Pre-eclampsia in pregnancy: facts and when to seek help

Pre-eclampsia is an effect of high blood pressure affecting one in 100 pregnant women and their babies. Any pregnant woman can develop pre-eclampsia, however you may be more at risk if you:

• had pre-eclampsia in previous pregnancies;
• have a family history of pre-eclampsia;
• are diabetic; or
• have a multiple pregnancy.

Mater Mothers’ Hospitals' Parent Education and Support Manager Michelle O’Connor explains that women may feel well in the early stages of pre-eclampsia and it’s not until your condition deteriorates that you may experience any symptoms. Symptoms include:

• persistent headaches
• swelling in your hands, feet, legs and face
• visual disturbances such as seeing stars or spots
• blurred vision
• heartburn or pain under your rib cage
• vomiting or feeling unwell
• a decrease in your baby’s movements.

“Your doctor or midwife should be notified immediately if you experience any of these symptoms. One or more tests may be needed when assessing you for pre-eclampsia,” Michelle said.

Tests include taking your blood pressure, checking for protein in your urine, testing your blood to assess how well your liver and kidneys are functioning and how well your blood is clotting. Pre-eclampsia affects these areas in particular and also how your reflexes and joints move (e.g. elbows or knees) when lightly tapped.

It is also important to check how your baby is coping with these changes in your body by monitoring your baby's heart rate pattern for 20 to 40 minutes (or longer, if necessary) using a cardiotocograph (CTG) machine with sensors placed over your belly and an ultrasound to check your baby's growth, how well the placenta is working and how much fluid surrounds your baby.

Michelle said the results of the tests will determine your treatment.

“Because pre-eclampsia can get worse quickly it’s important to stay near hospital and notify your doctor or midwife if you experience any of the symptoms mentioned above.

“Without treatment pre-eclampsia can, in rare cases, progress to a condition called eclampsia.

“Eclampsia is life-threatening, and you may have seizures that are similar in appearance to epilepsy,” Michelle said.

If your doctors are worried that you are in danger of eclampsia, they may recommend intravenous treatment with magnesium sulphate. Magnesium sulphate has been used for many years to prevent and treat eclampsia.

Treatment of pre-eclampsia varies. Sometimes nothing is required except strict monitoring or medication may be prescribed to lower blood pressure.

The only way to stop pre-eclampsia is to give birth. Most women who develop pre-eclampsia are more than 36 week pregnant so either have labour induced or undergo a caesarean.

Unfortunately some women develop pre-eclampsia before their baby is fully matured.  Doctors need to carefully balance the need for your baby to grow and mature—especially their lungs—against how unwell you are. Generally, the best incubator for your baby is your uterus, but pre-eclampsia can restrict the supply of oxygen and nutrients through the placenta, preventing your baby from growing properly.

Your doctor may recommend inducing labour early if there are concerns about your health or your baby's growth. You would usually be given two steroid injections 24 hours apart to prepare your baby's lungs for breathing. If you live a significant distance away from a large maternity hospital, you will be transferred prior to delivery to ensure that the neonatal nursery is available to provide advanced care for your preterm baby.

“A decision will be made regarding the best time to deliver your baby after discussion with you, your family and the medical and midwifery staff caring for you,” Michelle explains.

“You are the best indicator of how you feel and seeking advice when you think something is not quite right can make sure you and your baby are safe and healthy, that’s what we all want,” Michelle said.

For more information, see our Pregnancy—high blood pressure brochure.