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Pre-eclampsia and eclampsia: Symptoms, diagnosis, treatment and prevention

What are pre-eclampsia and eclampsia?

Pre-eclampsia and eclampsia are complications which can develop from around the 20th week of pregnancy, causing high blood pressure and protein in the urine, called proteinuria.

Pre-eclampsia affects up to 5% of pregnancies and may develop into the more severe eclampsia, which also causes seizures.

Pre-eclampsia is dangerous, since it may interfere with the placenta's ability to deliver oxygen and nutrition to the foetus. If this is the case, your baby may be born underweight, may have other health problems, and may need to be delivered early or by caesarean section.

Pre-eclampsia symptoms should be picked up during routine antenatal appointments.

Women with pre-eclampsia may develop swelling of the feet, ankles, face and hands caused by fluid retention, headache, vision problems and pain under the ribs.

Medical advice should be sought immediately through a midwife, GP surgery or out of hours NHS helpline.

Who gets pre-eclampsia and eclampsia?

Pre-eclampsia is more likely to happen again if you experienced it in previous pregnancies.

You are at increased risk of developing pre-eclampsia if:

  • This is your first pregnancy.
  • There is a long gap (10 years) between your current pregnancy and your last pregnancy.
  • Your mother or sister had pre-eclampsia or eclampsia during pregnancy.
  • You're carrying twins or it is a multiple pregnancy.
  • You're a teenager or over 40 at the time of pregnancy.
  • You already have high blood pressure, kidney disease, or diabetes.
  • You have a pre-pregnancy body mass index (BMI) greater than 30.

What causes pre-eclampsia and eclampsia?

The cause of pre-eclampsia is still unclear. Possible causes include injury to your blood vessels, or a disruption in the hormones that maintain your blood vessels.  Eclampsia usually develops when pre-eclampsia goes unnoticed and untreated.

What are the symptoms of pre-eclampsia and eclampsia?

It's critical for all pregnant women to watch for symptoms of pre-eclampsia, and to seek medical advice immediately if you notice any of the pre-eclampsia symptoms, which include:

  • Excessive weight gain because of fluid retention
  • Swelling of your legs, face or arms

If pre-eclampsia progresses from mild to moderate or severe, you may begin to notice other symptoms, such as:

  • Headaches
  • Vision changes (blurred vision, seeing double, seeing spots of light)
  • Abdominal pain
  • Dizziness or faintness
  • Ringing in the ears
  • Urinating less often
  • Nausea or vomiting
  • Blood in your vomit or urine
  • Confusion
  • Seizures. 

How is pre-eclampsia or eclampsia diagnosed?

If you notice rapid weight gain and swelling in your legs, face or arms, make an appointment to see your doctor or midwife since you could have pre-eclampsia. He or she will check your blood pressure and take a urine sample to look for protein in your urine. If you're diagnosed with pre-eclampsia, your doctor may also do tests to check your liver, kidney function and level of platelets (cells in the bloodstream that are involved in clotting) in your blood.

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