Pregnancy is a beautiful and exciting time, but unfortunately, it does not always go entirely without complications. One possible complication is preeclampsia, commonly known as pregnancy poisoning. It usually occurs after the 20th week of pregnancy and affects about six to eight percent of all pregnant individuals. Here, you will learn what the symptoms and risk factors of pregnancy poisoning can look like and how it is diagnosed and treated.
Signs and symptoms of pregnancy poisoning
Pre-eclampsia is often referred to as pregnancy poisoning in everyday language, but this is not entirely accurate, as the term can encompass several pregnancy-specific conditions. Pre-eclampsia is thought to develop when the fertilized egg does not implant properly into the uterine lining. Signs of pre-eclampsia can be very nonspecific; they depend on the type of the condition and how advanced it is. Clinically, pre-eclampsia is diagnosed when there is elevated blood pressure and increased protein excretion in the urine, often accompanied by worsening water retention in the feet and/or hands and, in severe cases, also in the face.
Many pregnant women also experience headaches, light sensitivity, nausea, vomiting, pain in the right upper abdomen, or neurological symptoms such as visual disturbances. All of these symptoms can, but do not necessarily, indicate preeclampsia. Therefore, it is best to discuss them with your doctor if they occur. Signs that your doctor may also detect in cases of preeclampsia include fluid retention in the lungs, impaired kidney function, a low platelet count, or an unusually small baby. In the worst case, preeclampsia can lead to eclampsia (neurological symptoms and severe seizures) or HELLP syndrome (liver dysfunction and a blood clotting disorder). This can be dangerous for both you and your unborn baby. That is why it is very important to take these signs seriously and have them checked by your doctor. In practice, you can also have a preventive assessment to determine whether you have an increased risk of preeclampsia.
Risk factors for pregnancy-induced hypertension
Preeclampsia in a previous pregnancy
Preeclampsia in the mother or sister
If your doctor suspects a particularly high risk of preeclampsia, early diagnostics may also be helpful. Such a risk exists, for example, in mothers who have previously experienced preeclampsia with complications, such as an early placental abruption, during a prior pregnancy. In this case, a specialized ultrasound examination of the uterine vessels in the first trimester can provide an indication of future preeclampsia development. Additionally, it is possible to determine your individual risk for preeclampsia through specific blood tests. If abnormalities are detected during these tests, your doctor can prescribe medications that effectively help prevent preeclampsia. According to recent studies, this can reduce the risk by over 60 percent.
Diagnosis and Treatment
If your doctor suspects preeclampsia, they will first measure your blood pressure on both arms. Additionally, your urine will be tested for protein, and your blood will be checked for protein levels, liver enzymes, and a low platelet count. Then, an ultrasound examination (Doppler sonography) will be performed to check your baby’s size and blood supply. During the contraction monitor (CTG), your doctor will monitor your baby’s heartbeat and any signs of labor. An ultrasound of your liver may also be performed for further evaluation.
Treatment for pregnancy poisoning depends heavily on the symptoms. In mild cases and in the early stages of preeclampsia, it is often sufficient to rest and possibly stay in bed. Your doctor may also prescribe antihypertensive medications.
If the symptoms do not subside or your blood pressure continues to rise, you may need further treatment in the hospital, where you can be closely monitored and receive prompt, expert care. During an inpatient stay, in addition to a blood pressure log, the total amount of protein in your urine over 24 hours will be measured, and your blood will be thoroughly examined. Your medications may be adjusted to include different blood pressure-lowering options, and you may also receive magnesium to prevent cramps. Additionally, your baby will be continuously monitored with the CTG. Unfortunately, it can happen that your baby needs to be born prematurely to avoid risks to you or your baby. Especially in cases of HELLP syndrome, the pregnancy often has to be ended earlier. In this situation, you are best cared for in the hospital, ideally one with a neonatal intensive care unit.
Nowadays, long-term effects for mothers and babies who experience preeclampsia are fortunately very rare. This is mainly because the condition is usually detected and treated very early during routine prenatal check-ups. Especially if you have risk factors for preeclampsia (but, of course, even if you do not), it is important to attend your prenatal appointments and share your concerns and questions with your doctor. This way, you and your baby will receive optimal care and you can enjoy your pregnancy with greater peace of mind.
