Preeclampsia (preeclampsia) | Afrilatest.be

Also read: Gestational Hypertension: High Blood Pressure During Pregnancy

HELLP syndrome

HELLP syndrome is a rare form of preeclampsia. It occurs in 0.2 to 0.6 percent of all pregnancies. HELLP stands for:

• Hemolysis: breakdown of blood cells
• Elevated Liver Test: Liver damage and elevated liver tests
• Low Platelets: shortage of platelets

Your doctor can use blood tests to determine if HELPP syndrome is present. If so, labor should be induced as soon as possible.

Also read: My Story: HELLP and Postnatal Depression

Cause

Pregnancy demands a considerable adjustment of the circulatory system: the blood volume increases by almost half, while at the same time the blood pressure drops slightly. This does not happen with pre-eclampsia. The blood volume remains smaller than desired and the blood vessels contract, causing the blood pressure to rise.

The cause of these abnormal phenomena is unknown, but it is most likely related to an abnormal development of the blood vessels at the site where the placenta is attached to the uterus. In addition, the endothelium, the cell layer that lines the blood vessels on the inside, is said to not function properly. It is suspected that it secretes substances that prevent the normal adaptation of the blood circulation to pregnancy.

The poor adaptation of the blood circulation leads to a lower blood flow to the placenta, kidneys, liver and brain. As a result, the functioning of these organs slowly becomes disrupted, which causes all sorts of problems.

Also read: Gingivitis and preeclampsia

Implications

• In the worst case, the placenta may become detached, the kidneys may fail, a convulsion may occur (similar to an epileptic seizure), bleeding may occur in the liver and brain, fluid may accumulate in the lungs, etc. These complications can ultimately be fatal.
• The baby's reduced blood supply can lead to severe growth retardation, oxygen deficiency, premature birth and death.

A number of groups appear to be at higher risk of preeclampsia. This is the case, for example, for women who are pregnant for the first time or whose grandmother, mother or sister also suffered from preeclampsia. There is also an increased risk among pregnant teenagers and women over 40.

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Evolution

The problems can occur at different times during pregnancy, but they often tend to worsen and spread. The earlier they occur and develop more quickly, the greater the risk of serious consequences. Fortunately, in most cases the problems remain limited.

The later the preeclampsia appears in the pregnancy, the greater the chance of bringing the child into the world. The more mature the child is, the fewer disadvantages it experiences. Even a sudden and rapidly developing preeclampsia is therefore less threatening to mother and child, provided that intervention is taken quickly.

Symptoms

Preeclampsia causes a number of symptoms that the woman can recognize herself. Other symptoms can only be detected by a doctor or by additional tests, e.g. on blood and urine.

Recognizable complaints:

• nausea and vomiting during the second half of pregnancy
• problems urinating or suddenly not being able to urinate. This indicates kidney problems
• abdominal pain high in the abdomen (near the liver and stomach), nausea and vomiting may indicate serious liver problems
• an abnormal build-up of fluid (edema)
• visual disturbances such as flies in front of the eyes, double vision, flashes of light
• abnormally high blood pressure (hypertension)
• a growth retardation of the baby. The doctor can recognize this on an ultrasound
• proteins in the urine (proteinuria)
• too much uric acid in the blood
• an abnormal breakdown of red blood cells (hemolysis).

These symptoms can occur either individually or in varying combinations.

If signs of preeclampsia have already been established, headache, nausea, visual disturbances, etc., may indicate an impending attack of convulsions. In the event of such symptoms, it is best to contact the doctor immediately. Fortunately, convulsions in pregnancy poisoning are very rare.

Also read: Nephrotic syndrome: swollen feet and ankles due to too much protein in the urine

Treatment

In the case of a mild form of preeclampsia, which does not pose an immediate threat to the mother and the development of the child, treatment is usually not given. People are usually allowed to stay at home. However, they must be carefully and frequently monitored by a doctor because the condition can suddenly worsen. Symptoms such as frontal headache, visual disturbances, sensitivity to light, vomiting, stomach complaints or abdominal pain can indicate this and are therefore a reason to contact a doctor immediately.

Women who are allowed to stay at home are also well advised to have their doctor give them detailed information on what to look out for. This way they can monitor whether or not their condition is getting worse. An important sign of this is the baby's movements.

As long as there is no immediate danger to the life of the mother or the baby, the most important problems are controlled as much as possible with medication. For example, the woman is given medication for high blood pressure. The fluid retention is counteracted. Painkillers are prescribed if necessary. In the meantime, the development of the mother and the fetus are monitored very frequently. In this way, one tries to slow down the symptoms and the unfavourable developments as much as possible and to turn them into the best possible conditions for the development of the fetus and for the well-being of the mother.

The ultimate goal is to prolong the pregnancy until conditions for birth are optimal. In doing so, one must constantly weigh up the threat to mother and child from preeclampsia against the possible benefits of a prolonged pregnancy for the child.

When the baby and the mother are in serious trouble and even in danger of death, childbirth is the only real solution. When the pregnancy is interrupted and the placenta is removed, preeclampsia stops almost immediately. The woman's metabolism then returns quite quickly to its original state before the pregnancy.

When to terminate the pregnancy?

• The 34th week of pregnancy is a landmark. Around that time, the pregnancy is nearing its end and the baby is already strong enough to survive a premature birth without too much trouble.
• If birth is unavoidable, efforts are made to delay the pregnancy sufficiently to allow the fetus to mature its lungs with medication and to transport the woman to a hospital with an intensive care unit for premature babies.

Also read: Premature baby

Prevention

Unfortunately, you cannot always prevent preeclampsia. The most important thing is to have yourself monitored and live healthily. Try to keep weight gain under control during your pregnancy. Also eat as little salt as possible.

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