Preeclampsia

Preeclampsia

Preeclampsia, which is a regularly occurring medical complication in over five (5) percent of pregnancies appearing most commonly at or around 20 weeks of gestation, involves a clinically-dangerous spike in the mother’s blood pressure during the prenatal and postpartum period accompanied by proteinuria in the preeclamptic patient’s bloodstream. Clinicians generally categorize preeclampsia as either severe or mild, pending the suspected risks for a given pregnancy in light of blood pressure rates and proteinuria measures.

For pregnant women, a medical professional should be consulted to determine appropriate preeclampsia prenatal and prevention care appropriate in a given patient’s case, as well as to ensure continued monitoring for warning signs of preeclampsia both before, during, and up to six (6) weeks following delivery.

Health Risks and Dangers Associated with Preeclampsia

Preeclampsia is a hypertensive blood pressure condition presenting exclusively with human pregnancy, and by medical estimates, is the proximate cause of well over half a million or more non-viable births each year annually, with preeclampsia being a contributing or primary cause of the deaths of some eighty thousand pregnant or post-partum period women as well.

Preeclampsia is a dynamic period of increased blood pressure and protein levels in a pregnant woman or prenatal infant, with the condition leading to a predictable and highly serious list of medical complications if the preeclampsia does not respond to initial treatment with antihypertensive medications and lifestyle changes for the mother. These medical complications closely linked to the original devolution of the preeclamptic state in pregnant women include:

  • Worsening cardiovascular instability in the mother, generally presenting as uncontrolled blood pressure spikes in patients with the expected result of stroke, should medical professionals remain unable to stabilize the preeclamptic mother’s blood pressure or resolve the proteinuria in the bloodstream
  • Failure to control for the cascade of complications descending from preeclampsia also positions eclamptic patients to experience seizures, multiple organ failures, and preterm deliveries prior to 37 weeks of gestational age, or in the form of a distressed or complicated birth in full-term infants
  • In less than ten percent of eclampsia patients, HELLP syndrome arises in which liver functioning is dramatically impaired by way of hemolysis (red blood cell death), increased presence of enzymatic byproducts in the liver, and comprised platelet counts in the mother or child.
  • In a limited number of cases, gestational hypertension occurs without the presence of protein level increases in the bloodstream (proteinuria), which while preventing renal complications associated with preeclampsia, still presents serious risks to both mothers and preterm infants with grave risks relating to liver failure, as well as other complications such as pulmonary edema and of course stroke
  • Premature birth is the ultimate result of many preeclamptic conditions, in which medical professionals attempt to balance extending the gestational growth period further beyond twenty to twenty-four weeks, while also balancing the risks of rapid deterioration of maternal and neonatal health in the event of an uncontrolled preeclamptic event
  • In all cases, the preeclampsia poses the largest risks to the fetus and mother in the form of potential oxygen deprivation to the brain by way of cardiovascular instability, stroke, intrauterine growth restriction, acidosis in the infant, or organ failure. Especially in the cases of premature births or medically-necessary deliveries prior to thirty-seven weeks of gestation, preeclampsia presents high risks for later developing complications such as cerebral palsy.
  • Death of both infant and mother are by far the largest risks faced by patients and medical professionals. An unmonitored pregnancy displaying preeclampsia places both patients in grievous risk and present a high probability of fatal medical complications to both infant and mother, if left unaddressed. Moreover, treated and monitored preeclampsia still results in ten thousand fetal deaths annually in the United States alone.

Signs and Symptoms of Preeclampsia

Fortunately, given the scope of the potentially lethal implications of the sudden and progressive rise in blood pressure in pregnant women, medical professionals adhere to a well-known list of symptoms and signs to assist with preventing, early identification, and treatment of preeclampsia presenting in pregnant women, including:

  • All pregnant women must be informed by their healthcare providers of the risks and warning signs associated with preeclampsia, including case-specific considerations being made by the attending obstetrician or gynecologist concerning the patient-specific risk factors that may increase the likelihood of preeclampsia occurring
  • Symptomology frequently noted by medical literature as indicative of preeclampsia includes most notably a rise in blood pressure in the patient, but also, swelling of the patient’s extremities, visual difficulties, relatively acute weight fluctuations, malaise, headache, nausea, and in certain patients, a noticeable increase or feeling of extreme anxiety
  • Known prenatal risks associated with later increased risk for developing preeclampsia include mothers with a prior pregnancy involving preeclampsia, mothers undergoing their first or multiple simultaneous pregnancies, mothers younger than eighteen (18) years old and mothers older than forty (4) years old, and those women with a family medical history containing incidents of preeclampsia
  • Likewise, risk factors associated with the increased likelihood of preeclampsia complications include maternal risk factors such as obesity, pregnancy by way of in vitro fertilization, sickle cell patients, the presence of polycystic ovarian syndrome, and the pre-existence of auto-immune disorders, such as lupus, arthritis, and MS also present increased patient risk for preeclampsia as well
  • Postpartum preeclampsia and eclampsia patients account for nearly four-fifths of a instances of preeclampsia causing the death of the mother, as the acute onset of the condition and less intensive medical monitoring following a healthy birth leave patients vulnerable to the rapid emergence of this condition without appropriate prevention and planning
  • The presence of preeclampsia can be confirmed by medical professionals most quickly via identification of high blood pressure in conjunction with tests for elevated protein levels in the patient’s bloodstream

Statistically, about 1 in 20 women will develop preeclampsia during pregnancy. If a pregnant women is experiencing high blood pressure, seeking immediate medical assistance is advisable, as preeclampsia and eclampsia in childbirth if left unresolved can swiftly and irreversibly initiate a cascade of progressively more lethal medical problems.

The Relationship between Preeclampsia and Cerebral Palsy

Though managed preeclampsia in pregnancy is common, the unknown etiological origins of eclampsia in pregnancy, as well as the rapid unfolding of the medical chain of events in light of uncheck hypertension, present a serious medical challenge to both parents and practitioners. Specifically, the ensuing deprivation of oxygen to both infants and mothers in the event of an eclamptic event is closely linked to pre and post-term infants later developing cerebral palsy symptoms. Additionally, preterm births forced by way of eclampsia risks in light of preeclampsia place infants in the position of losing any number of weeks of healthy gestational growth. If delivered pre-term or in a distressed manner, especially with comorbid appearance of suspected oxygen deprivation in the fetus, infants are at an exponentially increased risk of developing cerebral palsy symptoms later in childhood.

Resources:

http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregcomplications.htm

https://www.nlm.nih.gov/medlineplus/highbloodpressureinpregnancy.html

http://www.acog.org/~/media/For%20Patients/faq034.pdf

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