Although there is no fixed way to prevent pre-eclampsia, there are some measures which can be taken to reducing the risk of this condition
This includes:
- Being healthy prior to conceiving (this can also help minimise the risk of other pregnancy complications!
- Managing pre-existing medical conditions if any
- Do consult with your doctor in relation to this to best manage the conditions and have a healthy pregnancy
- Work towards maintaining a healthy body weight, a BMI between 19-25 is quite safe for women looking to have children.
- Avoid unnecessary stress
- Unnecessary stress can lead to increased blood pressure
- Having a healthy diet
- This includes eating balanced meals, such as more fruits and vegetables, while avoiding foods high in saturated fats and sodium.
- You may also consider increasing calcium intake if one has low calcium intake but at risk of pre-eclampsia
- Avoid alcohol and cigarettes
- Exercise regularly (150 minutes per week of moderate intensity exercise is good!)
- Going for routine checkups with obstetrician
Additionally, low dose aspirin is recommended for women at high risk (i.e. pre-existing hypertension, pre-eclampsia in previous pregnancies)
- This can start after 1st trimester (14 weeks)
- Lower risk of hypertension during pregnancy and development of pre-eclampsia
Routine Pregnancy Screening
What happens at the antenatal visits?
If you have been diagnosed with pre-eclampsia, it is important to go for antenatal visits 1-2x per week to follow up and monitor your condition! Your doctor may also perform some tests during these checkups, which can include:
- Tests to see if the condition is progressing
- Tests to monitor growth of fetus
- Ultrasound: an ultrasound can be used to check blood flow to the fetus, monitor its growth, and assess amniotic fluid[1].
- Cardiotocography: this is a method to electronically monitor the heart rate of the fetus, and can be used to detect signs of distress.
What can I do at home?
In cases of less severe pre-eclampsia, it can be managed on an outpatient basis, so it would be good to take these measures by yourself at home!
- Daily blood pressure monitoring
- Using a blood pressure monitor, you can take your blood pressure to check for abnormal levels as this could mean the condition has worsened.
- Keep track of baby’s kick count
- Keeping track of your baby’s kick count can help you monitor its movement and health to some extent.
Treatment Options
How can pre-eclampsia be treated? The treatment for each patient depends greatly on the severity of pre-eclampsia, and the stage of pregnancy which one is at.
For patients with pre-eclampsia that is mild,
- More bedrest, less physical activity to reduce blood pressure
- Close monitoring by doctor or midwife
Admission for inpatient monitoring will be considered if:
- Severe pre-eclampsia
- Persistent hypertension or proteinuria
Diet
While diet is not a sure way of treating pre-eclampsia, there are changes which can be made to one’s diet to avoid progression of the condition. This include:
- Having a low – moderate sodium content in food
- Increased protein consumption (pre-eclampsia involves proteinuria[2])
- For severe cases,
- Dietary changes during hospital stay can also include electrolyte and fluid replacements
Medications
Antihypertensive medication (to control blood pressure)
- Recommended when diastolic blood pressure above 100mmHg, and proteinuric gestational hypertension
- First-line choices include: methyldopa, labetalol, nifedipine
Steroid medications — corticosteroids
- Considered if patient has severe pre-eclampsia
- As baby may be delivered prematurely, this can help the baby’s lungs mature
- Temporarily improves platelet and liver function of the mother
Magnesium sulfate — anticonvulsant (to prevent seizures)
- Recommended for women with pre-eclampsia that are at risk of seizure
- Also given if patient has a plan for delivery
- Delivered to patient’s bloodstream intravenously (IV)
Delivery
Delivery is the only actual cure for pre-eclampsia.
- If pre-eclampsia is discovered at 37 weeks or after, the patient will be asked to deliver immediately if possible. This is because the baby would be fully mature by that time.
- This can be done through caesarean section or induced labour.
- Delivery at 37 weeks would also be recommended for patients with mild pre-eclampsia that is discovered earlier.
- If the baby is not doing well in the womb, it may also be advised to deliver earlier.
- However, if the patient has severe pre-eclampsia, delivery would be carried out as soon as possible past the 34 week mark.
- Usually delivered via caesarean section
- Baby may need to stay in NICU
Other factors which contribute to consideration of delivery:
- Evidence of fetal compromise (would be noticed from monitoring of baby)
- Problems with controlling blood pressure
- High risk of eclampsia, or eclampsia
- Evidence of severe organ dysfunction or multi-organ dysfunction in mother
- Clinician is confident of fetal maturity
Close follow-up (after giving birth)
After delivery of your child, pre-eclampsia will usually go away in a time span between a few hours to 6 months. However, follow-up is important as pre-eclampsia is a condition which can escalate quickly and have severe effects if not monitored.
- Monitoring of blood pressure right after delivery
- There is possibility that the mother’s condition deteriorates so must establish that blood pressure has stabilised
- Must continue to check blood pressure regularly even after leaving the hospital, medication may also continue depending on the patient.
- May be at higher risk of cardiovascular disease in the future
Postpartum Pre-Eclampsia
In some cases, patients may only experience pre-eclampsia after delivery, and it is important to get treatment as soon as possible. This condition usually occurs between 48 hours to 6 weeks after delivery.
- Common symptoms of postpartum pre-eclampsia include:
- Headaches and nausea
- Vision changes
- Abdominal pain
Pre-eclampsia can be a serious complication during pregnancy, but it is also one that can be managed with the help of a medical team. If you are pregnant or know someone who is, make sure to educate yourself on the signs and symptoms of pre-eclampsia so that you can seek treatment as soon as possible if necessary.
References:
https://www.nicoleconsultancy.com/nursing-care-for-preeclampsia-singapore/
https://www.sog.com.sg/resource-center/preeclampsia-risk-factors-symptoms-and-treatment/
https://www.aafp.org/afp/2004/1215/p2317.html
https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-20355751
https://www.huggies.com.sg/en-sg/parenting-center/pregnancy/preeclampsia
https://drpamelatan.com/preeclampsia-the-hidden-dangers-of-pregnancy/
https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/treatments
https://www.nhs.uk/conditions/pre-eclampsia/treatment/
https://www.healthline.com/health/preeclampsia#complications
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