Pregnancy health centre

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

What are pre-eclampsia and eclampsia?

Pre- eclampsia and eclampsia are forms of high blood pressure that occur during pregnancy, in association with a significant loss of protein in the urine, called proteinuria. As the names suggest, pre-eclampsia and eclampsia are related.
Pre-eclampsia, also called "toxaemia of pregnancy", may develop into the more severe eclampsia. Eclampsia has the same features as pre-eclampsia but is characterised by seizures.

These conditions, when they develop, usually occur during the second half of pregnancy - at or after 20 weeks -- although there are cases where they develop shortly after delivery.

Women with pre-eclampsia may have no symptoms initially, but can go on to develop headaches, visual disturbances, abdominal pain, vomiting, and experience a reduction in foetal movements. 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 and/or by caesarean section.

If your blood pressure continues to rise, your kidneys may have trouble functioning. A condition known as HELLP syndrome can develop in severe pre-eclampsia. HELLP syndrome includes the development of anaemia, disturbed liver function, and a low platelet count; platelets are needed for blood to clot. Too few platelets can increase your risk of bleeding spontaneously or even uncontrollably during delivery.

If your pre-eclampsia develops into eclampsia you may experience a seizure. This is a life-threatening situation for both you and your baby. During a seizure, you and your baby are at risk of being deprived of oxygen. In addition, the high blood pressure may cause the placenta to begin to separate from the wall of the uterus, called a placental abruption. This can cause severe bleeding and even death of the foetus and possibly the mother.

Who gets pre-eclampsia and eclampsia?

The NHS says mild cases of pre-eclampsia affects up to 10% of first-time pregnancies. More severe pre-eclampsia can affect 1-2% of pregnancies. 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.