Preeclampsia is the first of the risky situations that can endanger the life of the pregnant woman and the baby. Pregnancy poisoning is one of the conditions of pregnancy with high blood pressure. It is actually a pregnancy complication. It is among the top three most common causes of maternal death.

What is preeclampsia and who is at risk for preeclampsia?

Pregnancy is one of the most natural and physiological periods of life. During pregnancy, some undesirable situations may occur due to hereditary, environmental and psychosocial reasons, which can be severe enough to risk the life of the expectant mother or the baby. From another point of view, pregnancy itself is a risky situation, albeit slightly. Expectant mothers and babies can stay healthy depending on the time and method of intervention in these risky situations. Some simple situations that are intervened late or incorrectly can cause a picture that can go as far as the loss of the expectant mother or the baby.

What is Pregnancy Poisoning (Preeclampsia)? 

Preeclampsia is the first of the risky situations that can endanger the life of the pregnant woman and the baby. Pregnancy poisoning is one of the conditions of pregnancy with high blood pressure. It is actually a pregnancy complication. It is among the top three most common causes of maternal death. At the beginning of the measures to be taken to avoid this situation, the risk of pregnancy poisoning during the pre-pregnancy planning stage is to be determined and the necessary precautions should be taken. When the risk is detected in the early period, it is possible to prevent possible organ damage during or after pregnancy.

Pregnancy poisoning usually gives signs and symptoms after the 20th week of pregnancy. The most basic symptom is increased blood pressure during pregnancy. Due to the increase in blood pressure, insufficiency develops in many organs, especially the liver and kidney. If seizures occur in pregnant women due to preeclampsia, it is called eclampsia. Both eclampsia and preeclampsia can result in the loss of the mother and the baby.



It is thought that the most important factor is the placenta, as the picture of pregnancy poisoning improves with the separation of the placenta after delivery. Possible mechanisms are:

  • Disruption of the circulation between the mother’s uterus and placenta: Normally, there is damage to the vascular structure that provides oxygen and food exchange between the mother and the baby, due to inflammation in pregnancy poisoning. The exchange between the mother and the baby is disrupted, the veins contract and the blood pressure rises.
  • Impairment in renal functions: Absorption is impaired due to damage and contraction in renal vessels. The amount of urine decreases, the protein in the urine and the level of urea in the blood increase.
  • Impairment in liver functions : In general, vascular contractions impair liver functions, fluid and electrolyte imbalances occur, extravasation of fluid, edema and coagulation in blood vessels occur due to damage. If coagulation becomes widespread, a serious risky picture called DIC (disseminated intravascular coagulation) may develop.
  • Lung and heart problems : Fluid leaks into the lungs due to damage to the vessels. Accumulated fluid causes edema in the lungs and an increase in the load on the heart.
  • Brain problems : Fluid leakage into the brain, cerebral edema and seizures may develop in the future due to contractions in the intracranial blood vessels.

What are the signs and symptoms of preeclampsia? :

  • High blood pressure (blood pressure above 140/90 mmHg measured at least twice at different times),
  • Decreased amount of urine
  • loss of protein in the urine,
  • Headache,
  • Vision problems (light sensitivity, blurred vision, etc.),
  • Nausea, vomiting,
  • Stomach ache,
  • Shortness of breath,
  • Bleeding disorders,
  • Signs of liver failure,
  • Swelling in hands, face and legs,
  • Weight gain.

Risk factors of preeclampsia: 

  • Having high blood pressure before pregnancy,
  • Family history of pregnancy poisoning,
  • Stillbirth story,
  • First pregnancy,
  • Very young age or gestational age above 35 years,
  • Interpregnancy time less than 2 years or more than 10 years,
  • Obesity,
  • Multiple pregnancy,
  • Presence of diabetes mellitus
  • Migraine,
  • Coagulation disorders,
  • Chronic renal failure,
  • SLE (systemic lupus erythematosus),
  • Pregnancy with assisted reproductive techniques.

Diagnosis of preeclampsia: 

Anamnesis findings obtained from the expectant mother during pregnancy controls help the diagnosis. High blood pressure, bleeding disorders, kidney disease etc. are questioned before pregnancy.

  • High blood pressure is the main finding in the diagnosis. Values above 140/90 mmHg in blood pressure measurements measured twice and at least 4 hours apart are essential for diagnosis.
  • Urine tests (proteinuria),
  • Complete blood count (decrease in platelet level),
  • Liver (ALT, AST etc.) and kidney (urea, creatinine etc.) function tests,
  • Vision tests,
  • Ultrasonography,
  • NST (non-stress test).

Complications of preeclampsia: 

  • Kidney failure,
  • Heart failure,
  • DIC (disseminated intravascular coagulation) (disseminated coagulation disorder),
  • Liver failure,
  • Coagulation problems,
  • Vision loss,
  • Celebral hemorrhage,
  • Premature separation of the placenta,
  • Early birth,
  • Stillbirth

Treatment of preeclampsia: 

The basis of pregnancy poisoning treatment is to keep high blood pressure under control. Blood pressure lowering drugs can be used. In cases where the blood pressure level is very high, drugs suitable for pregnancy may be preferred. The use of magnesium sulfate under expert control can also be used to control very high blood pressure levels. Magnesium sulfate can also be used in the development of seizures.

If there is an underlying chronic disease, it is important to control it. Corticosteroids may be particularly useful in controlling pulmonary edema.

Pregnancy can be terminated if there is a life-threatening situation for the expectant mother. In cases of pregnancy poisoning kept under control, 34-37 days of pregnancy. It is recommended that the baby be taken by cesarean section between weeks. In some cases, a controlled normal delivery can be attempted.


Tags: