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Pre-eclampsia

Description of Pre-eclampsia

Pre-eclampsia (say "pre-ee-clamp-see-ah"), which is also called toxemia, is a problem that occurs in some women during pregnancy. It can happen during the second half of pregnancy. Your doctor will look for the following signs of pre-eclampsia: high blood pressure, swelling that doesn't go away and large amounts of protein in your urine.

Who is at risk for Pre-eclampsia?

Pre-eclampsia is more common in a woman's first pregnancy and in women whose mothers or sisters had pre-eclampsia. The risk of pre-eclampsia is higher in women carrying multiple babies, in teenage mothers and in women older than age 40. Other women at risk include those who had high blood pressure or kidney disease before they became pregnant. The cause of pre-eclampsia isn't known.

Does high blood pressure mean I have pre-eclampsia?

Not necessarily. If your doctor sees that your blood pressure is high, he or she will watch you closely for changes that could mean you have pre-eclampsia. In addition to high blood pressure, women who have pre-eclampsia also have excessive swelling. They may also have protein in their urine. Many women with high blood pressure during pregnancy don't have protein in their urine or extreme swelling, and don't get pre-eclampsia.

Does swelling mean I have pre-eclampsia?

Swelling alone doesn't necessarily mean you have pre-eclampsia. Some swelling is normal during pregnancy. For example, your rings or shoes might become too tight. Swelling is more serious if it doesn't go away after resting, if it's very obvious in your face and hands, or if it's a rapid weight gain of more than 5 pounds in a week.

What tests can show if I have pre-eclampsia?

No one test diagnoses pre-eclampsia. Your blood pressure will be checked during each doctor's visit. A big rise in your blood pressure can be an early sign that you might have pre-eclampsia. A urine test can tell if there is protein in your urine. Your doctor may order certain blood tests, which may show if you have pre-eclampsia. If you have signs of pre-eclampsia, your doctor may want to see you at least once a week and possibly every day.

What are the risks of Pre-eclampsia to the baby and me?

Pre-eclampsia can prevent the placenta (which gives air and food to your baby) from getting enough blood. If the placenta doesn't get enough blood, your baby gets less air and food. This can cause low birth weight and other problems for the baby.

Most women with pre-eclampsia still deliver healthy babies. A few develop a condition called eclampsia (seizures caused by toxemia), which is very serious for the mother and baby, or other serious problems. Fortunately, pre-eclampsia is usually detected early in women who get regular prenatal care, and most problems can be prevented.

What is the treatment for Pre-eclampsia?

If you have pre-eclampsia, delivery of the baby is the best way to protect both you and your baby. This isn't always possible, because it may be too early for the baby to live outside of the womb.

If delivery isn't possible because it's too early in your pregnancy, steps can be taken to manage the pre-eclampsia until the baby can be delivered. These steps include making your blood pressure drop, with bed-rest or medicines, and keeping a close eye on you and your baby. In some cases, hospitalization may be necessary.

One way to control high blood pressure when you're not pregnant is to cut the amount of salt you eat. This isn't a good idea if you have high blood pressure during pregnancy. Your body needs salt to keep up the flow of fluid in your body, so you need a normal intake of salt. Your doctor will tell you how much salt to eat each day and how much water you should drink each day.

Your doctor might tell you to take aspirin or extra calcium to prevent pre-eclampsia. Your doctor might also tell you to lie on your left side while you are resting. This will increase the flow of urine and take weight off your large blood vessels. Many doctors give magnesium sulfate to their patients during labor and for a few days afterward to help prevent eclampsia. Talk to your doctor about these things.

If my doctor decides to deliver the baby early, will I have to have a Caesarean section?

This is up to your doctor and you. A caesarean section (an operation to deliver the baby) is more likely if your health or your baby's health is in danger. If things aren't this serious, your doctor may use medicine (such as oxytocin) to start your labour, and you can deliver your baby normally through a vaginal delivery.

Symptoms of Pre-eclampsia

  • If you have any of these symptoms, call your doctor right away:
  • Severe headaches
  • Vomiting blood
  • Excessive swelling of the feet and hands
  • Smaller amounts of urine or no urine
  • Blood in your urine
  • Rapid heartbeat
  • Dizziness
  • Excessive nausea
  • Ringing or buzzing sound in ears
  • Excessive vomiting
  • Drowsiness
  • Fever
  • Double vision
  • Blurred vision
  • Sudden blindness
  • Pain in the abdomen (stomach)

This provides a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information on this subject, talk to your family doctor.

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