Pre-eclampsia in pregnancy

Along with a hefty list of side effects and symptoms like swelling, morning sickness and fatigue, pregnancy can also bring unwanted health conditions and complications. And, those pesky symptoms that you try to shrug off could even be a telltale sign of something more serious.

Pre-eclampsia is a pregnancy health condition which sometimes appears without symptoms but it can cause problems for you and your unborn baby. Knowing what to look out for can help you get the treatment that you need so we explain what is pre-eclampsia, the causes, symptoms and treatments.

What is pre-eclampsia?

Pre-eclampsia is a condition that sometimes strikes during the second and third trimester of pregnancy (from around 20 weeks) or immediately after giving birth. According to the NHS "Mild pre-eclampsia affects up to 6% of pregnancies, and severe cases develop in about 1 to 2% of pregnancies."

It is thought to relate to a problem with the placenta. "Pre-eclampsia can cause a combination of high blood pressure (hypertension) and protein in your urine (proteinuria)" says Shreelata Datta, an obstetrician at St Helier Hospital in Surrey.

What are the causes of pre-eclampsia?

The exact causes are not fully understood, but the condition is thought to be caused by the placenta not developing properly due to a problem with the blood vessels supplying it.

There are certain things which can increase your chances of developing pre-eclampsia.

Pre-eclampsia risk factors:

What are the symptoms of pre-eclampsia?

There are often no symptoms with pre-eclampsia unless it’s severe, other than heightened blood pressure. Swelling is a common and typically harmless side effect of pregnancy but it can indicate also indicate complications like pre-eclampsia.

‘If your pre-eclampsia is severe, symptoms include bad headaches that aren’t eased with paracetamol, problems with your vision, such as blurring or flashing lights before your eyes, severe pain just below the ribs, heartburn that doesn’t go away with antacids, rapidly increasing swelling of the face, hands or feet or generally feeling very unwell,’ says Shreelata.

How is pre-eclampsia diagnosed?

To find out whether have pre-eclampsia, your GP will take your blood pressure. If it is high, the next step would be looking for protein in your urine. You might then have further urine tests, or be referred to hospital for monitoring.

It is especially important to attend all antenatal appointments if you think you may be suffering from pre-eclampsia. ‘It may be picked up at your routine antenatal appointments when you have your blood pressure checked and urine tested,’ says Shreelata. ‘This is why it is always important to bring a urine sample to your midwife appointments.’

A new test known as the placental growth factor (PLGF) test, which checks the health of the placenta and can help spot preeclampsia in a day, will also now be offered to pregnant women on the NHS. The new guidelines will allow midwives to be able to use the test alongside other checks to quickly identify the condition.

Jeanette Kusel, from NICE told the BBC: "This is extremely valuable to doctors and expectant mothers as now they can have increased confidence in their treatment plans and preparing for a safe birth."

How is pre-eclampsia treated?

The only cure for pre-eclampisa is to give birth to your baby. Your GP might prescribe you certain medication for high blood pressure. Women at risk of high blood pressure are often advised to attend hospital two or three times per week to be monitored. There is a new app, The Hampton app, which has been recommended by the NHS. It allows women to check their blood pressure at home to prevent unnecessary hospital stays.

‘If you’re experiencing any of the symptoms associated with severe pre-eclampsia you should seek medical help immediately,’ says Shreelata. If in doubt, contact the maternity unit at your local hospital.

What is HELLP syndrome?

HELLP syndrome is sometimes thought to be a severe form of pre-eclampsia. This rare condition is a blood clotting disorder, meaning that the liver may be significantly injured.

The Pre-eclampsia Foundation explains: "HELLP syndrome was named by Dr. Louis Weinstein in 1982 after its characteristics:

HELLP syndrome can be difficult to diagnose, especially when high blood pressure and protein in the urine aren't present. Its symptoms are sometimes mistaken for gastritis, flu, acute hepatitis, gall bladder disease, or other conditions."

How does preeclampsia affect the baby?

The consequences for your baby may vary widely from being just a day under close observation to having lifelong disabilities. However, complications can occur if your baby is delivered early to relieve your symptoms of pre-eclampsia. Most cases of pre-eclampsia pass with no effect on the baby.

Can pre-eclampsia occur after the baby is born?

If you have pre-eclampsia during pregnancy, after birth you are very likely to recover. You may need to rest in hospital for longer and you'll likely set up a plan with a midwife so your blood pressure can be monitored.

However, in rare cases, pre-eclampsia can occur after the baby is born. Symptoms are the same as pre-eclampsia, but it may be more intense. It usually occurs within the first 72 hours after giving birth, but in rare cases can develop at any time during the first six weeks after birth. Seek medical help as soon as you notice any of the symptoms.

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