evidence suggests that pre-eclampsia is a risk factor for developing cardiovascular diseases such as chronic hypertension, heart disease, stroke, dementia or kidney disease later in life. Therefore it is advised that you see a doctor once a year to be screened for the above-mentioned conditions.