Preeclampsia: A dangerous pregnancy condition that should never be ignored

High blood pressure during pregnancy is often considered a common problem. But preeclampsia is much more serious than just “high BP in pregnancy.” Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and baby. The worrying part is that many important facts about it are still not widely known. Preeclampsia is not always preventable. But regular antenatal checkups, early diagnosis, and timely treatment can save both mother and baby.

The biggest myth about it is that preeclampsia happens only in the first pregnancy. Many women also assume that if the first pregnancy was normal, the next one will be safe too. But that is not guaranteed. Doctors say the risk can increase even in a second pregnancy. Preeclampsia is deeply linked to the placenta and the mother’s immune response. It can appear for the first time in a second or third pregnancy as well. The risk becomes higher if there is a long gap between pregnancies and/or the father is someone else. Weight gain, diabetes, high BP, increasing age, or twin pregnancy can also raise the chances.

One of the most frightening things about preeclampsia is how fast it can progress. A woman may feel fine in the morning and become critically ill by evening. In severe cases, seizures may even develop. You may have no noticeable symptoms. The first signs of preeclampsia are often detected during routine prenatal visits with a health care provider. Symptoms should never be ignored.

Along with high blood pressure, preeclampsia signs and symptoms may include:
• Excess protein in urine (proteinuria) or other signs of kidney problems
• Decreased levels of platelets in blood (thrombocytopenia)
• Increased liver enzymes that indicate liver problems
• Severe headaches
• Changes in vision, i.e. loss of vision, blurred vision or light sensitivity
• Shortness of breath
• Pain in the upper belly, under the ribs on the right side
• Nausea or vomiting
Weight gain and swelling (edema) are typical during healthy pregnancies. However, sudden weight gain or a sudden appearance of edema — particularly in face and hands — may be a sign of preeclampsia.

It can be a sign of other health conditions:
Usually, preeclampsia develops after 20 weeks of pregnancy. If it appears very early, doctors look for certain serious conditions. These include molar pregnancy and APLA syndrome. APLA syndrome is a blood clotting disorder. In this condition, clots can form in the placental blood vessels. Women with repeated miscarriages, severe pregnancy-related BP problems, poor baby growth, or repeated pregnancy complications may sometimes have this hidden condition. Early diagnosis can completely change treatment and improve pregnancy outcomes.

It's easy to identify earlier:Today, medical science can often identify high-risk women much earlier. Screening is usually done between 11 and 14 weeks of pregnancy. BP measurement, Doppler ultrasound scans, blood tests like PLGF and PAPP-A, and the mother’s medical history can help. Early prediction helps plan better prevention and monitoring. To reduce the risk, many women are advised to take low-dose aspirin, commonly known as Ecosprin. It helps improve blood flow to the placenta. It may also reduce the risk of severe preeclampsia and poor baby growth.

Management is the best treatment:If we talk about treatment, magnesium sulfate injection is considered one of the most important life-saving medicines in obstetrics. Many people think it is given only to reduce blood pressure. But its main role is different. It helps prevent seizures. It protects the brain. Most importantly, it saves the mother from eclampsia. In some high-risk pregnancies, doctors may also recommend arginine supplements. It helps relax blood vessels. It may support better blood flow and placental function in selected cases.

Dr. Preety Aggarwal MBBS, DGO, DNB, Medical Director (Gurgaon) – Obstetrics and Gynaecology, Motherhood Hospital, Gurugram