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Introduction:

Preeclampsia is a complication that manifests in maternal high blood pressure during the second half of pregnancy or soon after labor (1). Some noticeable symptoms include severe headaches and nausea, impaired vision or light sensitivity, sudden weight gain, swelling (edema), shortness of breath, and discomfort in the right side of the upper belly. In addition, Preeclampsia is characterized by the identification of the following conditions during routine prenatal visits: proteinuria (presence of protein in urine), signs of kidney damage, low levels of platelets, and elevated liver enzymes that indicate liver problems. Obviously if left untreated, this could result in fatal outcomes for both mother and baby.

Preeclampsia risks for the fetus:

In cases of Preeclampsia, new blood vessels do not develop and evolve optimally in the placenta. If the placenta is unable to receive enough blood, there will be limited oxygen and nutrient supply for the fetus; hence, leading to fetal growth restriction. Preterm birth or unplanned, premature birth before 37 weeks of pregnancy may occur, inducing problems in breathing, feeding, vision, hearing, development, and cognition such as cerebral palsy. Apart from that, preeclampsia may initiate placental separation from the inner uterine wall before delivery, further leading to heavy bleeding that could potentially be life-threatening. If left untreated, seizures or coma may occur as severe preeclampsia progresses to eclampsia.

Causes of Preeclampsia:

Several factors have been thought to be associated with preeclampsia manifestation; the leading cause being the improper development of new blood vessels in the placenta (1). Irregular placental blood circulation ultimately leads to irregular regulation in the maternal blood flow—inducing a spike in blood pressure. Additionally, interplaying causation between maternal hypertension and limited placental blood supply has been observed (2). It may be helpful to look out for the risk factors for Preeclampsia when planning to conceive or when conceiving. Higher risks tend to be present amongst mothers with a history of preeclampsia in a previous pregnancy, chronic gestational hypertension, type 1 or type 2 diabetes, kidney disease, and autoimmune disorders. Furthermore, mothers conceiving twins (or more) of African and Indigenous descent; older than 35 years; conceiving after 10 years since the previous pregnancy; or conceiving by in vitro fertilization are at an elevated risk for this complication (3).

Prevention & Treatment of Preeclampsia:

For mothers matching the risk factors mentioned above, preventative measures such as maintaining a healthy weight, controlling blood pressure and blood sugar, performing regular exercise, and having a fixed sleep routine can be taken to reduce the risk of developing preeclampsia (1). Moreover, a diet low in salt and caffeine with a daily intake of baby aspirin has been shown to reduce the risk. Signs of preeclampsia can also be identified early on during routine prenatal visits and would not take long for a diagnosis. For severe cases of preeclampsia, healthcare professionals may discuss the scheduling and management for premature delivery of the baby depending on the gestational period of the pregnancy and the overall well-being of both mother and baby.

Hospitalization is often encouraged for closer monitoring of blood pressure and plausible complications. For less severe cases, frequent visits to healthcare providers may be encouraged to monitor blood pressure, changes in symptoms, and fetal well-being. You’ll likely be asked to check your blood pressure daily at home. Medications that are likely to be prescribed include antihypertensive drugs, anticonvulsant medication, and corticosteroids. For a more personalized dietary assessment and recommendations, be sure to check our website and reach out to one of our nutritionists, https://mundushealth.com/make-appointments/.

References:

  1. Ives CW, Sinkey R, Rajapreyar I, Tita ATN, Oparil S. Preeclampsia-Pathophysiology and Clinical Presentations: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Oct 6;76(14):1690-1702.
  2. Rana S, Lemoine E, Granger JP, Karumanchi SA. Preeclampsia: Pathophysiology, Challenges, and Perspectives. Circ Res. 2019 Mar 29;124(7):1094-1112.
  3. Fox R, Kitt J, Leeson P, Aye CYL, Lewandowski AJ. Preeclampsia: Risk Factors, Diagnosis, Management, and the Cardiovascular Impact on the Offspring. J Clin Med. 2019 Oct 4;8(10):1625.


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