Pre-eclampsia And Eclampsia

What are preeclampsia and eclampsia?

Preeclampsia (toxemia) and eclampsia are conditions that can develop during week 20 or later of pregnancy. Most often you will have high blood pressure and protein in your urine when you have preeclampsia. Preeclampsia progresses to eclampsia if you have a seizure. This does not include women with a known seizure disorder. These conditions can create mild to life-threatening health problems for you and your unborn baby.

What are the signs and symptoms of preeclampsia and eclampsia?

• Swollen face, hands, and legs
  
  
• Weight gain of 2 or more pounds each week
  
  
• Headache
  
  
• Spotted or blurred vision
  
  
• Pain in the upper abdomen

What increases my risk for preeclampsia and eclampsia?

Caregivers believe preeclampsia and eclampsia are caused by problems with how the placenta grows or attaches to the uterus. The placenta is an organ that nourishes an unborn baby. You have a higher risk of developing these conditions if:

• This is your first pregnancy.
  
  
• You are pregnant with twins or multiples.
  
  
• You have a personal or family history of preeclampsia or eclampsia.
  
  
• You are overweight.
  
  
• You have diabetes or kidney disease.
  
  
• You are older than 40.

How are preeclampsia and eclampsia diagnosed?

Your caregiver will ask about your symptoms and when they began. He will check for swelling in your face, hands, or legs. Tests may include:

• Blood pressure: Caregivers will suspect preeclampsia if your blood pressure is 140/90 mmHg or more for at least 2 readings. Your blood pressure will need to be checked 1 to 2 times a week until your baby is born.
  
  
• Blood tests: Blood tests are done to check the function of your liver and kidneys. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may need blood tests every week while you are pregnant.
  
  
• Urine test: Caregivers collect a urine sample to check for protein. You may need to give caregivers a urine sample at each visit. You may also need to do a 24-hour urine test. You will collect your urine every time you urinate for 24 hours, even at night. You will be given a jug to store the urine in, which needs to be kept cold. After you have collected your urine, it is sent to a lab to be tested for protein and kidney function.

How is my unborn baby monitored when I have preeclampsia or eclampsia?

You may need to keep track of how often your baby moves or kicks over a certain amount of time. Ask your caregiver how to do kick counts and how often to do them. You may also need the following tests at each visit until your baby is born:

• Fetal biophysical profile: A fetal biophysical profile is a test that combines a nonstress test and a special ultrasound of your unborn baby. The nonstress test measures changes in your baby's heartbeat when the baby moves. The ultrasound will show your baby's movement, growth, and how his breathing muscles are working. Caregivers can check the amount of fluid around your baby. The ultrasound will also show if your baby's lungs are working. The nonstress test and ultrasound may also be done separately.
  
  
• Umbilical cord Doppler: An umbilical cord Doppler test checks blood flow through the umbilical cord. The umbilical cord carries nutrients from the placenta to your unborn baby. A small metal disc with gel on it is placed on your skin over the umbilical artery. You can hear a whooshing sound when the blood is flowing through the artery.

How are preeclampsia and eclampsia treated?

• Medicines:
  
  
  • Blood pressure medicine: This medicine helps lower your blood pressure during your pregnancy and protects your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.
    
    
  • Magnesium sulfate: This medicine prevents seizures. This medicine is commonly given through an IV in the hospital. An IV is a thin tube put into your vein for giving medicines and liquids.
    
    
  • Steroids: This medicine is given 12 to 24 hours before your baby is delivered if he needs to be born early. The medicine helps your baby’s lungs develop.
  
  
• Rest: Your caregiver may tell you to rest more often if you have mild symptoms of preeclampsia. Lie on your left side as often as you can. You may need complete bedrest if you have more severe symptoms. You may need to be in the hospital for this if your condition worsens.
  
  
• Delivery: Preeclampsia and eclampsia usually end after your baby is born. Caregivers may deliver your baby right away if he is full-term (37 weeks or more). You may need to deliver your baby early if you or the baby have life-threatening symptoms.

What are the risks of preeclampsia and eclampsia?

• Preeclampsia and eclampsia can create serious health problems for you and your unborn baby. Your baby may not grow as he should and may need to be delivered early. Placental abruption can occur if the placenta pulls away from the uterus too soon. This condition is life-threatening for your baby. High blood pressure that is not controlled can lead to blood clots, kidney or liver failure, or stroke in the mother.
  
  
• Severe forms of preeclampsia cause seizures or coma. A coma is when you look like you are asleep but you cannot be awakened. Preeclampsia and eclampsia can sometimes develop up to 30 days after birth, and the risk is highest 1 to 2 days after delivery. Ask your caregiver if you have questions or concerns about your pregnancy, condition, treatment, or care.

Where can I find support and more information?

• Preeclampsia Foundation
  6767 N. Wickham Road, Suite 400
  Melbourne , FL 32940
  Phone: 1- 321 - 421-6957
  Web Address: http://www.preeclampsia.org
  

• The American College of Obstetricians and Gynecologists
  409 12th Street, SW
  Washington , DC 20090
  Phone: 1- 202 - 638-5577
  Web Address: http://www.acog.org
  

When should I contact my caregiver?

Contact your caregiver if:

• You have new or increased swelling in your face, hands, or legs.
  
  
• You are urinating less than usual.
  
  
• You have new or increased vision changes. These include blurred or spotted vision.
  
  
• You do not feel your baby's movements as often as usual.

When should I seek immediate care?

Seek care immediately or call 911 if:

• You develop a severe headache that does not go away.
  
  
• You have severe abdominal pain with nausea and vomiting.
  
  
• You are urinating very little or not at all.
  
  
• You have a seizure.
  
  
• You are bleeding from your vagina.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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