S, a first-time mother, was admitted to the hospital due to high blood pressure and excessive protein in her urine (proteinuria). She was at 37 weeks gestation. Her pregnancy had been smooth sailing at first, but as she entered her third trimester, ominous signs began to appear. She experienced excessive weight gain accompanied by swelling in her hands and feet. Her blood pressure rose from 110/70mm Hg to 150/95 mm Hg prior to admission to the hospital. Additionally, she experienced occasional headaches and felt nauseous. S was diagnosed with preeclampsia, a serious complication of pregnancy.
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What Is Preeclampsia?
Preeclampsia is characterized by elevated blood pressure, high levels of protein in the urine indicating kidney damage (proteinuria), or other signs of organ damage. Preeclampsia typically arises after 20 weeks of pregnancy in women whose blood pressure had previously been within normal limits. Its onset is often subtle, with symptoms varying from mild to severe, making timely diagnosis and intervention challenging.
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If left untreated, preeclampsia can lead to severe—even fatal—complications for both the mother and baby.
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What Causes Preeclampsia?
The exact cause is not fully understood. Experts believe that it is probably due to multiple factors including abnormal functions of the placenta, aberrant immune response, genetic factors, and dysfunction of the cells lining the blood vessels. This complexity makes early identification difficult.
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Early Detection of Preeclampsia
Early detection of preeclampsia relies on antenatal screening aimed at identifying women at risk. These include
·        Women who became pregnant via in vitro fertilization,
·        Multiple pregnancy (twins and triplets),
·        Women with gestational diabetes,
·        Women over age 35,
·        Women with chronic hypertension, obesity, polycystic ovary syndrome(PCOS)
·        Previous pregnancy with preeclampsia
·        Family history
The measurement of blood pressure and urinary protein levels during routine antenatal visits serves as a cornerstone in the surveillance of preeclampsia.
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Recent advancements in using blood biomarkers like placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFLT-1), and uterine artery Doppler ultrasound have improved early detection and risk assessment. PlGF, produced by the placenta, helps identify individuals at risk by measuring its levels in maternal serum. Elevated levels of sFLT-1, combined with decreased PlGF levels, are predictive markers for preeclampsia. Doppler ultrasound checks placental blood flow, which can be impaired in preeclampsia.
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Patient education is vital for pregnant mums to recognize warning signs and seek early medical help, leading to better outcomes for both mother and baby.
Conclusion
With a combination of screening methods and patient education, preeclampsia can be detected early, leading to improved pregnancy outcomes.
S had her labor induced shortly after admission and delivered a healthy baby boy weighing 3 kg. Her blood pressure gradually returned to normal a week after delivery.
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