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Headaches, vomiting and swollen feet may seem like typical symptoms of pregnancy, but if they persist into the later trimesters, something may be seriously wrong.

Doyen of hypertensive disorders during pregnancy, Professor J. Moodley, Chair of the Ministerial Committee on Confidential Enquiries into Maternal Deaths, shared insight into the enigma that is preeclampsia on the second World Preeclampsia Day on May 22.

Preeclampsia is the highest direct cause of maternal death in the country contributing to 14.8% of deaths during pregnancy, according to Moodley, thus the need generate awareness is urgent.

What is preeclampsia?

Pre-eclampsia is a condition that typically occurs after 20 weeks of pregnancy. It is a combination of:

  • raised blood pressure (hypertension).

  • protein in your urine (proteinuria).

The exact cause of pre-eclampsia is not understood. Often there are no symptoms and it may be picked up at your routine antenatal appointments when you have your blood pressure checked and urine tested.

Why do I need to know if I have preeclampsia?

Pre-eclampsia is common, affecting between two and eight in 100 women during pregnancy. Severe pre-eclampsia can be life-threatening for both mother and baby. Around 10 out of 100 women develop severe pre-eclampsia during pregnancy. The symptoms tend to occur later on in pregnancy but can also occur for the first time only after birth.

The symptoms of severe pre-eclampsia include:

  • severe headache that doesn't go away.

  • Nausea and vomiting in late pregnancy.

  • problems with vision, such as blurring or flashing before the eyes.

  • heartburn that doesn't go away with antacids.

  • rapidly increasing swelling of the face, hands or feet.

  • feeling very unwell.

  • Abdominal pain.

These symptoms are serious, pregnant woman experiencing them should seek medical help immediately.

How may preeclampsia affect my baby?

Pre-eclampsia affects the development of the placenta (afterbirth), which may prevent your baby growing as it should. If the placenta is severely affected, your baby may become very unwell.In some cases, the baby may even die in the womb.

Who is at risk of preeclampsia and can it be prevented?

Pre-eclampsia can occur in any pregnancy but you are at higher risk if:

  • your blood pressure was high before you became pregnant.

  • your blood pressure was high in a previous pregnancy.

  • you have a medical problem such as kidney problems or diabetes.

If any of these apply to you, you should be advised to take calcium and low-dose aspirin (150mg) once a day from 12 weeks of pregnancy, to reduce your risk.

You are more likely to develop preeclampsia if more than one of the following applies:

  • this is your first pregnancy

  • you are aged 40 or over.

  • your last pregnancy was more than 10 years ago.

  • you are very overweight - a BMI (body mass index) of 35 or more.

  • your mother or sister had preeclampsia during pregnancy.

  • you are carrying more than one baby.

What happens if I develop severe preeclampsia?

If you develop severe pre-eclampsia, you will be cared for by a specialist team. The only way to prevent serious complications is for your baby to be born. Treatment includes medication (either tablets or via a drip) to lower and control your blood pressure. You will also be given medication to prevent fits and will be closely monitored in the labour ward. In more serious cases, you may need to be admitted to an intensive care unit.

What happens after the birth?

Pre-eclampsia usually goes away after birth. However, if you have severe preeclampsia, complications may still occur within the first few days and so you will continue to be monitored closely.

So what should you do?

  • Plan your pregnancy: the ideal time to have your baby is between the ages of 22 and 32.

  • Have a healthy diet (especially calcium rich diets) and light to moderate exercise prior to the pregnancy.

If pregnant:

  • See a health professional/attend antenatal care between 10 and 14 weeks of pregnancy.

  • Let the health professional know if you have a family history of high blood pressure.

  • Let the health professional know if you have had high blood pressure in a previous pregnancy or if you were taking high blood pressure tablets prior to pregnancy (chronic hypertension) or are diabetic or have kidney disease.

  • If you have any of the above and if you are overweight, you will be regarded as being a risk (having a higher chance of preeclampsia and the health professional may suggest that you have more frequent visits during the antenatal period, or you will have to be seen by an expert in preeclampsia). The health professional may also prescribe aspirin if you fall into the group of women at risk.