To mark National Pre-Eclampsia Awareness Day on Friday 22nd July, we asked Wellbeing of Women, the leading charity funding pioneering research into women’s reproductive health and one of its researchers, Dr. Alice Hurrell, trainee in obstetrics and gynaecology at University College London, to tell us a bit more about this pregnancy complication and some of the work that is currently being done to better understand the condition.
What is pre-eclampsia?
Pre-eclampsia is a condition that affects 1 in 20 pregnancies. During pre-eclampsia, blood vessels become constricted, resulting in high blood pressure (hypertension) and causing protein to leak from the kidneys into the urine (proteinuria). In some cases, a mother and her baby can become seriously unwell with pre-eclampsia. Caring for women with pre-eclampsia involves carefully balancing the risks to mother and baby.
Whilst the exact cause of pre-eclampsia is not yet fully understood, it is thought to originate in the placenta (the organ linking the mother’s blood supply with the baby’s). Reduced blood flow to the placenta can lead to reduced growth of the baby and this may be evident prior to the mother presenting with high blood pressure or protein in the urine.
What are the risk factors?
Factors that can increase the risk of a woman developing pre-eclampsia, include:
- Having suffered from pre-eclampsia in a previous pregnancy
- A family history of pre-eclampsia
- Having heart disease or having previously experienced a stroke
- Chronic high blood pressure
- Chronic kidney disease
- Type 1 or 2 Diabetes
- A history of autoimmune disease, including systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel disease.
Other factors that can slightly increase your chances include:
- Your first pregnancy
- Aged over 40 years
- At least 10 years since your last pregnancy
- Body mass index (BMI) higher than 35
- Expecting multiple babies (twins or triplets)
What are the symptoms?
For some women, further symptoms aside from high blood pressure or protein in the urine may develop, including:
- visual disturbances, such as seeing flashing lights
- pain in the top or right hand side of the abdomen
- feeling generally unwell
Medical advice should always be sought immediately if any of these symptoms are experienced.
However, as the onset of pre-eclampsia can be devoid of symptoms, in the second half of pregnancy it is important for women to be seen more frequently by their midwife or doctor to monitor blood pressure and test their urine for protein in order to anticipate signs of pre-eclampsia, particularly for women at increased risk.
In very rare cases, women with pre-eclampsia may present with a seizure or eclamptic fit due to severely elevated blood pressure.
How is pre-eclampsia treated?
Despite ongoing research, the cause of pre-eclampsia is still poorly understood and therefore treatment options are very limited. Delivery of the baby and placenta is usually the best option though not ideal because early delivery exposes the baby to the complications associated with prematurity, whilst continuing the pregnancy puts the mother’s own health at risk. However, if the baby stops growing or the mother becomes very unwell with pre-eclampsia then obstetricians would advocate delivery of the baby.
There are medications that can be given to lower blood pressure in pre-eclampsia. However, these only treat one of the symptoms of the condition rather than the underlying cause that results in pre-eclampsia. Women with severe pre-eclampsia may be taking several medications to lower blood pressure by the time of delivery.
How can I prevent pre-eclampsia?
Pre-eclampsia cannot always be prevented. However, women who have at least one high risk factor, or more than one moderate risk factor upon consultation with their doctors may be recommended to start taking aspirin from 12 weeks of pregnancy until approximately 36 weeks.
What are the latest medical advances in this area?
Wellbeing of Women is currently undertaking research into pre-eclampsia led by Dr. Alice Hurrell, who has taken time out of her clinical work to pursue this vital area of research. Dr. Hurrell’s work is focusing on the interaction between the immune system and blood flow in the development of pre-eclampsia, as it is hoped that this will lead to targeted therapies to better prevent or cure pre-eclampsia, resulting in improved outcomes for mothers and babies.
Pre-eclampsia poses a huge problem for mothers and babies in developing countries, exacerbated by the lack of antenatal care. As a result, there is a large body of vital research currently being undertaken to try to better understand pre-eclampsia, both in the UK and globally. Around the world, numerous avenues are being actively studied into the condition, including how to predict who will get pre-eclampsia, how to prevent pre-eclampsia and how to treat or cure pre-eclampsia.
Wellbeing of Women
Tel: 020 3697 7000
Address: First Floor, Fairgate House, 78 New Oxford Street, London WC1A 1HB