TV shows like Downton Abbey and Call the Midwife have lately brought preeclampsia back into the public eye. Thankfully, medical practices have improved since the ’20s and the ’50s, but preeclampsia still poses a serious threat to 5–8 percent of pregnancies. We talked to Dr. Carol Lace Brown-Elliott, a local high-risk obstetrician then practicing at North Texas Perinatal Associates, to get the hard facts about preeclampsia, including the symptoms to watch for in your own pregnancy.
DFWChild: What exactly is preeclampsia?
Dr. Brown-Elliot: Preeclampsia is a disease unique to pregnancy that is defined as hypertension (high blood pressure) and proteinuria (protein in urine). The underlying cause is unknown but felt to be related to damage to the cells that line our blood vessels. The signs and symptoms of preeclampsia occur due to vasospasm (blood vessel squeeze) limiting blood supply to several of the body’s organs.
This may manifest as hypertension, headache, blurry vision, seeing spots, fluid in the lungs, protein in the urine, decrease in the ability of the kidneys to make urine, abnormalities in the blood count, abnormalities in clotting and abnormal liver function.
C: Are there varying severities of preeclampsia?
BE: Yes, mild preeclampsia and severe preeclampsia. Severe preeclampsia is defined as blood pressure readings greater than 160/110, persistent 2+ proteinuria, and evidence of the other organs being affected by the vasospasm. When the placenta is affected it may cause fetal breath impairment, low amniotic fluid volume and separation of the placenta from the uterine wall.
Mothers may experience headache and blurry vision, and see spots. The lungs can fill up with fluid causing difficulty breathing; the liver cells may become damaged releasing chemicals and/or the liver can swell causing pain under the right rib area or in the area of the lower chest bone. When the kidneys are affected a mother may notice that she hasn’t had to urinate very often. And, when the blood is affected, the platelet count can decrease to very low numbers, which can affect clotting.
There is also a very serious disease, felt to be a variant of severe preeclampsia, referred to as the HELLP Syndrome. The HELLP Syndrome means hemolysis (red blood cells burst open), elevated liver functions (liver cells are damaged) and low platelets.
C: What warning signs should expectant mothers look for?
BE: Pregnant women should pay attention to headache over the forehead, blurry vision, seeing spots (black or white), right or upper mid-abdominal pain, not urinating and excessive swelling of the face and hands.
C: What kind of dialogue should pregnant women have with their healthcare providers?
BE: They should ask whether their blood pressure and urine protein are in the normal range. It’s important that expectant mothers report any changes in vision, headache, excessive swelling of the hands and face, decrease in urination and right and/or mid-abdominal pain.
C: Is lack of awareness a major problem?
BE: Well, for the obstetric physician and nurse, no. Whenever a pregnant woman’s blood pressure and urine is assessed for protein we’re screening for preeclampsia. However, we could certainly increase the patient and family awareness by making a statement every time we take an expectant mother’s blood pressure and assess her urine that we are screening for preeclampsia, and explain the importance of reporting any of the signs or symptoms of preeclampsia.
C: Is there a cure for preeclampsia?
BE: The only cure for preeclampsia is delivery of the fetus and placenta.
C: Is there anything else you would like to add?
BE: Expectant moms who have chronic hypertension or are carrying twins or higher orders of fetuses are examples of patients who are at higher risks of developing preeclampsia. Expectant parents can learn more about preeclampsia, increase their own awareness and the awareness of family members by speaking to their obstetricians and contacting The Preeclampsia Foundation.
This article was originally published in May 2013.
