Preeclampsia - OAWHealth

Preeclampsia

By Dr. Loretta Lanphier, ND, CN, HHP, CH

It can be very upsetting to discover that you have developed a potentially serious complication during pregnancy. Preeclampsia fits that description, and it can have significant effects for both mother and baby. However, it is important to know that the majority of women with preeclampsia are able to deliver healthy babies and fully recover themselves. Conventional medicine will tell you there are no preventative measures that can be taken against preeclampsia, when the truth is that women who pursue a healthy lifestyle before conception and during pregnancy have a much lower incidence of preeclampsia. Let’s take a look at the whys and wherefores of this relatively common condition and see if we can learn a bit about how to best treat and, most importantly, prevent this disorder.

What is Preeclampsia?

Preeclampsia is one of the most common forms of hypertension related to pregnancy, and increased blood pressure along with the presence of excess protein in the urine are the defining characteristics of preeclampsia. Any form of hypertension during pregnancy can have serious consequences, and ultimately preeclampsia can progress into full-blown ecclampsia, which may cause seizures and coma, and is potentially fatal. However, this does not usually happen if preeclampsia is carefully monitored and managed. The good news is that there are ways to treat preeclampsia that do not involve the use of medications that may be dangerous to both the mother and the fetus.

Preeclampsia is a quite common complication of pregnancy, occurring in approximately 7% of first-time pregnancies. It is also sometimes referred to as pregnancy-induced hypertension, and is diagnosed when blood pressure readings and the amount of protein in the urine reach certain levels after the first 20 weeks of pregnancy.

Besides preeclampsia, other less common forms of hypertension during pregnancy include:

  • Chronic hypertension: This form most often affects women who had high blood pressure before conception. It is diagnosed when hypertension is experienced before 20 weeks of pregnancy, or if it lasts for more than 12 weeks after childbirth.
  • Chronic hypertension with superimposed preeclampsia: This label is put on cases where chronic high blood pressure existed before pregnancy, and classic preeclampsia develops after 20 weeks, including hypertension and protein in the urine.
  • Gestational hypertension: Also called late hypertension, this form occurs after 20 weeks of pregnancy, but does not manifest protein in the urine. Women with late hypertension are susceptible to developing preeclampsia.

What Are the Signs and Symptoms of Preeclampsia?

Preeclampsia may go unnoticed by the mother, essentially having no distinct symptoms in its early stages. One of the problems with identifying preeclampsia is that some of its signs can also be present in the course of normal pregnancies. Examples include swelling, headaches, and nausea. The best way to be sure that you are not experiencing preeclampsia or other pregnancy complications is to carefully monitor your blood pressure, urine protein levels, and other vital signs by including regular visits to your health care provider as part of your prenatal routine.

Blood pressure is measured in mm/Hg, and as a ratio of two numbers: systolic over diastolic. Normal blood pressure during pregnancy varies from woman to woman, but is generally considered to be no higher than 130/85 mm/Hg. When it comes to diagnosing preeclampsia, a reading greater than 140/90 mm/Hg is an indicator of preeclampsia, as are increases of 30 or more in the systolic number and/or 15 or more in the diastolic reading. Your blood pressure should be taken at every visit to your health care practitioner. Keep in mind that one high reading alone is not necessarily indicative of preeclampsia. What you are looking for is trends or large spikes in the readings that do not return to previous levels.

A simple urine test using a dipstick can alert you to excess protein in your urine, a condition known as proteinurea. If you get a positive reading, your provider may suggest a more accurate test that involves gathering urine over a 24 hour period and having it analyzed in a lab for protein content. Levels greater than 500 mg of protein point towards preeclampsia.

If a person with preeclampsia does experience symptoms, some of the most common ones include:

  • Severe headaches
  • Blurry vision, or changing vision
  • Supersensitivity to light
  • Nausea and/or vomiting
  • Dizziness
  • Pain in the upper abdomen (usually under the ribs on the right hand side)
  • Decreased urination
  • Sudden weight gain (typically 2 pounds or more per week)
  • Edema: A certain amount of edema (swelling) is normal in pregnancy, but extensive swelling, especially in the hands and face, may indicate preeclampsia.

One of the biggest factors of preeclampsia that can be so damaging, to both mother and baby, is leakage of blood vessels that leads to fluid accumulation in tissues throughout the body. In addition to edema in the face and hands, preeclampsia can trigger issues in other areas including:

  • Eyes: Hypertension and fluid in the eyes can cause blurriness, a detached retina, or even blindness in some women.
  • Lungs: Fluid in the lungs can lead to respiratory distress and shortness of breath.
  • Kidneys: In preeclampsic women, the tiny blood vessels in the kidneys can leak, allowing protein cells, which are normally too large to exit the bloodstream, to enter the urine. Excessive amounts of protein in the urine can cause many serious complications, including low-birth weight babies, and even fetal death in some cases.
  • Liver: Liver damage from preeclampsia can be quite extensive. A condition called HELLP syndrome occurs when swelling in the liver results in the destruction of red blood cells and platelets (cells involved in blood clotting), and abnormally high levels of certain liver enzymes. In extreme cases, the liver may rupture.
  • Brain: Leaky blood vessels in the brain can lead to dangerous conditions such as seizures, coma, and even death. In addition, women can experience brain damage due to oxygen deprivation during seizures.
  • Placenta: Leakage of blood vessels leading to the placenta can result in inadequate amounts of blood reaching the placenta. This deprives the fetus of both nutrients and oxygen, and can trigger stunted growth, premature birth, or even stillbirth.

Preeclampsia can also increase risk for a condition known as placental abruption. This condition involves abnormal separation of the placenta and the uterus before delivery. Heavy bleeding can result, which is hazardous to both baby an mom, and is potentially life threatening for both as well.

What Causes Preeclampsia?

The standard take by conventional medicine is that the cause of preeclampsia is still unknown. It is suspected that poor blood supply to the uterus is a factor. However, recent research points to the general health of women before conception, especially regarding their circulatory system, the strength of the immune system, and their dietary and lifestyle choices. Here we see the same pattern that is associated with so many other forms of disease. Obesity, a poor diet, a weakened immune system, and a sedentary lifestyle all are factors that make it much more likely for a woman to experience preeclampsia while pregnant. Studies have shown that women who have pre-existing conditions such as diabetes, lupus, and kidney disease are also at greater risk for preeclampsia. Even those in mainstream medicine are starting to see the connection between preeclampsia, the immune system, and overall wellness. Medical textbooks will tell you preeclampsia cannot be prevented, but I beg to differ. Researchers discovered in a study done in 2006 that women who took multivitamins and maintained a healthy weight before conception could reduce their risk for preeclampsia by a whopping 70%.

There are also other risk factors that increase the likelihood of developing preeclampsia. Some of these include:

  • New mothers: Women who have never given birth, technically known as “nulliparas,” are more likely to experience preeclampsia than those who have given birth in the past. For reasons that are not known, preeclampsia rates also increase for women who have given birth before, but are having their first baby with a new partner.
  • Age: Women who are under 20 or over 35 are at greater risk for preeclampsia.
  • Multiple pregnancy: If you are carrying twins, triplets, etc., risk for preeclampsia also increases.
  • History of preeclampsia: If you have experienced preeclampsia in previous pregnancies, you have an increased chance of having it again. Statistics tell us that 33% of women who have had at least one pregnancy with preeclampsia will develop it in a future pregnancy.

What Treatments Are Available for Preeclampsia?

Fortunately, there are treatments available that avoid the use of medications, as these are particularly dangerous during pregnancy for both mom and baby. However, you may run across situations where drugs are recommended. Be very careful about using medication to manage preeclampsia. Typically, recommendations may be made for meds to lower blood pressure. The problem with this is that a woman’s blood pressure is supposed to increase a bit during pregnancy to ensure that the fetus gets adequate blood supply for much-needed nutrients and oxygen. If blood pressure medications are used, it may put the baby at risk. Sometimes corticosteroid drugs are also prescribed. These can have serious consequences for anyone, much less a pregnant woman and her baby. Avoid the use of these if at all possible.

The good news is that preeclampsia can usually be dealt with through lifestyle changes such as bed rest. This is the most natural way to control hypertension related to pregnancy. Depending on the severity of your preeclampsia, recommendations may vary from limited activity to total bed rest. Talk it over with your provider and be ready to commit to whatever is best for you in your situation. If total bed rest is needed, use the time to relax and catch up on things such as reading, writing letters, or just plain old relaxing and staying calm. This can go a long ways towards reducing the hypertension that is causing the preeclampsia in the first place.

The other common option offered to women with preeclampsia is to induce labor for premature delivery. This is something you should talk over with your pregnancy health provider and make the best decision possible for you and your baby. Issues such as the use of drugs to induce labor or possible surgical interventions such as caesarean section must be considered. Educate yourself so that you can make the best move. Sometimes early delivery is a wise choice, especially if the preeclampsia is severe and steps such as bed rest have not helped.

Prevention is, of course, the best treatment. A lifestyle that pursues wellness and avoids disease is the most effective way to combat preeclampsia and all other forms of disease as well. Remember that prevention begins today. The choices you make now will affect your wellness tomorrow and farther into the future as well.

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