Pre-eclampsia & Hypertension

Pre-eclampsia is more than just high blood pressure. It is rooted in the early development of the placenta. When the placenta's blood vessels don't develop correctly, they cannot deliver enough oxygen to the baby. This causes the placenta to release substances into the mother's bloodstream that 'irritate' her blood vessels, leading to high blood pressure and potential damage to her kidneys, liver, brain, and blood-clotting system.

While pre-eclampsia can happen to anyone, the risk is higher for:

• First-time mothers or those with a new partner.
• History of Pre-eclampsia: In a previous pregnancy.
• Medical Conditions: Existing high blood pressure, diabetes, kidney disease, or autoimmune conditions (like Lupus).
• Multifetal Pregnancy: Carrying twins or triplets.
• Advanced Maternal Age: Women over 40.

We use a combination of tools to monitor and diagnose the condition:

1. Blood Pressure Monitoring: Two readings of 140/90 or higher, taken four hours apart.
2. Proteinuria: Checking for protein in the urine, which indicates the kidneys are under stress.
3. Blood Tests: Checking liver enzymes, platelet counts, and kidney function.
4. sFlt-1/PlGF Ratio: A modern blood test that helps predict who is likely to develop pre-eclampsia in the coming weeks.

Management depends on the severity and how far along the pregnancy is:

• Mild Pre-eclampsia: Monitoring at home or in the clinic, with frequent BP checks and fetal growth scans.
• Severe Features: Hospitalization is required. We use medications to lower blood pressure and Magnesium Sulfate to prevent seizures (eclampsia).
• Aspirin Prophylaxis: For women identified as high-risk during their first-trimester screen, we prescribe low-dose aspirin (150mg) to be taken nightly, which can reduce the risk of early-onset pre-eclampsia by up to 60-80%.

The only definitive 'cure' for pre-eclampsia is the delivery of the baby and the placenta.

• Stability: Our goal is to reach at least 37 weeks. If the condition becomes severe, we may need to deliver earlier to protect the mother's life.
• The Baby: Babies of pre-eclamptic mothers are often smaller (FGR) and may need specialized care in the NICU if born prematurely.
• Long-term: Most women's blood pressure returns to normal within weeks of delivery, but they have a higher risk of cardiovascular issues later in life, making long-term health follow-up essential.

If you experience any 'Red Flag' symptoms, you must contact your doctor or visit the emergency room immediately:

• Severe Headaches that don't go away with paracetamol.
• Vision Changes: Blurring, flashing lights, or spots.
• Upper Abdominal Pain: Often felt under the ribs on the right side.
• Sudden Swelling: Especially in the face and hands.

At the MFM Unit, Dr. Leanne Bricker specializes in the management of hypertensive disorders. We provide a comprehensive screening and surveillance program to keep you and your baby safe.