With mild pre-eclampsia, the symptoms are generally related to excess weight gain and fluid retention. Presence of new onset persistent headache, epigastric pain, or visual disturbances would suggest severe preeclampsia.
HELLP syndrome occurs in 5-10% of patients and is characterized by:
- Elevated liver enzymes
- Low platelet count
HELLP Syndrome occurs twice as common in multigravidae. It can be confused with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. HTN, although frequently seen, is not always present.
Conditions associated with HELLP Syndrome include:
- abruption placenta,
- fetal demise,
- and hepatic rupture.
Researchers continue to study ways to prevent preeclampsia, but so far, no clear strategies have emerged.
In certain cases, however, you may be able to reduce your risk of preeclampsia with:
Calcium supplementation of at least 1 gram per day is recommended during pregnancy as it prevents preeclampsia where dietary calcium intake is low, especially for those at high risk. Low selenium status is associated with higher incidence of preeclampsia.
Taking aspirin is associated with a 1% to 5% reduction in preeclampsia and a 1% to 5% reduction in premature births in women at high risk. The World Health Organization recommends low-dose aspirin for the prevention of preeclampsia in women at high risk and recommend it be started before 20 weeks of pregnancy.
There is insufficient evidence to recommend either exercise or strict bedrest as preventative measures of pre-eclampsia.
In low-risk pregnancies the association between cigarette smoking and a reduced risk of preeclampsia has been consistent and reproducible across epidemiologic studies. High-risk pregnancies (those with pregestational diabetes, chronic hypertension, history of preeclampsia in a previous pregnancy, or multifetal gestation) showed no significant protective effect. It is recommended that smoking be stopped prior to, during and after pregnancy.
There are several risks and complications associated with preeclampsia.
Problems affecting the mother:
Eclampsia causes involuntary contraction of the muscles that pregnant women can experience, usually from week 20 of the pregnancy or immediately after the birth.
During an eclamptic fit, the mother's arms, legs, neck or jaw will twitch involuntarily in repetitive, jerky movements. She may lose consciousness and may wet herself. The fits usually last less than a minute.
While most women make a full recovery after having eclampsia, there's a small risk of permanent disability or brain damage if the fits are severe.
HELLP syndrome is a rare liver and blood clotting disorder that can affect pregnant women. It's most likely to occur immediately after the baby is delivered, but can appear any time after 20 weeks of pregnancy, and in rare cases before 20 weeks.
The letters in the name HELLP stand for each part of the condition:
- "H" is for haemolysis – this is where the red blood cells in the blood break down
- "EL" is for elevated liver enzymes (proteins) – a high number of enzymes in the liver is a sign of liver damage
- "LP" is for low platelet count – platelets are substances in the blood that help it to clot
HELLP syndrome is potentially as dangerous as eclampsia, and is slightly more common. The only way to treat the condition is to deliver the baby as soon as possible. Once the mother is in hospital and receiving treatment, it's possible for her to make a full recovery.
The blood supply to the brain can be disturbed as a result of high blood pressure. This is known as a cerebral hemorrhage, or stroke. If the brain doesn't get enough oxygen and nutrients from the blood, brain cells will start to die, causing brain damage and possibly death.
- Pulmonary oedema – where fluid builds up in and around the lungs. This stops the lungs from working properly by preventing them from absorbing oxygen.
- Kidney failure – when the kidneys cannot filter waste products from the blood. This causes toxins and fluids to build up in the body.
- Liver failure – disruption to the functions of the liver. The liver has many functions, including digesting proteins and fats, producing bile and removing toxins. Any damage that disrupts these functions could be fatal.
Blood clotting disorder
The mother's blood clotting system can break down. This is known medically as "disseminated intravascular coagulation".
This can either result in too much bleeding because there aren't enough proteins in the blood to make it clot, or in blood clots developing throughout the body because the proteins that control blood clotting become abnormally active.
These blood clots can reduce or block blood flow through the blood vessels and possibly damage the organs.
Problems affecting the baby:
Babies of some women with pre-eclampsia may grow more slowly in the womb than normal, because the condition reduces the amount of nutrients and oxygen passed from the mother to her baby. These babies are often smaller than usual, particularly if the pre-eclampsia occurs before 37 weeks.
If pre-eclampsia is severe, a baby may need to be delivered before they're fully developed. This can lead to serious complications, such as breathing difficulties caused by the lungs not being fully developed (neonatal respiratory distress syndrome). In these cases, a baby usually needs to stay in a neonatal intensive care unit so they can be monitored and treated.
Some babies of women with pre-eclampsia can even die in the womb and be stillborn. Most of these babies die because of complications related to early delivery.