You're expecting a baby and everything seems to be going wonderfully... until your blood pressure spikes and your doctor utters a worrying word: preeclampsia. Every year, this complication affects thousands of expectant mothers and can endanger their health as well as that of their baby. What are the signs to watch for? What are the risks for the child? Can it be prevented? In this article, we decipher everything you need to know to better understand preeclampsia and take action before it's too late.
Preeclampsia: definition
Preeclampsia = not a very pretty word for a serious pregnancy complication. This condition, of placental origin, affects the circulation of blood vessels between the mother and the fetus. It manifests itself by:
- high blood pressure;
- blood clotting abnormalities.
When does it occur? Generally, in the 2nd trimester of pregnancy , after the 20th week of pregnancy. But, we reassure you from the outset: it remains relatively rare! Because, according to Inserm , it affects approximately 5% of pregnant women. Most of the time, if it is well supported, the baby is born healthy and we manage to avoid any form of serious complication. But in 1 in 10 cases, it becomes more severe. It is, for example, responsible for a third of very 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" the blood vessels from properly supplying blood to the body. The result: blood circulation between the mother's blood and the fetus is disrupted. We'll quickly explain the risk factors and most common causes of preeclampsia.
You may be at some risk of developing preeclampsia if you "check" one of the following boxes:
- You have a medical history such as chronic hypertension, diabetes or kidney disease.
- You have a family history of preeclampsia and your genetics may make you more vulnerable.
- You have already developed preeclampsia during a previous pregnancy.
- You are expecting twins or triplets, so you increase your placental “load” and the risk of complications.
- You are experiencing your first pregnancy at less than 20 years old or at more than 40 years old.
- 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 may interfere with its implantation.
So, let's reassure you right away: yes, these risk factors can increase the possibility of developing preeclampsia. But there's no indication that you'll develop it! So don't panic if you're one of the women at risk. If you've established 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 referred to as a "silent illness." Why? Because it can develop discreetly, with no visible signs at first. However, there are a few symptoms that can alert us from 20 weeks of pregnancy. For example:
- Your blood pressure is higher than average.
- An abnormal presence of protein has been detected in your urine analysis.
- Parts of your body suddenly swell, such as your face, hands, and legs. This is due to excessive fluid retention… Potentially a telltale sign of preeclampsia.
But sometimes preeclampsia can worsen and lead to more worrying symptoms. Such as:
- Severe headaches that resist painkillers.
- Visual disturbances (blurred vision, sensitivity to light, appearance of “floaters”).
- Rapid weight gain.
- Abdominal pain, in the pit of the stomach, with a feeling of a bar under the ribs, often located on the right.
- Less marked baby movements.
In any case, take these symptoms seriously. They can develop into serious complications, such as:
- eclampsia (which causes seizures);
- HELLP syndrome (which causes liver damage and the breakdown of your red blood cells).
In short, if any of these signs appear, don't hesitate... Go straight to the doctor!
What risks does preeclampsia pose to the baby?
Preeclampsia doesn't just affect pregnant women: it can also have a direct impact on fetal development. This is due to disruptions in the blood flow between the mother's blood and the placenta. This lack of oxygen and nutrients can lead to several complications for the baby, ranging from serious to mild.
Intrauterine growth retardation (IUGR)
One of the most common consequences of preeclampsia is IUGR. This fetal growth restriction results in a baby weighing less than normal for their gestational age. The placenta is unable to nourish the baby properly, limiting growth and increasing the risk of neonatal distress at birth.
Premature birth and risks of complications
When preeclampsia becomes severe, labor may need to be induced prematurely to protect both mother and baby. However, the earlier the birth occurs, the higher the risk of complications. These include:
- The baby is born with immature lungs, which require respiratory assistance.
- He has difficulty regulating his body temperature because he has not yet accumulated enough fat.
- He has digestive and immune problems, which increases the risk of infections at birth.
Fetal distress and risk of death in utero
If the mother's blood flow to the baby is compromised, the baby may lack oxygen, causing acute distress and, in extreme cases, death.
Long-term consequences
Some babies born to mothers who suffered from preeclampsia may be at greater risk of developing cardiovascular disease in adulthood. The cause: stress experienced in utero.
How to avoid preeclampsia during pregnancy?
Well, first things first: you can't necessarily prevent preeclampsia. However, there are certain measures you can take to reduce the risk of developing a complication. Here are some of them.
1. Medical monitoring adapted to pregnant women at risk
From the very beginning of pregnancy, women at risk can benefit from optimal nutrition. This involves:
- A clinical examination that allows us to identify whether they are indeed at-risk patients.
- More frequent monitoring of blood pressure.
- Regular urine tests.
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2. A balanced diet and a healthy lifestyle
To limit severe forms of preeclampsia, you can also adjust a few lifestyle habits. It's nothing complicated, we promise! For example, try:
- Limit your salt intake to maintain your blood pressure.
- Promote a diet rich in fruits, vegetables, omega-3s and fiber to improve blood circulation.
- Conversely, avoid ultra-processed foods rich in fast sugars, which can promote inflammation and oxidative stress.
- Practice moderate physical activity (prenatal yoga, walking) to reduce the risk of hypertension and poor circulation of maternal blood to the baby.
- Regulate your stress using relaxation techniques, such as meditation or sophrology.
3. Aspirin and calcium (in low doses)
According to the WHO , in some women who have a risk factor, doctors may recommend:
- Low-dose aspirin from the end of the first trimester to improve maternal blood flow to the placenta.
- Calcium supplementation if a pregnant woman does not consume enough in her diet.
Of course, don't self-medicate during your pregnancy! These are medical recommendations that only a doctor can make. So, first and foremost, get informed and consult a healthcare professional to discuss them.
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How is preeclampsia diagnosed and treated?
Once again, rest assured: preeclampsia is now very easily diagnosed and treated. Long live the progress of science!
Diagnosis through medical care
Now, health professionals are able to detect pre-eclampsia in a pregnant woman during prenatal consultations thanks to several tests:
- Blood pressure measurement: If your blood pressure is above the norm twice in a row, then this is a first warning sign.
- Urine analysis: we check for the presence (or absence) of protein in the urine.
- Blood tests: Your platelets, liver enzymes and kidney function are measured to assess the severity of the condition.
- Ultrasound and fetal Doppler: we assess the baby's growth and the quality of blood exchange with the placenta.
Support and treatments
In truth, the only curative treatment for preeclampsia is childbirth. This is because it eliminates the main cause of the disease: the placenta. However, treatment will also depend on the pregnancy stage and the severity of the symptoms.
Before the 34th week of amenorrhea, close monitoring is implemented 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 if there is a risk of premature delivery.
Once this term has passed, induction or delivery by cesarean section may be considered to avoid further complications.
At the same time, doctors can also offer:
- 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 always arise after delivery.
In summary, preeclampsia remains a serious complication of pregnancy. And it requires significant medical monitoring to monitor both the mother and the unborn child. So, no: it can't always be avoided. However, with proper monitoring, preventive measures, and prompt treatment, the risks can be minimized and you can enjoy a more stress-free pregnancy!