Preeclampsia: What is it and how is it treated?

You're expecting a baby and everything seems to be going wonderfully... until your blood pressure soars and your doctor utters a worrying word: pre-eclampsia. Every year, this complication affects thousands of expectant mothers and can endanger their health and that of their baby. What are the signs to watch out for? What are the risks for the baby? Can it be avoided? In this article, we'll break down everything you need to know to better understand pre-eclampsia and act before it's too late.

Preeclampsia: Definition

Preeclampsia = a not-so-pretty word for a severe pregnancy complication. This placental disorder affects the blood vessel circulation between the mother and the fetus. It is characterized by:

• high blood pressure;
• blood clotting abnormalities.

When does it occur? Generally, in the 2nd trimester of pregnancy, after the 20th week of gestation. But, rest assured from the outset: it remains relatively rare! According to Inserm, it affects about 5% of pregnant women. Most of the time, with proper management, the baby is born healthy, and serious complications can be avoided. However, in 1 out of 10 cases, it becomes more severe. For example, it is responsible for a third of all extremely premature births in France. Even more serious: it remains a major cause of morbidity, growth retardation, and maternal and fetal mortality.

What are its causes and risk factors?

From the first weeks of pregnancy, the placenta sometimes has difficulty implanting properly. This "prevents" blood vessels from adequately irrigating the body. The result: blood circulation between the maternal blood and the fetus is disrupted. We will briefly explain the most common risk factors and causes of preeclampsia.

You might have a higher risk of developing preeclampsia if you "check" one of the following boxes:

• You have a medical history of chronic hypertension, diabetes, or kidney disease.
• You have a family history of preeclampsia, and your genetics might make you more vulnerable.
• You developed preeclampsia in a previous pregnancy.
• You are expecting twins or triplets, which increases your placental "load" and the risk of complications.
• You are experiencing your first pregnancy before the age of 20 or after the age of 40.
• Your BMI is over 30, which is associated with a high risk of preeclampsia.
• An incompatibility has been detected between your immune cells and those of the placenta, which can hinder its implantation.

So, let us reassure you right away: yes, these risk factors can increase the possibility of developing preeclampsia. But there's no indication that you will develop it for sure! So don't panic if you are among the women at risk. If you have been undergoing regular medical monitoring from the beginning of your pregnancy, there's no reason for things to go wrong.

What are the symptoms of preeclampsia?

Preeclampsia is often called a "silent disease." Why? Because it can develop discreetly, without visible signs at first. However, there are some symptoms that can raise a red flag from 20 weeks of pregnancy. For example:

• Your blood pressure is above average.
• An abnormal presence of protein has been detected in your urine analysis.
• Certain parts of your body suddenly swell, such as your face, hands, and legs. This is due to excessive fluid retention... Potentially a tell-tale sign of preeclampsia.

But, sometimes, preeclampsia can worsen and lead to more alarming manifestations. Such as:

• Intense headaches that don't respond to painkillers.
• Visual disturbances (blurred vision, light sensitivity, appearance of "floaters").
• Rapid weight gain.
• Abdominal pain, in the pit of the stomach, with a band-like sensation below the ribs, often located on the right.
• Less noticeable fetal movements.

In any case, take these symptoms seriously. Because they can progress to serious complications, such as:

• eclampsia (which causes seizures);
• HELLP syndrome (which leads to liver damage and the breakdown of your red blood cells).

In short, if any of these signs appear, don't hesitate... Go straight to a doctor!

What risks does preeclampsia pose to the baby?

Preeclampsia doesn't just affect the pregnant woman: it can also have a direct impact on fetal development. This is due to disruptions in circulation between the maternal blood and the placenta. This insufficient oxygen and nutrient supply can lead to several complications for the baby, of varying severity.

Intrauterine Growth Restriction (IUGR)

One of the most frequent consequences of preeclampsia is IUGR. This fetal growth restriction results in a birth weight below the norm for the baby's gestational age. The placenta fails to nourish the baby properly. This limits its growth and increases the risk of neonatal distress at birth.

Premature delivery and risk of complications

When preeclampsia becomes severe, labor may sometimes need to be induced prematurely to protect the mother and her baby. However, the earlier the birth, the higher the risk of complications. These include:

• The baby is born with immature lungs, requiring respiratory assistance.
• Difficulty regulating body temperature, as the baby hasn't accumulated enough fat yet.
• Digestive and immune problems, increasing the risk of infections at birth.

Fetal distress and risk of intrauterine death

If the maternal blood flow to the baby is compromised, the baby may lack oxygen. This can lead to acute distress and, in extreme cases, death.

Long-term consequences

Some babies born to mothers who experienced preeclampsia may be at higher risk of developing cardiovascular disease in adulthood. The cause: the stress experienced in utero.

How to prevent preeclampsia during pregnancy?

Well, first of all: preeclampsia cannot always be prevented. However, certain measures can be taken to reduce the risk of developing a complication. Here they are.

1. Medical monitoring adapted for pregnant women at risk

From the beginning of pregnancy, at-risk women can benefit from optimal care. This involves:

• A clinical examination to identify if they are indeed at-risk patients.
• More frequent blood pressure monitoring.
• Regular urine tests.

Curious if there are signs that can predict labor? Our article on Grandma's tricks to know when you're going into labor might surprise you!

2. A balanced diet and a healthy lifestyle

To limit severe forms of preeclampsia, you can also adjust some of your lifestyle habits. Nothing complicated, we promise! For example, try to:

• Limit your salt intake to maintain healthy blood pressure.
• Opt for a diet rich in fruits, vegetables, omega-3s, and fiber to improve blood circulation.
• Conversely, avoid ultra-processed foods and those high in simple sugars, which can promote inflammation and oxidative stress.
• Engage in moderate physical activity (prenatal yoga, walking) to reduce the risk of hypertension and poor maternal blood circulation to the baby.
• Manage your stress through relaxation techniques, such as meditation or sophrology.

3. Aspirin and calcium (low dose)

According to the WHO, for some women with a risk factor, doctors may recommend:

• Low-dose aspirin from the end of the first trimester to improve maternal blood circulation to the placenta.
• Calcium supplementation if a pregnant woman doesn't consume enough in her diet.

Of course, no self-medication during your pregnancy! These are medical recommendations that only a doctor can make. So, get informed first and consult a healthcare professional to discuss them.

Want to take care of yourself after childbirth? Beware, you might fall for our postpartum dietary supplements!

How is preeclampsia diagnosed and treated?

Once again, rest assured: preeclampsia is now very well diagnosed and treated. Long live scientific progress!

Diagnosis through medical management

Healthcare professionals can now detect preeclampsia in pregnant women during prenatal consultations through several examinations:

• Blood pressure measurement: if your blood pressure is above normal twice in a row, it's a first warning sign.
• Urine analysis: checking for the presence (or absence) of protein in the urine.
• Blood tests: specifically measuring your platelets, liver enzymes, and kidney function to assess the severity of the pathology.
• Ultrasound and fetal Doppler: evaluating fetal growth and the quality of blood exchange with the placenta.

Management and treatments

To be frank, the only curative treatment for preeclampsia… is delivery. Because it eliminates the primary cause of the disease: the placenta. However, management will also depend on the stage of pregnancy and the severity of the symptoms.

Before 34 weeks of amenorrhea, close monitoring is put in place to prolong the pregnancy, while monitoring the mother and fetus. A doctor may sometimes administer corticosteroids to accelerate the maturation of the baby's lungs in case of a risk of premature birth.

Once this term is passed, an induction or C-section may be considered to avoid further complications.

In parallel, doctors may also suggest:

• antihypertensive treatment;
• magnesium sulfate…

... Depending on the severity of the situation. In any case, they will implement close postpartum monitoring of the mother and her baby, as complications can still arise after delivery.

To summarize, preeclampsia remains a serious pregnancy complication. And it requires significant medical monitoring to protect the mother and unborn child. So, no: it cannot always be avoided. Nevertheless, with good follow-up, preventive measures, and prompt management, the risks are greatly limited, allowing for a more serene pregnancy!