Verified by: Midwife Maria Midstam 

Preeclampsia means that pregnant women have high blood pressure and may develop some other symptoms, often in late pregnancy. This is usually detected by the midwife during routine check-ups. Because pre-eclampsia can be dangerous for the baby, pregnant women are offered more regular check-ups at the maternity clinic. 

What is pre-eclampsia?

Maternity care in Sweden started in the 1950s, partly to detect pregnant women who developed symptoms of pre-eclampsia during their pregnancy. This is a disease that can only occur during pregnancy and can have rather diffuse symptoms.

During antenatal care visits, blood pressure is checked and the patient is asked to provide a urine sample to check for protein in the urine. These checks are done to detect whether the pregnant woman has developed or is developing symptoms.

Patients should have blood pressure above 140/90 measured on several occasions and often have protein in their urine. Preeclampsia affects 3-7% of all pregnant women around the world per year, which corresponds to about 8.5 million pregnant women. In Sweden, about 5000 pregnant women are affected per year, which is about 5%.

The disease appears after week 20 of pregnancy, often in late pregnancy after week 34. Usually the symptoms are mild, and it is also possible to become ill in the immediate postpartum period.

Why do you get pre-eclampsia?

The cause of the disease is not yet fully understood, but it is believed that the placenta does not function properly. Already when the placenta is formed, it attaches too superficially to the endometrium, which means that particles and cells from the placenta and the fetus can leak into the blood of the pregnant woman. Pregnant women may have risk factors before pregnancy that increase the likelihood of contracting the disease. Examples of risk factors include being a first-time mother with a history of pre-eclampsia, having a BMI of more than 30, being older than 40 and a history of high blood pressure during pregnancy.

Certain diseases can also pose a risk. These include type 1 or 2 diabetes, high blood pressure, certain autoimmune diseases or chronic kidney disease. If you have had a baby before and then become ill or have high blood pressure, this increases your risk of having another pregnancy. Expecting more children or having undergone an IVF pregnancy with egg donation also poses a risk of being affected.

Symptoms

There are symptoms that pregnant women should be aware of. These are: nausea and vomiting (after week 18), visual disturbances such as flickering eyes, headaches, upper abdominal pain, rapid swelling of the face, hands and feet. General malaise where you feel shaky and absent-minded. Always contact emergency services if you think you may have suffered pre-eclampsia. Usually those affected do not become very ill, but there are two serious forms of the disease and you should be aware of them.

HELLP - a more severe form of pre-eclampsia with general organ involvement, mainly the liver. About 10-20% of those affected by a more severe form of pre-eclampsia develop HELLP.

Eklampsi - The other serious variant is called eclampsia, which means that the pregnant or new parent has generalized seizures that cannot be explained by an underlying disease (such as epilepsy). However, eclampsia is very rare.

What happens if you get a diagnosis?

If you are pregnant and have been diagnosed with pre-eclampsia, you can expect more frequent visits to the midwife in the maternity ward. It is common for the patient to be admitted to a specialist maternity unit, which is usually attached to a maternity hospital. If necessary, you will be admitted as a hospital patient, either to a ward called Antenatal or to the maternity ward. Antenatal is a ward that cares for women during pregnancy.

If pre-eclampsia is known to exist, the person who becomes pregnant again will see a doctor and will usually be put on medication to reduce the likelihood of contracting the disease again. Those who become ill can be treated with drugs to lower their blood pressure, but there is currently no cure apart from giving birth. In some cases, this may mean that the baby needs to be delivered earlier than expected.

Preeclampsia can be dangerous for the baby as the function of the placenta may be impaired. Extra ultrasound scans are often carried out to see how the baby is growing in the womb; the frequency of extra checks depends on the severity of the condition.

Want to learn more about high blood pressure (hypertension) during pregnancy? Click here here!