Preeclampsia: symptoms, diagnosis and treatment

Abstract

Preeclampsia is a condition that begins during pregnancy, usually after the 20th week. However, the symptoms and signs of preeclampsia may persist after delivery, and rarely the condition might not be recognized until after the baby is born. A woman with preeclampsia develops high blood pressure and usually protein in her urine, and she often has swelling (edema) of the legs, hands, face, or entire body. When preeclampsia becomes severe, it can cause dangerous complications for the mother and the fetus. One of these complications is eclampsia, the term used when seizures develop in a woman with severe preeclampsia. Another concern is the higher risk of stroke during pregnancy and after delivery. A woman with mild preeclampsia may not notice any symptoms, or she may have only mild swelling of the hands or feet. However, most pregnant women have some degree of swelling of the feet. So not all swelling indicates preeclampsia. When preeclampsia is severe it may progress to cause seizures. Most often they are generalized seizures, causing a woman to lose consciousness and have jerking movements of the arms and legs. She also may lose control of her bladder or bowels. Preeclampsia can be especially difficult to detect in women who have a history of high blood pressure (hypertension) before pregnancy. One in four women with high blood pressure develops preeclampsia during pregnancy, so it is essential that these women be monitored closely for changes in blood pressure and for protein in the urine. The outlook for full recovery from preeclampsia is very good. Most women begin to improve within one to two days after delivery, and blood pressure returns to their normal pre-pregnancy range within the next one to six weeks in almost all cases. However, for some women, there is still a risk of complications during this time.