Last updated September 2011. Planned review date: September 2013
Pre-eclampsia and premature birth
Make sure you attend all your antenatal appointments so that problems such as high blood pressure, which can lead to pre-eclampsia, can be picked up.
Pre-eclampsia is a serious condition that only occurs during pregnancy, typically after 20 weeks. It is a combination of hypertension (raised blood pressure) and proteinuria (the presence of protein in your urine). Sometimes other organs, such as the liver or kidneys can become affected and there can be problems with blood clotting. It can sometimes cause problems with the baby’s growth (see intrauterine growth restriction).
Pre-eclampsia literally means 'before eclampsia' as it can potentially progress to a more dangerous condition known as eclampsia, which occurs in one in 2,000 pregnancies. Eclampsia can cause fits or convulsions. In severe cases, eclampsia can sometimes cause the death of the mother or the baby. Therefore, it is important to manage the condition safely.
Pre-eclampsia is thought to affect one in ten of all pregnancies. In most of these cases, it will be a mild case and may have no effect on pregnancy.
Delivering the baby is the only certain treatment for severe pre-eclampsia, which is why pre-eclampsia is a cause of premature birth .
Signs and symptoms of pre-eclampsia
Women with mild pre-eclampsia may not show any symptoms, and the condition is usually only discovered during routine antenatal appointments (through standard blood pressure checks and urine samples). The main signs are raised blood pressure combined with the presence of protein in the urine.
If pre-eclampsia gets more severe, more serious symptoms can develop, including:
• headaches
• blurred or altered vision
• severe heartburn
• nausea or vomiting
• confusion
• shortness of breath
• severe oedema (swelling of the face, hands and/or feet).
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How common is pre-eclampsia?
Between 0.6 and 2.7 percent of women have high blood pressure when they become pregnant, while between 4.2 and 7.9 percent develop it during pregnancy. Of those, some will develop pre-eclampsia. However, a mild case of high blood pressure that develops during pregnancy is not harmful and just means that you will have more frequent appointments with the healthcare team.
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Treatment for pre-eclampsia
If standard blood pressure and urine tests indicate you might be at risk of pre-eclampsia, you will have a series of further tests to check that there are no problems with your kidney, liver or bloodclotting functions.
The team will also check that your baby is growing properly, and will look at the volume of amniotic fluid and the flow of fluids through the umbilical artery,
If you have a mild case of pre-eclampsia, the team may advice you to rest and may give you medicine to lower your blood pressure.
If you have severe pre-eclampsia you may need to have an emergency caesarean.
To read more about pre-eclampsia, click here.
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HELLP Syndrome
HELLP syndrome
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HELLP syndrome (Haemolysis, Elevated Liver enzymes,,Low Platelets) is a particularly severe form of pre-eclampsia. It can cause severe breathing difficulties, which can result in the death of the mother and severe health problems for the baby
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Symptoms of HELLP syndrome
- haemolysis (where the red blood cells disintegrate)
- raised levels of liver enzymes
- a low count of platelets (white blood cells)
You will experience these as:
- nausea and vomiting
- upper abdominal pain
- headache
- vision problems.
It can cause severe breathing difficulties for the mother and severe health problems for the baby. HELLP syndrome occurs in 0.05 to 0.7% of all pregnancies and in 8-24% of cases with severe pre-eclampsia.
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In this section
Explaining premature birth:
Your premature baby:
You can also read about
Sources
NICE (2010, reviewed 2011 ) High blood pressure in pregnancy, Understanding NICE guidance, National Institute for Health and Clinical Excellence, p7
Royal College of Obstetricians and Gynaecologists (2007) Pre-eclampsia: what you need to know, p3, http://www.rcog.org.uk/womens-health/clinicalguidance/pre-eclampsia-what-you-need-know
Royal College of Obstetricians and Gynaecologists (2006, reviewed 2010) The Management of Severe Pre-eclampsia/Eclampsia, p1, http://www.rcog.org.uk/files/rcog-corp/GTG10a230611.pdf
NHS Choices (accessed 2012) Health A-Z, Pre-eclampsia, Overview, http://www.nhs.uk/Conditions/Pre-eclampsia/Pages/Introduction.aspx
NHS Choices (accessed 2012) Health A-Z, Pre-eclampsia, Symptoms, http://www.nhs.uk/Conditions/Pre-eclampsia/Pages/Introduction.aspx
NICE (2010) Hypertension in pregnancy, The management of hypertensive disorders during pregnancy, National Institute of Health and Clinical Excellence, p 38-39, http://www.nice.org.uk/nicemedia/live/13098/50418/50418.pdf
National Perinatal Epidemiology Unit (2011) HELLP Syndrome, NPEU, https://www.npeu.ox.ac.uk/ukoss/current-surveillance/hellp-syndrome#r2
NICE (2010) Hypertension in pregnancy, The management of hypertensive disorders during pregnancy, National Institute of Health and Clinical Excellence, p 33, http://www.nice.org.uk/nicemedia/live/13098/50418/50418.pdf
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