World Pre-eclampsia Day 2023: World Pre-eclampsia Day is observed on the May 22 every year to spread awareness about one of the leading causes of maternal and infant mortality worldwide.
Pre-eclampsia refers to the elevation of blood pressure equal to or more than 140/90 mm Hg and the presence of excessive protein in urine after the 20th week of pregnancy. It is one of the reasons why expectant mothers should not miss ante-natal check-ups (at least 4). Regularly monitoring blood pressure levels can aid in the early detection of this potentially life-threatening condition.
While pre-eclampsia typically manifests after the 20th week of pregnancy, it can, in some cases, be identified earlier. Sudden weight gain, persistent headaches, elevated blood pressure, swelling of the hands and face, blurred vision, and abdominal pain serve as warning signs, indicating the need to promptly consult with an obstetrician. These proactive measures contribute to the early identification and management of this disorder.
The American College of Obstetricians and Gynecologists (ACOG) classifies pre-eclampsia into non-severe and severe categories. Non-severe pre-eclampsia may progress to a severe state, where blood pressure levels soar to 160/110 mm Hg or higher. Severe pre-eclampsia is often accompanied by cerebral edema (swelling due to fluid retention) leading to headaches and visual disturbances caused by optic fundus changes. Abdominal pain may also be experienced. Laboratory reports may reveal elevated liver enzymes and serum creatinine, as well as increased protein excretion through urine, indicating renal involvement.
The following are the risk factors for pre-eclampsia:
Primiparity: First-time mothers, also called primigravidae, are at a higher risk for developing pre-eclampsia. Exposure to chorionic villi (small projections of the placenta that help exchange nutrients from the maternal blood to the foetus) for the first time can cause an increase in blood pressure.
Age: The chances of risk are higher if pregnancy is before 18 years or after 35 years of age.
BMI: A high Body Mass Index of more than 35 kg/m2 acts as a predisposing factor to preeclampsia.
Multiple pregnancy: When the womb of a female carries more than one foetus, most often resulting in identical or non-identical twins or even triplets, it is referred to as a multiple pregnancy, which can lead to pre-eclampsia.
Maternal co-morbidities: If the mothers suffer from any other medical health condition like diabetes, hypertension, or renal disease, they become more susceptible to this pregnancy complication.
Family history: A female having a family history of pre-eclampsia must be extra cautious, as genetics play a role in its evolution.
The complications of this condition include abruptio placenta, where the placenta (responsible for exchanging gases and nutrients between the mother and the baby) gets separated from the uterine wall before birth. Acute renal failure, pleural effusion (excess fluid in the cavity outside the lungs) and laryngeal oedema can also be seen.
Pre-eclampsia can be fatal not only to the mother but also to the baby, as it can lead to pre-term delivery, prematurity and sepsis. Functional changes in the placenta can place the foetus in jeopardy.
It may also progress to seizures, stroke and, ultimately, death. Awareness and timely visits can help in preventing and managing pre-eclampsia.
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