The Effects Of Preeclampsia And How It Can Negatively Impact A Pregnancy

Preeclampsia/Eclampsia is a complicated pregnancy-induced syndrome that usually occurs after the 20th week of gestation. Together with gestational hypertension, the continued presence of chronic hypertension, and the superimposition of preeclampsia on chronic hypertension, preeclampsia is one of the four categories of hypertensive disorders during pregnancy, which affect 5%-10% of all pregnancies [1]. Preeclampsia is a leading cause of maternal mortality and morbidity, as well as a major cause of adverse effects on fetal well-being both worldwide and in the US. Specifically, one third of severe maternal morbidities, 10%-15% maternal death in low-/middle- income countries and 15% of preterm birth is attributed to preeclampsia [1-3]. The diagnostic criteria of preeclampsia has been changing during the past two decades (Table 1). The most recent guidelines for hypertension during pregnancy by the American College of

Jane Johnson shows many symptoms and tests positive for tests that indicate that she has Preeclampsia. We know this because Jane’s symptoms, which she mentions in her letter, include new onset hypertension and swelling which also happen to be common symptoms of preeclampsia. Preeclampsia can also cause women to rapidly fluctuate in weight and Jane states that, while also explaining how she is experiencing swelling in the ankles, that she has suddenly started gaining weight. Jane also claims that the source of her high blood pressure is anxiety, as she is inexperienced in motherhood, but coupled with her other worrying symptoms, and with the fact that preeclampsia is often found in women experiencing their first pregnancy provides many reasons to conduct urine and blood tests.

“It is believed that HELLP syndrome affects about 0.2 to 0.6 percent of all pregnancies” (American Pregnancy Assosiation, 2016, para 1). HELLP stands for hemolysis, elevated liver enzymes, and low platelet count. Although the cause to HELLP syndrome is still unkown, there are several signs and symptoms the pregnant patient and her health care provider should be aware of in order to prevent serious and life threatening consequenses to the mother and baby.

The term 'gestational hypertension' has replaced the older term of 'pregnancy induced hypertension' and is a more accurate description. Preeclampsia and toxemia - disorders of gestational hypertension - are responsible for more than 76,000 maternal deaths and more than 500,000 infant deaths annually.

(2) Therefore, for medics to effectively manage the eclamptic patient, they should understand key signals and, ideally, the patient’s past medical history. Based on data analysis of patients considered to be “at risk” for developing eclampsia, those with “prior pre-eclampsia, chronic hypertension (HTN), pre-gestational diabetes, assisted reproductive technology, and BMI >30 were most strongly associated with a high rate of pre-eclampsia.” (4) Lastly, women at both extremes of childbearing age (young and old) are more likely to develop pre-eclampsia than other parous women. These are key factors to consider when initially evaluating a patient at greater than 20 weeks gestation with BP of over 140/90. (2)

By managing your weight and following a nutritious diet, exercising regularly, and avoiding potential harmful substances like lead and radiation can decrease the risk of complications during pregnancy and protect the infant’s development (National Institutes of Health, 2014). Pregnant women with existing conditions such as diabetes and high blood pressure are at risk of preeclampsia/eclampsia therefor should take extra precautions monitoring their condition (National Institutes of Health, 2014). According to the article The Global Impact of Preeclampsia and Eclampsia by Leila

When a woman is pregnant, any risk to herself or her baby is a significant problem. How many women suffer from Preeclampsia? Out of five to ten women. A woman who had a normal blood pressure before pregnancy can develop high blood pressure and excess proteins in her urine after the first twenty weeks of pregnancy. When this occurs a woman is told she has a disease named preeclampsia, which puts her baby and herself at risk. Preeclampsia grows unexpectedly after twenty weeks, with a high increase in blood pressure, excess proteins in her urine, extreme headaches, nausea, dizziness, sudden weight gain as sudden symptoms as sudden signs of sickness.

Pre-eclampsia is sustained hypertension with the presence of proteinuria after 20 weeks gestation, 3-10% of pregnant women develop this condition (Bodnar LM, Ness RB & et al. 2005). The risk of developing pre-eclamspia triples in women with a BMI above 30 when compared to a BMI below 20 (Bodnar LM, Ness RB & et al. 2005). It has been suggested by Bodnar & et al. (2005) that the metabolic and biochemical disturbances such as insulin resistance and chronic inflammation associated with obesity could impact the development of pre-eclampsia, hence the increased risk for Kelly (Bodnar LM, Ness

During the second half of pregnancy, the combination of the normal systemic inflammation of pregnancy and preexisting vascular inflammation may be excessive and generate the clinical features of the pre-eclampsia syndrome (Stage 3) (Redman and Sargent, 2010). If true, then this condition, on its own, would not be associated with abnormal placentation and placental perfusion, such as FGR or markers of syncytiotrophoblast stress. The view of dichotomous placental and maternal pre-eclampsia is likely simplistic. It is probable that the impact of preexisting systemic inflammation would not be confined to the end of pregnancy. For example, it is not known whether pregestational systemic inflammation (as with obesity) or insulin resistance (as with

(2014) discuss that gestational hypertension, pre-eclampsia and premature rupture of the membranes are three risk factors that increase the risk of placental abruption. Cigarette smoking, multiple pregnancy, prior history of placental abruption, polyhydramnios, high parity, external cephalic version, prolonged rupture of membranes and abdominal trauma are additional risk factors that can increase the risk of a placental abruption (Victorian State Government; Better Health Channel 2014 & South Australian Maternal and Neonatal Clinical Network (SAMNCN) 2016a). Hence why a woman with any of the mentioned risk factors are monitored more closely for signs of pregnancy abnormalities including placental

Preeclampsia is heterogeneous in its presentation as well its association with long-term effectss for child and mother. Pre-eclampsia exists as two major types, namely; maternal and placental pre-eclampsia (Ness and Roberts 1996). It is widely agreed upon that poor placentation is strongly associated with Foetal Growth Restriction (FGR), even when pre-eclampsia is absent, but it is less clearly documented in association with normal fetal growth and

The different diagnosis’ were classified according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Every medical diagnosis that the researchers needed to study were classified by their consequential number. This study used exclusively public data, according to the Tri-Council Policy statement of 2010, the institutional review board approval was not required, which is not uncommon for retrospective designs. The statistical analysis of maternal outcomes were identified using the ICD-9 codes and categorized by antepartum, intrapartum, and postpartum. The diagnosis’ in each of those three categories were gestational hypertension, mild and severe pre-eclampsia, eclampsia, eclampsia superimposed on pre-existing hypertension, gestational diabetes, placental abruption, preterm rupture of membranes, vaginal or cesarean delivery, instrumental delivery, preterm delivery, hemorrhage, wound complications,

In summary, although rare, complications can develop in pregnant women if preeclampsia is not diagnosed on time, monitored and managed appropriately. These complications can affect both the mother and the

Johnson and Taylor also state (2010,p.43) that most woman have a normal blood pressure during pregnancy but the diastolic number can decrease in the first and second trimesters then return to normal from the middle of the pregnancy. Although some women can develop a hypertension disorder called pre-eclampsia which can be very dangerous for both mother and baby. (Johnson, Taylor, 2010, p. 47).

The sign and symptoms of PPH include; the apparent excessive bleeding, hematocrit-reduction of the number of red blood cells, reduced blood pressure, development of symptoms of shock and anaemia, and severe pain and swelling of tissues and muscles of the vagina, vulva, pelvic and perineum (Simpson & Creehan, 2008). Besides, Ricci & Kyle (2009) avow that there are different factors that place a mother at risk for PPH, and they comprise; prolonged first, second or third stage of labour, previous history of PPH, foetal macrosomia, uterine infection, arrest of descent and multiple gestation. Other risk factors may include; mediolateral episiotomy, coagulation abnormalities, maternal hypertension, maternal exhaustion, malnutrition or anaemia, preeclampsia, precipitous birth, polyhydramnios and previous placenta previa (Ricci & Kyle, 2009).