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Pre-eclampsia
Pre-eclampsia is
a complication of pregnancy characterized by high blood pressure,
swelling (edema), and protein in your urine (proteinuria). It usually
occurs in the second half of pregnancy and can be mild or severe.
During pregnancy,
your blood volume increases. Normally the blood vessels in your
body relax during this time to help accommodate the increased blood
flow. When pre-eclampsia occurs, the blood vessels don't relax and
blood pressure rises.
Pre-eclampsia occurs in about 1 out of 10 pregnancies. Some women
are at higher risk.
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Increased
Risk of Pre-eclampsia
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- Under
20 years old
- Over
35 years old
- Pregnant
for the first time
- Pregnant
with twins or more
- Chronic
hypertension or diabetes
- Family
history of pre-eclampsia
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Why
Pre-eclampsia Is of Concern
The pregnant woman with pre-eclampsia can experience damage to
her kidneys and liver. This damage usually repairs itself after
the baby is delivered. Sometimes fluid can accumulate in the lungs
of a pregnant woman with this disease. If pre-eclampsia is severe,
blood clotting can be affected and there is a risk of internal bleeding.
Some women with
pre-eclampsia will develop HELLP
syndrome. HELLP stands for Hemolytic
anemia (when red blood cells break down), Elevated
Liver transaminases (a sign
of liver damage), and Low Platelet
count (this can mean difficulty with blood clotting). HELLP
syndrome is a condition where the liver isn't functioning normally.
It is a complication that occurs in a small group of women with
pre-eclampsia or pregnancy complicated by hypertension. This condition
can be mild or severe. When severe, it can be life threatening for
both mother and baby.
Pre-eclampsia can
decrease the flow of blood to the uterus. The placenta may not be
able to supply enough nutrients and oxygen and the baby's growth
may slow. Your provider may want to monitor your baby for signs
of stress if you develop pre-eclampsia.
Signs of Pre-eclampsia
You could develop pre-eclampsia without experiencing any symptoms.
This is one of the reason it is so important to keep all your prenatal
visits. Your weight, blood pressure and urine are usually checked
to screen for signs of pre-eclampsia. Some women do develop symptoms.
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Warning
Signs
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- Severe
headache or blurred vision
- Nausea
or vomiting
- Dizziness
or double vision
- Excessive
swelling of the hands or feet
- Decreased
frequency of urination
- Rapid
pulse
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If you experience
symptoms, you should call your health care provider immediately.
Pre-eclampsia is a serious problem, however, most women will deliver
a healthy baby if it is detected early.
Treatment
for Pre-eclampsia
The usual treatment for pre-eclampsia is delivery. If you are
at less then thirty-seven weeks gestational age, your provider may
delay delivery while carefully monitoring you and your baby. This
conservative management is usually only possible if your blood pressure
elevation is mild. Bedrest,
medication, blood pressure monitoring or hospitalization may be
necessary.
Prevention
of Pre-eclampsia
Pre-eclampsia is not always preventable for those at risk, however,
steps can be taken to lower chances it will develop or to delay
it. Being in good health before you become pregnant is probably
the best thing you can do. Women who start their pregnancy at a
normal body weight, are well nourished, don't smoke are less likely
to develop pre-eclampsia. If you are at higher risk, be sure to follow
all prenatal care advise and keep your medical appointments.
Diet
and Pre-eclampsia
Is there a link between diet and pre-eclampsia? Some studies
indicate that poorly nourished women develop pre-eclampsia more often.
Studies of calcium supplementation for preventing pre-eclampsia have
had mixed results with some recent studies showing no effect. A
recent study showed that supplemental vitamin C and vitamin E may
reduce pre-eclampsia in high risk women. The authors caution that
it is too soon to recommend supplementation. Pregnant women should
make sure their diet is adequate in food sources of these vitamins
and take only the supplements prescribed by their prenatal care
provider. The
best advice appears to be to:
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Diet
Strategies To Prevent Pre-eclampsia
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- Maintain
a normal weight before pregnancy.
- Avoid
excessive pregnancy weight gain.
- Consume
adequate sources of calcium.
- Eat a
well
balanced, prenatal diet
- Eat
adequate fresh fruits and vegetables.
- Take
prescribed prenatal vitamins and calcium supplements.
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It is not usually
recommended to restrict salt intake during pregnancy. On-the-other-hand,
avoiding excessive salt
use is a good idea. Discuss salt
and sodium recommendations with your physician if you are at
higher risk for pre-eclampsia.
What
About Future Pregnancies?
If you have pre-eclampsia with one pregnancy, you may be at higher
risk for developing it again. This is particularly true if you developed
severe pre-eclampsia, or if it occurred earlier in your pregnancy.
Women with pre-eclampsia
are at higher risk for developing chronic hypertension in later
years. Be sure and have your blood pressure checked regularly and
inform you regular health care provider about your pregnancy complications.
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