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Preeclampsia (Toxaemia of pregnancy, Pre eclampsia) : Symptoms, Causes, Diagnosis and Treatment

What is Preeclampsia?

Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal.

Left untreated, preeclampsia can lead to serious ? even fatal ? complications for both you and your baby. If you have preeclampsia, the most effective treatment is delivery of your baby. Even after delivering the baby, it can still take a while for you to get better.

If you're diagnosed with preeclampsia too early in your pregnancy to deliver your baby, you and your doctor face a challenging task. Your baby needs more time to mature, but you need to avoid putting yourself or your baby at risk of serious complications.

Rarely, preeclampsia develops after delivery of a baby, a condition known as postpartum preeclampsia. Preeclampsia is when you have high blood pressure and possibly protein in your urine during pregnancy or after delivery. You may also have low clotting factors (platelets) in your blood or indicators of kidney or liver trouble.

Preeclampsia generally happens after the 20th week of pregnancy. However, in some cases it occurs earlier, or after delivery.

Preeclampsia is also known as Toxaemia of pregnancy, Pre eclampsia. Preeclampsia belongs under the category of Pregnancy disease. Generally Female are the victim of the Preeclampsia. Seriousness of this disease is Medium.

Symptoms of Preeclampsia are :

  • high blood pressure 
  • High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

  • Difficulty in breathing
  • Experiencing breathing difficulty describes discomfort when breathing and feeling as if you can?t draw a complete breath. This can develop gradually or come on suddenly. Mild breathing problems, such as fatigue after an aerobics class, don?t fall into this category.

    Breathing difficulties can be caused by many different conditions. They can also develop as a result of stress and anxiety.

    It?s important to note that frequent episodes of shortness of breath or sudden, intense breathing difficulty may be signs of a serious health issue that needs medical attention. You should discuss any breathing concerns with your doctor.

  • liver abnormalities
  • Your liver is a key part of your digestive system, responsible for cleaning out toxins from your blood, processing medicines, producing bile, helping you digest fat, storing glucose and producing proteins for clotting your blood, among many other things.

  • Less urine discharge
  • Dehydration is the most common cause of decreased urine output. Typically, dehydration occurs when you?re ill with diarrhea, vomiting, or another illness, and can?t replace the fluids that you?re losing. When this happens, your kidneys retain as much fluid as possible.

  • Vomiting
  • Vomiting, or throwing up, is a forceful discharge of stomach contents. It can be a one-time event linked to something that doesn?t settle right in the stomach. Recurrent vomiting may be caused by underlying medical conditions.

    Frequent vomiting may also lead to dehydration, which can be life-threatening if left untreated.

  • Nausea
  • Nausea and vomiting are common signs and symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis ? often mistakenly called stomach flu ? or the morning sickness of early pregnancy.

    Many medications can cause nausea and vomiting, as can general anesthesia for surgery. Rarely, nausea and vomiting may indicate a serious or even life-threatening problem.

  • abdominal pain
  • Abdominal pain has many potential causes. The most common causes ? such as gas pains, indigestion or a pulled muscle ? usually aren't serious. Other conditions may require more-urgent medical attention.

    While the location and pattern of abdominal pain can provide important clues, its time course is particularly useful when determining its cause.

    Acute abdominal pain develops, and often resolves, over a few hours to a few days. Chronic abdominal pain may be intermittent, or episodic, meaning it may come and go. This type of pain may be present for weeks to months, or even years. Some conditions cause progressive pain, which steadily gets worse over time.

  • Vision problems, such as blurred vision, double vision or loss of peripheral vision
  • Double vision is the perception of two images of a single object seen adjacent to each other (horizontally, vertically, or obliquely) or overlapping. Diplopia is the medical term for double vision. Polyplopia is the perception of three or more images of a single object overlapping each other.

    Double vision is called "monocular" when the double image is perceived by an eye that is tested alone. In "binocular" double vision, each eye sees a single image when tested alone, but a double image is present when both eyes are open.

  • Severe Headache
  • Headaches are a common health problem ? most people experience them at some time.

    Factors that lead to headaches may be:

    Frequent or severe headaches can affect a person?s quality of life. Knowing how to recognize the cause of a headache can help a person take appropriate action.

    Causes

    Preeclampsia can be caused due to:

    Doctors can?t yet identify one single cause of preeclampsia, but some potential causes are being explored. These include:

    There are also risk factors that can increase your chances of developing preeclampsia. These include:

    • being pregnant with multiple fetuses
    • being over the age of 35
    • being in your early teens
    • being pregnant for the first time
    • being obese
    • having a history of high blood pressure
    • having a history of diabetes
    • having a history of a kidney disorder

    Nothing can definitively prevent this condition. Doctors may recommend that some women take baby aspirin after their first trimester to help prevent it.

    Early and consistent prenatal care can help your doctor diagnose preeclampsia sooner and avoid complications. Having a diagnosis will allow your doctor to provide you with proper monitoring until your delivery date.

    What kind of precaution should be taken in Preeclampsia?

    While preeclampsia cannot be fully prevented, there are a number of steps a woman can take to moderate some factors that contribute to high blood pressure.

    These can include:

    • drinking between 6 and 8 glasses of water every day
    • avoiding fried or processed food
    • excluding added salt from the diet
    • regular exercise
    • avoiding alcohol and caffeine intake
    • keeping the feet elevated a few times per day
    • resting

    Treatment for the Preeclampsia

    Diagnosis

    To diagnose preeclampsia, you may check your baby?s health with:

    • Ultrasound. This is a prenatal test that uses sound waves and a computer screen to make a picture of your baby in the womb. Ultrasound checks that your baby is growing at a normal rate. It also lets your provider look at the placenta and the amount of fluid around your baby to make sure your pregnancy is healthy.
    • Nonstress test. This test checks your baby?s heart rate.
    • Biophysical profile. This test combines the nonstress test with an ultrasound.

    Tests that may be needed

    If your doctor suspects preeclampsia, you may need certain tests, including:

    • Blood tests. Your doctor will order liver function tests, kidney function tests and also measure your platelets ? the cells that help blood clot.
    • Urine analysis. Your doctor will ask you to collect your urine for 24 hours, for measurement of the amount of protein in your urine. A single urine sample that measures the ratio of protein to creatinine ? a chemical that's always present in the urine ? also may be used to make the diagnosis.
    • Fetal ultrasound. Your doctor may also recommend close monitoring of your baby's growth, typically through ultrasound. The images of your baby created during the ultrasound exam allow your doctor to estimate fetal weight and the amount of fluid in the uterus (amniotic fluid).
    • Nonstress test or biophysical profile. A nonstress test is a simple procedure that checks how your baby's heart rate reacts when your baby moves. A biophysical profile uses an ultrasound to measure your baby's breathing, muscle tone, movement and the volume of amniotic fluid in your uterus.

    Treatment depends on how severe your preeclampsia is and how far along you are in your pregnancy. Even if you have mild preeclampsia, you need treatment to make sure it doesn?t get worse.

    Treatment

    Treatment depends on how severe your preeclampsia is and how far along you are in your pregnancy. Even if you have mild preeclampsia, you need treatment to make sure it doesn?t get worse.
    The most effective treatment for preeclampsia is delivery. You're at increased risk of seizures, placental abruption, stroke and possibly severe bleeding until your blood pressure decreases. Of course, if it's too early in your pregnancy, delivery may not be the best thing for your baby.

    If you're diagnosed with preeclampsia, your doctor will let you know how often you'll need to come in for prenatal visits ? likely more frequently than what's typically recommended for pregnancy. You'll also need more frequent blood tests, ultrasounds and nonstress tests than would be expected in an uncomplicated pregnancy.

    Medications

    Possible treatment for preeclampsia may include:

    • Medications to lower blood pressure. These medications, called antihypertensives, are used to lower your blood pressure if it's dangerously high. Blood pressure in the 140/90 millimeters of mercury (mm Hg) range generally isn't treated.

    Although there are many different types of antihypertensive medications, a number of them aren't safe to use during pregnancy. Discuss with your doctor whether you need to use an antihypertensive medicine in your situation to control your blood pressure.

    • Corticosteroids. If you have severe preeclampsia or HELLP syndrome, corticosteroid medications can temporarily improve liver and platelet function to help prolong your pregnancy. Corticosteroids can also help your baby's lungs become more mature in as little as 48 hours ? an important step in preparing a premature baby for life outside the womb.
    • Anticonvulsant medications. If your preeclampsia is severe, your doctor may prescribe an anticonvulsant medication, such as magnesium sulfate, to prevent a first seizure.

    Bed rest

    Bed rest used to be routinely recommended for women with preeclampsia. But research hasn't shown a benefit from this practice, and it can increase your risk of blood clots, as well as impact your economic and social lives. For most women, bed rest is no longer recommended.

    Hospitalization

    Severe preeclampsia may require that you be hospitalized. In the hospital, your doctor may perform regular nonstress tests or biophysical profiles to monitor your baby's well-being and measure the volume of amniotic fluid. A lack of amniotic fluid is a sign of poor blood supply to the baby.

    Delivery

    If you're diagnosed with preeclampsia near the end of your pregnancy, your doctor may recommend inducing labor right away. The readiness of your cervix ? whether it's beginning to open (dilate), thin (efface) and soften (ripen) ? also may be a factor in determining whether or when labor will be induced.

    In severe cases, it may not be possible to consider your baby's gestational age or the readiness of your cervix. If it's not possible to wait, your doctor may induce labor or schedule a C-section right away. During delivery, you may be given magnesium sulfate intravenously to prevent seizures.

    If you need pain-relieving medication after your delivery, ask your doctor what you should take. NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can increase your blood pressure.

    Possible complication with Preeclampsia

    Complications from preeclampsia disease in your baby may include:
    Preeclampsia can keep your placenta from getting enough blood, which can cause your baby to be born very small. This is called fetal growth restriction.

    It?s also one of the most common causes of premature births and the complications that can follow, including learning disabilities, epilepsy, cerebral palsy, and hearing and vision problems.

    • Premature birth. Even with treatment, you may need to give birth early to help prevent serious health problems for you and your baby.
    • Placental abruption. This is when the placenta separates from the wall of the uterus (womb) before birth. It can separate partially or completely. If you have placental abruption, your baby may not get enough oxygen and nutrients. Vaginal bleeding is the most common symptom of placental abruption after 20 weeks of pregnancy. If you have vaginal bleeding during pregnancy, tell your health care provider right away.
    • Intrauterine growth restriction (also called IUGR). This is when a baby has poor growth in the womb. It can happen when mom has high blood pressure that narrows the blood vessels in the uterus and placenta. The placenta grows in the uterus and supplies your baby with food and oxygen through the umbilical cord. If your baby doesn?t get enough oxygen and nutrients in the womb, he may have IUGR.

    Preeclampsia can cause rare but serious complications that include:

    • Stroke
    • Seizure
    • Fluid buildup in your chest
    • Heart failure
    • Reversible blindness
    • Bleeding from your liver
    • Bleeding after you've given birth
    • kidney disease
    • pulmonary edema

    When preeclampsia or eclampsia damages your liver and blood cells, you can get a complication called HELLP syndrome. That stands for:

    • Hemolysis. This is when the red blood cells that carry oxygen through your body break down.
    • Elevated liver enzymes. High levels of these chemicals in your blood mean liver problems.
    • Low platelet counts. This is when you don?t have enough platelets, so your blood doesn?t clot the way it should.

    References:

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