What you need to know about preeclampsia

Romy*, who had her twins at Mediclinic Sandton, never really thought about why she had check-ups with her doctor every week instead of once a month. “I knew that I had been labelled a ‘geriatric’ mother, because I fell pregnant with my twins through IVF when I was 41. 

My gynaecologist also explained that I had ‘gestational diabetes’ and ‘preeclampsia’, but he didn’t make a big thing of it. He just monitored the pregnancy carefully, taking exceptionally good care of me.”

She didn’t fully understand the implications of preeclampsia until she had to spend three weeks in and out of the hospital, and realised her twins were likely to be born early.

“I was very naïve, but my doctor kept me grounded and didn’t let me worry,” Romy says, “so I put all my faith in him”. Her symptoms included mild dizziness, very high blood pressure, extreme swelling of her hands and ankles, and blurry vision. “Because my gynae managed the condition so well, I honestly thought these symptoms were usual for pregnancy!”

However, not all mothers with preeclampsia are as fortunate. Jennifer* says her condition put her in the ICU with HELLP syndrome, a serious (though rare) complication that affects the blood and liver. It can lead to blood clotting issues, liver and kidney failure, placental separation, and premature birth.

Jennifer’s experience highlights why it’s important to treat preeclampsia as soon as it’s diagnosed.

Dr Hlengane Maluleke, an obstetrician and gynaecologist at Mediclinic Limpopo, explains that preeclampsia is most common in women who are pregnant for the first time. “The risk decreases with later pregnancies, as long as the father of your children is the same,” he adds.

Symptoms of preeclampsia include high blood pressure, protein in the urine, and swelling in the legs, usually starting in the second trimester.

However, Dr Maluleke explains that while preeclampsia was once mainly seen as a blood pressure issue, it’s now understood to be a condition that affects multiple organs, including the brain, eyes, lungs, heart, liver, kidneys, and blood. It can also impact your baby early on in pregnancy.

“Although there are many theories about the cause of preeclampsia, little is actually known about what triggers it, besides the fact that the cause is related to the placenta,” he says.

However, there are some known factors that can increase the risk of preeclampsia, such as having had it in a previous pregnancy, a family history of the condition, or if you’re living with other health issues like diabetes, high blood pressure, autoimmune disease, or kidney disease. Women carrying multiple babies or those who have had IVF treatment are also at a higher risk.

Dr Maluleke explains that because preeclampsia can cause serious health problems for both mother and baby, your doctor will closely monitor you for symptoms. These include rapid weight gain, severe swelling in the hands and ankles, headaches, vision changes, stomach pain, nausea, vomiting, and trouble breathing.

Unfortunately, many of these symptoms are also common in pregnancy, which is why it's important for your doctor to regularly check your blood pressure and test for protein in your urine.

Dr Maluleke says that some preventive measures include avoiding excessive weight gain and taking low doses of aspirin and calcium. If you have diabetes, make sure it's well controlled.

If you already have preeclampsia, your doctor will prescribe medication to lower blood pressure and carefully monitor your pregnancy to ensure that your baby is developing well. “Every decision is made with the mother’s safety in mind, and in rare cases, a termination may be suggested,” says Dr Maluleke.

Remember that with the right care and attention, many women with preeclampsia go on to have healthy pregnancies and babies.