Pregnancy brought immeasurable joy to 35-year-old homemaker, Naina Suresh (name changed). Everything was a smooth sail until she suddenly developed shortness of breath, dizziness and difficulty in passing urine. She was 34 weeks into her pregnancy then. Without waiting longer, she visited her consulting doctor, Dr Kavya Krishna Kumar, consultant – obstetrician and gynaecologist, Motherhood Hospitals, Chennai. The doctor found that her blood pressure was high. She suspected Suresh had developed preeclampsia.
Of the various maternal complications that could arise during pregnancy, preeclampsia is one of them.
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In 2011, the World Health Organisation (WHO) advocated the need for implementing the maternal near-miss (MNM) approach. The term, MNM, can be defined as the case of any woman who suffered and survived a near-fatal complication during pregnancy, childbirth or within 42 days of termination of pregnancy. Severe preeclampsia is one of the enlisted conditions that could lead to MNM.
Dr Kumar claims that globally nearly two to eight per cent of the gestational population report incidences of preeclampsia. Preeclampsia is a chronic hypertensive condition that is unique to gestational women who are in their 20th week of gestation.
Physiological symptoms of preeclampsia in pregnancy
- Systolic blood pressure is ≥ 140 and/or diastolic blood pressure is ≤ 90.
- Any one of the new-onset conditions such as: proteinuria (high level of protein in the urine); maternal organ dysfunctions (such as liver, kidney, heart); uteroplacental dysfunctions (damage to the placenta)
Preeclampsia in pregnancy: warning signs
Dr Kumar claims that although high blood pressure on examination is the predominant condition that could indicate preeclampsia, the following are the early signs of preeclampsia:
- Blurred vision
- Pain in the upper abdomen
- Nausea, shortness of breath and vomiting
- Occasional decrease in urine output
Dr Kavita Pujar, senior consultant, obstetrics and gynaecology, Kinder Women’s Hospital and Fertility Centre, Bengaluru, enlists a few additional symptoms that should prompt pregnant women to visit the doctor immediately:
- Swelling of the feet and puffiness of the face
- Sudden weight gain
Who is at risk?
“Preeclampsia is more common in teenage pregnancies (ie, between 15-17 years). It can also occur among pregnant women above 35,” says Dr Pujar.
Dr Kumar gives a list of women who are at risk of developing preeclampsia:
- Women with a case history of hypertension or diabetes before gestation
- Women with a history of preeclampsia during their previous pregnancies
- Women who are pregnant with twins/triplets/quadruplets or more
- Women with a case history of chronic kidney disease
Regarding the male population, Dr Kumar emphasises a significant insight into this condition. She tells Happiest Health, “Men born from a preeclampsia pregnancy are more likely to father a preeclampsia pregnancy.”
Treatment during pregnancy
“Preeclampsia cannot be reversed, but the cure is to give birth,” says Dr Kumar.
She recalls Suresh’s case and says that the first line of treatment for preeclampsia is controlling the blood pressure. Suresh was administered medications and injections to control her blood pressure. But it was not helping. “Hence, we decided to perform a caesarean section on Suresh for the baby’s and the mother’s good. She delivered a healthy baby, although it was a preterm birth,” says Dr Kumar. Normally, a mother delivers in the 40th week of her pregnancy.
One of the fatal risks that can develop with preeclampsia is HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count).
Dr Pujar tells Happiest Health about one of her patients, Ayeza Sheikh (name changed), a 37-year-old chef.
Sheikh developed preeclampsia during the 37th week of gestation. Her blood test indicated HELLP syndrome (where the liver enzymes were drastically elevated and platelet counts were low).
Dr Pujar decided to perform a caesarean section for the birth of Sheikh’s baby, as an emergency medical step. Consequently, the focus shifted to the mother’s recovery.
“Sheikh’s liver parameters reverted to normal within six weeks from delivery,” recalls Dr Pujar.
“Regular antenatal care largely helped in early diagnosis and management. High blood pressure can be easily diagnosed during regular check-ups, and you can avoid developing other symptoms of preeclampsia with early diagnosis,” says Dr Pujar.
Treatment post pregnancy
Childbirth does not end preeclampsia in some cases. The symptoms can prevail till six weeks after delivery for some women. This is known as postpartum preeclampsia. This condition is marked by high blood pressure, excess protein in urine, headaches, nausea and shortness of breath.
“Regular blood pressure check-ups at the clinic and controlling blood pressure helps,” says Dr Kumar.
“Suresh developed severe postpartum haemorrhage. She also had severe hypertension. Her eyesight was affected after delivery. Once again, our sole focus was controlling blood pressure. In a span of a few weeks, her blood pressure became normal and her eyesight improved.”
Experts suggest that dietary restrictions, psychological well-being, regular antenatal check-ups, weight management and regular exercise can largely prevent this condition.
Dr Kumar tells Happiest Health various ways of preventing preeclampsia:
Healthy eating: It has been proven that a low glycaemic diet – consisting of unprocessed whole grains, fruits, beans and healthy fats – works great in preventing this condition. Pregnant women should also include vegetables, olive oil, fruits and poultry in their diet. They should avoid eating processed meat, caffeine, white bread, oily/junk food, salty snacks and fizzy drinks.
Weight management: Monitoring and managing weight can drastically reduce the risk of developing preeclampsia.
Mineral supplements: In some cases, doctors recommend low-level supplementation of vitamins and minerals.
Sleep and exercise: Regular exercise and good sleep can work wonders in maintaining overall health to prevent any maternal complications.