Question 1

What are preeclampsia and eclampsia?

Accepted Answer

Preeclampsia is when a pregnant woman suddenly develops high blood pressure, sometimes referred to as hypertension, and experiences protein in her urine, called proteinuria, which is an indicator of kidney damage. The condition, which generally begins after about 20 weeks of pregnancy, impacts about 1 in 25 pregnancies in the United States, according to the Centers for Disease Control and Prevention. Preeclampsia is not a medical emergency. But if it worsens and causes seizures or coma, the condition becomes known as eclampsia, which is a medical emergency. “They are related conditions,” James J. Walker, a specialist in high-risk obstetrics and preeclampsia at the University of Leeds in England, said in a phone interview. “Convulsions or seizures … that’s the main differentiation.” Lady Sybil, a character in “Downton Abbey,” a television drama set in 1920s Britain, died of eclampsia, and Hippocrates drew attention to headaches, heaviness and convulsions during pregnancies.

Question 2

What are the symptoms of preeclampsia?

Accepted Answer

The symptoms of preeclampsia vary and may include enduring headaches, changes in vision, pain in the upper stomach area, nausea, swelling of the face or hands, sudden weight gain and difficulty breathing, according to the CDC. Some women can be more at risk of developing preeclampsia, if it is their first time giving birth; they had preeclampsia in a previous pregnancy or have a family history of it; they have chronic high blood pressure; are pregnant with more than one baby; or became pregnant via in vitro fertilization. Some studies have shown a greater risk of preeclampsia among Black and Indigenous women compared to others, according to the Mayo Clinic. This may be due to inequalities in access to prenatal care and chronic stressors that affect one’s health and well-being, rather than biology, it said. “Eclampsia is one of the most severe end points of developing preeclampsia in pregnancy and obviously can result in maternal death,” said Sara Hillman, associate professor of maternal and fetal medicine at the UCL Institute for Women’s Health in London. “[While] preeclampsia is common, fortunately severe preeclampsia and eclampsia is rare.” Hillman added that it can be easy to mistake preeclampsia symptoms for “common pregnancy problems,” such as headaches, stomach pain and nausea. The “seizure or ‘eclamptic fit’ can be the first presentation” of the disease, she added. In rare cases, preeclampsia can also happen after giving birth, said Walker. This is termed postpartum preeclampsia and is a serious medical condition. Symptoms are similar to preeclampsia but also include severe bleeding. Postpartum preeclampsia can occur regardless of whether the woman had preeclampsia during pregnancy. Mothers are most at risk of postpartum preeclampsia in the first 24 to 48 hours after delivery and must be actively monitored, Walker said.

Question 3

Can a woman survive preeclampsia?

Accepted Answer

Yes. Most women with preeclampsia will deliver healthy babies and fully recover. “Preeclampsia during pregnancy is mild in the majority of cases,” according to the National Institutes of Health. “However, a woman can progress from mild to severe preeclampsia or to full eclampsia very quickly―even in a matter of days.” Eclampsia is one of the major causes of maternal death globally, the World Health Organization said, noting that the vast majority occurred in low and lower income countries in 2020. The NIH said preeclampsia and eclampsia accounted for more than 50,000 maternal deaths every year, and can in rare instances be fatal for both the mother and baby. Death is normally caused by organ failure, stroke or pulmonary edema, which is fluid in the lungs, Walker said.

Question 4

Does preeclampsia affect the baby?

Accepted Answer

It can, depending on how severe the symptoms are. Preeclampsia can cause complications with the placenta, which connects the mother to the fetus. If the placenta doesn’t get enough blood, it can lead to a lack of oxygen and nutrients to the baby, which can impact its growth. Preeclampsia can also lead to premature baby delivery, which can cause developmental risks. In severe instances, where there is placental abruption, it can cause stillbirth and infant death. Infants born preterm due to preeclampsia may also be at higher risk of problems later in life such as learning disorders, cerebral palsy, epilepsy, deafness, and blindness, NIH said. In the United States, approximately 10,500 babies die from preeclampsia each year and an estimated half a million worldwide, according to the Preeclampsia Foundation, a U.S.-based nonprofit. Stillbirths from preeclampsia — babies that die in utero after 20 weeks of gestation — number between 1,000 and 2,200 in the United States, it said.

Question 5

Is there a way to treat preeclampsia?

Accepted Answer

The best treatment is early detection and regular prenatal checks. Treatment can include regular monitoring until delivery; bed rest; administering low-dose aspirin to control blood pressure, anticonvulsive medication such as magnesium sulfate, or steroid injections; and regular blood and urine tests and fetus scans, according to NIH. In some instances, medical professionals may determine that early delivery is the best way to avoid further complications and prevent fatalities. When a woman has severe preeclampsia and is at 34 weeks of pregnancy or later, the American College of Obstetricians and Gynecologists recommends delivery as soon as medically possible. “Delivery starts the cure process,” Walker said. Des Bieler contributed to this report.

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