Preeclampsia and Eclampsia - What You Need to Know

Pregnancy is a fantastic time. Your body is changing, and you are growing a human! However, as your pregnancy progresses, it's essential to be aware of potential complications. Two relatively common complications are preeclampsia and eclampsia. Here's what you need to know about these conditions.

What is Preeclampsia?

Preeclampsia is a disorder that only happens in pregnant women, occurring after 20 weeks of gestation. In some cases, the development of preeclampsia can begin up to 6 weeks after delivery. Preeclampsia causes new-onset Hypertension and proteinuria (protein in the urine), a marker of kidney damage.

Preeclampsia can cause damage to other organs like the brain and liver. Symptoms can vary widely, from no symptoms or only mild ones in some women to severe preeclampsia that develops into a life-threatening illness for others.

What is Eclampsia?

Eclampsia is a complication of preeclampsia and occurs when the woman develops seizures (convulsions). Eclampsia can be severe, so it's essential to know the signs and symptoms and seek medical advice if you think you or someone you know may have preeclampsia.

If you have preeclampsia or are at risk for developing it, there are specific steps you can take to help reduce your chances of developing complications from the condition. These include eating a healthy diet, getting adequate rest, and managing underlying health conditions like diabetes or high blood pressure.

Preeclampsia and eclampsia are severe conditions that require immediate medical attention. With the proper treatment and care, women with these conditions can go on to deliver healthy babies without any complications. Talk to your doctor as soon as possible if you think you may have preeclampsia or eclampsia.

Why do these changes happen in preeclampsia and eclampsia?

Unfortunately, the exact cause is still unclear. However, some research suggests that it may be partly due to an abnormal placenta – specifically, the development of fibrous tissues in the uteroplacental arteries. These arteries usually dilate (5-10 times their standard size) and become large enough to deliver plenty of blood to the developing fetus during pregnancy. But when they become fibrous in a woman with preeclampsia, they narrow and can't provide enough blood to the placenta. This leads to impaired growth of the fetus and may even cause fetal death in severe cases.

At this point, the hypoperfused placenta begins to release pro-inflammatory proteins that cause damage to the mother's endothelial cells, resulting in Hypertension and other effects. Endothelial cell dysfunction is also thought to cause vasoconstriction - narrowing of the blood vessels - which impacts kidney function, causing increased fluid retention and salt retention.

When diagnosing preeclampsia, Hypertension is defined as a systolic blood pressure of 140 mmHg or greater or a diastolic blood pressure of 90 mmHg or more significant. In severe preeclampsia, systolic blood pressure can be 160 mmHg or greater, and diastolic blood pressure can be 110 mmHg or more critical. These extreme blood pressures can lead to a hemorrhagic stroke or placental abruption, in which the placenta detaches prematurely from the uterine wall. There can also be local areas of vasospasm - which means that less blood might reach certain parts of the body, leading to glomerular damage and proteinuria.

Reduced blood flow to the liver can lead to severe liver injury and swelling, which can also stretch out the capsule around the liver. This can cause elevated levels of certain enzymes in the blood, like serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST). Stretching the liver capsule can also cause right upper quadrant pain, or epigastric pain, a classic symptom of severe preeclampsia.

Endothelial injury in pregnant women with preeclampsia is also thought to cause increased platelet (blood cell fragments) consumption and the formation of thrombi - tiny blood clots - in the microvasculature. Having all these small blood clots in the blood is like having dozens of boulders in the middle of a fast-moving river. It becomes treacherous for red blood cells to navigate through; before long, they slam against a clot and get destroyed - a process called hemolysis. This leads to the very high levels of protein in the urine that are characteristic of severe preeclampsia.

Reduced blood flow to the retina can cause blurred vision, the sensation of seeing flashing lights, and the development of a scotoma - a small part of the visual field with slightly worse visual acuity.

In women with preeclampsia, poorer blood flow to the placenta can lead to further thrombus formation and even fetal death. If you have been diagnosed with preeclampsia or are at risk for developing it, there are several steps you can take to help reduce your chances.

HELLP syndrome (H = hemolysis, EL = elevated liver enzymes, LP = low platelets)

This condition consists of red blood cell destruction in the liver, reduced liver function, low platelets, and high levels of an enzyme called lactate dehydrogenase (LDH). The symptoms associated with HELLP syndrome can mimic and can eventually lead to full-blown eclampsia.

In addition to the various symptoms of preeclampsia, eclampsia can also accompany seizures. If a pregnant woman with preeclampsia develops seizures, she must receive medical attention as soon as possible. In severe cases, a woman may even develop status epilepticus - when an individual has an episode that lasts more than 30 minutes and requires medical intervention.

Signs/ Symptoms and prevention of preeclampsia and eclampsia:

- Hypertension (high blood pressure)

- Protein in your urine (proteinuria)

- Swelling (edema) in the hands, face, or ankles

- General discomfort or uneasiness

- Headaches or changes in vision

- Nausea and vomiting

- Shortness of breath

- Increased or rapid heart rate

- Decreased urine output

If you have been diagnosed with preeclampsia or are at risk for developing it, there are several steps you can take to help reduce your chances of developing eclampsia. These include:

- Monitoring your blood pressure and urine regularly

- Reducing your salt intake

- Getting plenty of rest and regular exercise

- Avoiding alcohol and tobacco products

- Consult with your doctor regularly to ensure that you keep a close eye on any changes in your health or symptoms of preeclampsia or eclampsia.

- Get regular prenatal care

- Eat a healthy diet

- Avoid excess weight gain during pregnancy

Doing these things can help to reduce your risk of developing eclampsia. Suppose you have preeclampsia or are at risk of developing it. In that case, these steps can be crucial in preventing complications like HELLP syndrome or even the onset of seizures. If you are experiencing any of the symptoms mentioned above, speak with your doctor as soon as possible. Early diagnosis and treatment can help reduce your risk of developing eclampsia and other preeclampsia-related complications.

Preeclampsia and eclampsia are severe health conditions that can affect pregnant women and their babies. These conditions are characterized by high blood pressure, protein in the urine, swelling of hands or feet, headaches or vision changes, nausea and vomiting, and shortness of breath. In severe cases, women with preeclampsia or eclampsia may experience seizures and reduced blood flow to the placenta, leading to complications such as HELLP syndrome.

If you are pregnant and experiencing these symptoms, you must speak with your doctor as soon as possible. Early diagnosis and treatment can help reduce your risk of developing eclampsia and other preeclampsia-related complications. Some steps to help lower your risk include maintaining a healthy diet, getting regular exercise and rest, avoiding alcohol and tobacco products, and seeing your doctor regularly for monitoring and treatment. These proactive measures can help improve your and your baby's health during pregnancy.

Conclusion

While there is no definitive treatment for preeclampsia or eclampsia, there are some steps women can take to help manage their symptoms and prevent complications. These include eating a healthy diet, getting enough rest and sleep, addressing any underlying health conditions like diabetes or high blood pressure, and working closely with your doctor throughout the pregnancy. With the proper support, women with preeclampsia and eclampsia can go on to deliver healthy babies without complications.

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