When blood pressure soars

Pre-eclampsia cannot be predicted, reliably prevented, or treated

Because pre-eclampsia is known to be associated with serious dysfunction of the placenta, doctors and midwives are concerned about the health of the baby, when it happens.

Ultimately, the only treatment is delivery of the baby, which could, of course, in some cases put the baby at severe risk from 'prematurity'.

If you do develop pre-eclampsia, you will be asked to have more regular checks of both your blood pressure and your urine. You may be encouraged to bed-rest at home or even be admitted to hospital - or referred to the Day Unit of the antenatal department - for further observation and monitoring.

These checks could consist of:

• 4-6 hourly blood pressure measurements
• 24-hour urine collection - in order to measure the amount of protein
• Routine blood samples - in order to determine the severity of the disease
• Ultrasound - to determine your baby's growth and monitor your baby?s heart to watch for signs of distress.

Drugs may be necessary in order to reduce high blood pressure. Remember that I have already mentioned the only real 'cure' for pre-eclampsia is delivery of your baby.

If the pre-eclampsia is very bad, your doctor may want to induce you to start your labour and in some cases a Caesarean Section may be necessary.

The risks of pre-eclampsia

For the baby: While unborn, the supply of oxygen and nutrients can be dangerously reduced because of the damage to the placenta (after birth).

This long-standing damage to the life-line may already have caused some retardation in the baby's growth - which can be seen on the ultrasound scanning.

On the other hand, if delivered prematurely, the chances of survival may be reduced. As far as the baby's health is concerned, the timing of the delivery can involve difficult, and emotionally 'charged' decisions, by the doctors who are involved with the care of the mother and baby.

For the mother: The changes in blood pressure can be life threatening and may have a detrimental effect on her circulation and many of her internal organs.

The frightening figure for the UK, of 7-10 maternal deaths - as a result of untreated pre-eclampsia - and up to 900-1000 deaths of babies each year, as result of severe pre-eclampsia, has to be mentioned.

In severe cases of pre-eclampsia, and where delivery has occurred, the mother will be carefully monitored over several days, as there is a risk of eclampsia itself - a life threatening disease for the mother.

There is some positive news

The majority of mothers with pre-eclampsia do, fortunately, make a good recovery. Their symptoms usually disappear after delivery, and the blood pressure and 'urine protein' return to normal after two weeks or so.

Their babies, too, survive the precarious few weeks, recover and continue to thrive.

These same women often go on to enjoy normal health in a subsequent pregnancy. It is very important, therefore, to attend all your antenatal check-ups so that any pre-eclampsia can be detected early and carefully managed.

Remember, too, that in most cases - even if you have to be admitted to hospital - the bed rest does produce a gradual fall in blood pressure, which is often sufficient to delay the need for premature delivery of the baby.

This in turn, will afford the baby an increased chance of survival.

If you have a history of pre-eclampsia, closer and more frequent health monitoring will be necessary in any subsequent pregnancies. This will start earlier in the pregnancy than usual, or ideally, even before conception.

The message is: consult your doctor and plan ahead.

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