Preeclampsia is a condition of increased blood pressure accompanied by the presence of protein in the urine. This condition occurs after the gestational age of more than 20 weeks.
Preeclampsia must be treated to prevent complications and prevent it from developing into eclampsia which can threaten the lives of pregnant women and fetuses. One of the factors that can increase the risk of preeclampsia is pregnant women aged more than 40 years or under 20 years.
Symptoms of Preeclampsia
Preeclampsia generally develops gradually. Signs and symptoms that will appear along with the development of preeclampsia are:
- High blood pressure (hypertension)
- Proteinuria (found protein in the urine)
- Severe or persistent headaches
- Visual disturbances, such as blurred vision or sensitivity to light
- Pain in the pit of the stomach or upper right abdomen
- Hard to breathe
- Dizziness, weakness, and not feeling well
- Decreased frequency of urination and decreased urine volume
- Nausea and vomiting
- Swelling in the legs, hands, face, and some other body parts
- Weight gain suddenly
Causes of Preeclampsia
The exact cause of preeclampsia is still unknown. However, it is suspected that this condition is caused by abnormalities in the development and function of the placenta, the organ that functions to distribute blood and nutrients to the fetus. These abnormalities cause blood vessels to narrow and the emergence of different reactions from the body of pregnant women to hormonal changes. As a result, problems arise in pregnant women and fetuses.
- Although the cause is unknown, the following factors are considered to trigger disorders of the placenta:
- Have or are suffering from diabetes, hypertension, kidney disease, autoimmune disease, and blood disorders
- Have had preeclampsia in a previous pregnancy
- First time pregnant
- Pregnant again after a gap of 10 years with previous pregnancies
- Pregnant at the age of less than 20 years or more than 40 years
- Contain more than one fetus
- Being obese during pregnancy, as indicated by a body mass index (BMI) 30 kg/m2
- The current pregnancy is the result of in vitro fertilization (IVF)
- There is a history of preeclampsia in the family
Preeclampsia Diagnosis
The doctor will ask for complaints and symptoms experienced by pregnant women, as well as the health history of pregnant women and their families. Next, the doctor will perform a thorough physical examination, including blood pressure, pulse, respiratory rate, body temperature, swelling of the legs, feet, and hands, as well as the condition of the womb.
If the pregnant woman's blood pressure is more than 140/90 mmHg on 2 examinations with an interval of 4 hours, the doctor will perform the following investigations to confirm the diagnosis of preeclampsia:
- Urine test, to determine the level of protein in the urine
- Blood tests, to check liver, kidney, and blood platelet counts
- Ultrasonography (USG), to see fetal growth
- Doppler ultrasound, to measure the efficiency of blood flow to the placenta
- Nonstress test (NST) with cardiotocography or CTG, to measure the fetal heart rate as it moves in the womb
Preeclampsia Treatment
Preeclampsia will be resolved if the fetus is born. However, pregnant women who experience preeclampsia will be given the following treatments to overcome complaints and prevent complications:
- Drugs
While still adopting a healthy lifestyle, the doctor may give the following drugs to pregnant women who have preeclampsia:
- Antihypertensive drugs. Antihypertensive drugs are usually given if the blood pressure of pregnant women is very high. Generally, if the blood pressure of pregnant women is still around 140/90 mmHg, antihypertensive drugs are not needed.
- Corticosteroid drugs. This drug is used in severe preeclampsia or when the HELLP syndrome is present. In addition, this drug can accelerate the maturation of the fetal lungs.
- MgSO4 drug. In severe preeclampsia, the doctor will give injections of MgSO4 to prevent complications, such as seizures.
- Hospital treatment
If preeclampsia is severe or getting worse, pregnant women will be treated so that their condition is monitored. During treatment, the doctor will perform routine blood tests, NST, and ultrasound to monitor the health of pregnant women and fetuses.
- Postnatal care
After delivery, monitoring still needs to be done. Usually, patients need to be hospitalized a few days after delivery. Patients also still need to take antihypertensive drugs prescribed by the doctor and have regular check-ups until about 6 weeks after giving birth.
Complications of Preeclampsia
If left untreated, preeclampsia can lead to complications, such as:
- Eclampsia is a pregnancy complication characterized by high blood pressure and seizures
- Organ damage, such as pulmonary edema, kidney failure, and liver failure
- Heart disease
- Blood clotting disorders
- Placental abruption
- hemorrhagic stroke
- HELLP Syndrome
Complications can also attack the fetus. Fetal complications include:
- Fetal growth is stunted
- Born prematurely
- Born with low weight
- Neonatal respiratory distress syndrome (NRDS)
When to go to the doctor
Immediately consult a doctor if you experience the symptoms of preeclampsia that have been mentioned above. This is because preeclampsia needs to be treated by a doctor as soon as possible so that complications do not occur and do not develop into eclampsia.
In a normal pregnancy, the schedule for regular check-ups to the doctor is as follows:
- 4th to 28th week: once a month
- 28th to 36th week: every 2 weeks
- 36th to 40th week: once a week
If diagnosed with preeclampsia, pregnant women will be asked to visit a doctor more often, so that their condition and condition of the fetus can be monitored.
If pregnant women have conditions that can increase the risk of preeclampsia, such as hypertension in pregnancy, kidney disease, autoimmune disease, diabetes, blood disorders, or have experienced preeclampsia in a previous pregnancy, it is also necessary to have more frequent check-ups with the doctor to monitor the condition of pregnant women.
Prevention of Preeclampsia
There is no specific way to prevent preeclampsia. However, there are several things that can be done to reduce the risk of preeclampsia, namely:
- Carry out routine check-ups during pregnancy
- Controlling blood pressure and blood sugar if you have hypertension and diabetes conditions before pregnancy
- Implementing a healthy lifestyle, among others by maintaining an ideal body weight, fulfilling nutritional needs, not eating foods that are high in salt, diligently exercising, and not smoking
- Take vitamin or mineral supplements according to doctor's advice
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