Carter 1

Caela Carter

Russell Thomas

ENG 1201-525

22 March 2019

Preeclampsia

Preeclampsia is a dangerous pregnancy complication that affects nearly one in

twenty pregnant women (Lavoipierre). When my mother was pregnant with me she had

developed this condition leading to me being born six weeks premature. In the year of

2015, I was pregnant with my first child and I had a gut feeling from the beginning that

something was off. Before I became pregnant, I was roughly one-hundred and fifteen

pounds. I started gaining a lot of weight and I was retaining large amounts of water; so

much so that by the end of my pregnancy, I was one-hundred and eighty pounds. Around

twenty four weeks of gestation I tried to inform my doctor that I believed I had

preeclampsia but everyone, including my family, told me I was being paranoid. When I

went to my thirty four week check up on a Friday the doctors found protein in my urine

which is a symptom of preeclampsia. They instructed me to complete a twenty four hour

urine collection over the weekend to determine how much protein my body was

eliminating. However, Saturday morning something felt extremely wrong.

The next day both of my arms were numb and tingly like they were asleep and the

feeling would not go away for three hours. I called my sister who was a medical assistant

and asked if she could take my blood pressure for me. When she assessed my blood

pressure it was 136/72 mmHg, which was high for me since my blood pressure typically
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stayed around 100/60 mmHg. I contacted the on call nurse and she instructed me to head

to labor and delivery to get examined. When I arrived at the hospital, the nurse came in to

take my vitals and my blood pressure had risen to 180/94 mmHg. They immediately told

me I had to be admitted into the hospital and that I had to be induced the following

morning. The doctors administered a magnesium sulfate drip and told me it was to

prevent my body from having seizures. I ended up having my son six weeks early and he

had to be admitted into the Neonatal Intensive Care Unit (NICU) for two weeks. Since I

was on the magnesium drip, I was not allowed to get out of my bed for twenty-four hours

after delivery. They rushed my son to the NICU immediately after he was born and I was

unable to see or hold him for a full twenty four excruciating hours. Due to my blood

pressure not going down, I also had to stay in the hospital for a full week and be put on

hypertension medication for six weeks postpartum. Preeclampsia is one of the leading

causes of death in laboring mothers around the world. If women are more aware of the

dangers and serious risks and complications associated with preeclampsia, they will be

able to recognize the symptoms and can notify their health care team. If women are more

aware of the signs and symptoms of preeclampsia, doctors can closely monitor the

mother’s health, try to deliver the baby closer to term, and the maternal and fetal death

rate can possibly be decreased.

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Fig. 1. This is a photo of my son in the NICU born premature at 34 weeks due to

preeclampsia.

As previously stated, preeclampsia is a complication that affects one in twenty

pregnancies. This condition is characterized by high blood pressure, proteinuria (protein

in the urine), and severe swelling and edema. Women who have not yet been diagnosed

with preeclampsia may experience headaches, blurry vision, fatigue, and/or notice that

they are retaining water. According to the textbook, Preeclampsia Basic, Genomic, and

Clinical, some common risk factors of preeclampsia include: if it is the woman’s first

pregnancy with a new father, if she has a family history of the condition, if she has been

diagnosed with preeclampsia in previous pregnancies, if she has a higher body mass

index (BMI), or has preexisting hypertension or diabetes (Saito 4-17). If a woman

develops preeclampsia in one of her pregnancies, it does not mean she will develop it in

subsequent pregnancies. The mother will be considered high risk and will be monitored

for any signs in her later pregnancies if she has been previously diagnosed. The mother

may be instructed to take a small dose of aspirin each day during her pregnancy due to
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the possibility of “baby” aspirin lowering blood pressure. In Figure 2 below, it illustrates

how the diseased placenta releases dangerous proteins into the mother’s bloodstream. The

illustration shows how these toxins can lead to systemic vasoconstriction, endothelial

dysfunction, end-organ damage, hypertension, proteinuria, and HELLP syndrome.. As

one can see, preeclampsia can be quite dangerous for the mother and her unborn child.

Fig. 2. This graphic shows some of the health issues preeclampsia can cause (Jorge

Muniz)

There are approximately seventy thousand women that die each year from

preeclampsia complications (Lavoipierre). Currently, there is no cure or treatment for

preeclampsia other than to deliver the unborn fetus which is why it is so important to

raise awareness of this dangerous diagnosis. If preeclampsia is caught early enough,

health care providers may instruct the mother to stay on strict bed rest to help keep her

blood pressure down. Medical researchers are still not able to determine what causes this

dangerous condition, but it is believed that preeclampsia is caused by the placenta

releasing abnormal toxins and excess proteins (Lavoipierre). However, health care
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professionals are still working to help find out ways to use different medications to treat

preeclampsia.

If not caught early, preeclampsia can turn into eclampsia. Eclampsia is a

potentially fatal condition that can occur, typically in late pregnancy, that causes the

mother to have seizures. Eclampsia is quite rare and only affects one in every two to three

thousand pregnancies each year (Keating). However, this condition is responsible for

fourteen percent of maternal deaths (Keating). Women who develop eclampsia have a

type of seizure known as grand mal seizure. A grand mal seizure is characterized by

sudden unconsciousness, muscle stiffness, and convulsions (Healthwise Staff). During

the seizures, the fetal oxygen supply is drastically decreased which can lead to

developmental deficits and possible death of the fetus. Due to the fear of women

developing seizures while in labor, the healthcare provider will generally administer a

twenty-four up to a forty-eight hour intravenous infusion of magnesium sulfate.

Magnesium sulfate is the drug of choice for pregnant women with eclampsia. Common

side effects of this medication are sweating, flushing, confusion, weakness, and low

blood pressure which can lead to nausea and vomiting. Women with eclampsia have been

shown to have seizures before, during, and up to six weeks after delivery of the baby

(Healthwise Staff). These dangerous seizures can lead to the mother going into a coma,

brain damage, and fetal and/or maternal death. Since the high blood pressure and other

complications associated with preeclampsia can be fatal, it is necessary to raise

awareness of this condition to try and decrease the mortality rate during labor.
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HELLP Syndrome is another dangerous pregnancy complication. This condition is

believed to be a severe form of preeclampsia that affects five to twelve percent of

mothers who have been diagnosed with preeclampsia (preeclampsia.org). However, it is

unknown if HELLP is a total separate disorder or part of preeclampsia since some women

develop HELLP without showing any signs of preeclampsia. HELLP stands for

hemolysis, elevated liver enzymes, and low platelet count. This disorder has between a

one to thirty percent mortality rate (preeclampsia.org). When women develops HELLP

Syndrome they may develop a blood clotting disorder known as disseminated

intravascular coagulation (DIC) which can lead to severe bleeding or hemorrhage

(“HELLP Syndrome”). If the mother hemorrhages she may need to have a blood

transfusion depending on the amount of blood loss. Other complications associated with

HELLP Syndrome are placental abruption, pulmonary edema, lung failure in the mother

and/or fetus, acute renal failure, Intrauterine Growth Restriction (IUGR), and ruptured

liver hematoma (“HELLP Syndrome: Symptoms, Treatment and Prevention”).

Furthermore, it is strongly advised that a pregnant woman receives routine prenatal care

especially since there are so many dangerous complications that can arise.

Pregnancy complications such as preeclampsia, eclampsia, and HELLP Syndrome

are not only dangerous for the mother, but the unborn fetus as well. Due to the danger of

these conditions to the mother’s health, it is often necessary to deliver the baby

immediately to save the mother. If the mother is diagnosed early on in pregnancy and she

must deliver due to the serious complications of these disorders, the baby may not make

it if it is delivered before twenty-four weeks gestation. Preeclampsia can also cause the
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placenta to separate from the wall of the uterus which is known as placental abruption

(“Preeclampsia”). If this occurs, the baby will not receive the proper amount of oxygen

and nutrients it needs. Improper oxygen and nutrient levels can cause IUGR to occur.

IUGR is classified as intrauterine growth restriction which leads to the fetus being

smaller than normal. This results from the high blood pressure of the mother causing the

blood vessels in the uterus and placenta to narrow (“Preeclampsia”). Preeclampsia can

also lead to low birth weight. Being born prematurely can cause lots of health issues for

the baby such as apnea, respiratory distress syndrome, bleeding in the brain, jaundice,

anemia, and numerous other complications that can arise (March of Dimes). Because of

the dangers preeclampsia can cause to the baby as well as the mother, it is important for

pregnant women and health care providers to be more aware of the signs and symptoms.

According to Freya Michie, a journalist for Australia’s ABC News, Melbourne’s

Royal Women’s Hospital has discovered a blood test that can predict the risk of a woman

developing preeclampsia later on in her pregnancy (Michie). The blood test measures two

different proteins that are found in the placenta. When a woman has preeclampsia, these

protein levels from the placenta are abnormal (Michie). Due to the dangerousness of

these protein levels, they can cause decreased oxygen supply to the fetus which can lead

to other complications such as low birth weight, premature birth, and can even be fatal

(Michie). Stephanie Micallef-Smith was forced to deliver her daughter at twenty-six

weeks gestation due to preeclampsia (Michie). Preeclampsia is typically not discovered

until later on the pregnancy so by then the only option is to generally deliver the fetus.

With this test, doctors can be prepared to try and give the mother and baby a better
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outcome. Currently this blood test is only found at the one hospital in Australia, but

healthcare professionals and researchers are pushing for the test to be worldwide to help

save more lives. When a pregnant mother’s blood pressure is too high, it can lead to

organ damage to the liver, brain, and kidneys. However, if the condition is caught early

enough the healthcare professionals can properly monitor and manage any symptoms the

mother has with medications to try and prolong her pregnancy.

In a separate article from ABC News in Australia, Ange Lavoipierre wrote about a

separate breakthrough for preeclampsia. Melbourne’s Mercy Hospital in Australia

discovered that the drug Nexium, prescribed for reflux, may help prevent the dangerous

toxins released by the placenta (Lavoipierre). Dr. Natalie Hannan is one of the

researchers that came upon this discovery. Dr. Hannan stated that they found Nexium

was able to block the proteins from being released by the placenta as well as prevent

preeclampsia from playing a large role at the end of pregnancy in small animal studies.

This article was published in the beginning of 2017 and Dr. Hannan hinted that they were

in the midst of creating a clinical trial in South Africa where the preeclampsia rates are

significantly high (Lavoipierre). Although there is still no cure, Australia seems to be

making leaps and bounds to help manage the dangers of preeclampsia.

In 2015, a study was being conducted in St. Louis, Missouri at Barnes-Jewish

Hospital and SSM Health St. Mary’s Hospital on pregnant women with preeclampsia

between twenty three and thirty weeks pregnant (Munz). The focus of the study was to

determine if administering Recombinant Human Antithrombin would help women with

preeclampsia stay pregnant longer rather than have to deliver the baby prematurely.
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Recombinant Human Antithrombin is used to prevent abnormal blood clotting and

inflammation (Munz). This drug may help because researchers believe that preeclampsia

may be caused by insufficient blood flow to the placenta caused by abnormal clotting

(Munz). Dr. George Macones, the chair of Obstetrics at Barnes-Jewish Hospital, stated

that early onset preeclampsia rates are increasing possibly due to women becoming

pregnant that have pre-existing hypertension, diabetes, and lupus (Munz). Although there

are currently no published results of the study, the goal was to keep the fetus in the womb

as close to full term as possible since babies born before thirty four weeks have more

complications.

As explained above, preeclampsia is a dangerous pregnancy condition that affects

five percent of pregnant women globally. This dangerous condition is currently the

leading cause of maternal mortality. Due to the fact that many do not know enough about

preeclampsia, mothers often do not realize they have this disorder. Since there is no cure

for preeclampsia, typically the only option is to deliver the baby. Preeclampsia is what

lead to me being born six weeks premature and also lead to me having to deliver my own

son six weeks early. My son was only four pounds when he was born in 2015. He is now

three, but is still extremely underweight. In conclusion, preeclampsia is a serious, and

possibly life threatening condition that affects both the mother and her unborn child.
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Works Cited

Healthwise Staff. “Eclampsia (Seizures) and Preeclampsia.” Eclampsia (Seizures) and

Preeclampsia | Michigan Medicine, University of Michigan, 5 Sept. 2018,

www.uofmhealth.org/health-library/tn5187. Web. 21 March 2019.

“HELLP Syndrome.” Stanford Children's Health - Lucile Packard Children's

Hospital Stanford, Stanford Children's Health,

www.stanfordchildrens.org/en/topic/default?id=hellp-syndrome-90-P02454. Web.

23 March 2019.

“HELLP Syndrome: Symptoms, Treatment and Prevention.” American Pregnancy

Association,

American Pregnancy Association, Aug. 2015,

americanpregnancy.org/pregnancy-complications/hellp-syndrome/. Web. 23

March 2019.

“Helping Save Mothers and Babies from Illness and Death Due to Preeclampsia.”

Preeclampsia Foundation Official Site, Preeclampsia Foundation,

www.preeclampsia.org/. Web. 1 March 2019.

Keating, Corinne. "Everything you need to know about eclampsia." Medical News Today.

MediLexicon, Intl., 9 Mar. 2017. Web. 20 Mar. 2019.

<https://www.medicalnewstoday.com/articles/316255.php>

Lavoipierre, Ange. “Pre-Eclampsia Breakthrough Could See Reflux Drug Nexium Help

Treat
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Deadly Pregnancy Complication.” Pre-Eclampsia Breakthrough Could See Reflux

Drug Nexium Help Treat Deadly Pregnancy Complication - ABC News

(Australian Broadcasting Corporation), ABC News, 24 Jan. 2017,

https://www.abc.net.au/news/2017-01-24/preeclampsia-breakthrough-potentially-

life-saving/8207566. Web. 17 Mar. 2019.

Michie, Freya. “New Blood Test Brings Hope to Women with Life-Threatening

Pregnancy

Condition Pre-Eclampsia.” New Blood Test Brings Hope to Women with Life-

Threatening Pregnancy Condition Pre-Eclampsia - ABC News (Australian

Broadcasting Corporation), ABC News, 3 May 2018,

https://www.abc.net.au/news/2018-05-03/new-blood-test-for-deadly-pre-

eclamspsia-pregnancy-

condition/9723950?pfmredir=sm&fbclid=IwAR1hj6KNTtQ4LiwsmnGk4NJvOB6

p89FjM4YejRyClwA1eyECbPFYok3S_7Y. Web. 17 Mar. 2019.

Muniz, Jorge. “Preeclampsia: Pathophysiology.” Medcomic, 2018,

https://medcomic.com/medcomic/preeclampsia-pathophysiology/. Accessed 6

April 2019.

Munz, Michele. “First Drug to Treat Early Onset Preeclampsia Tested in St. Louis Area.”

St. Louis Post-Dispatch (MO), 25 Nov. 2015.

https://www.stltoday.com/lifestyles/health-med-fit/health/first-drug-to-treat-early-

onset-preeclampsia-tested-in-st/article_2d2343a0-399b-5691-b541-

08717fd9f1a4.html. Web. 1 March 2019.

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“Preeclampsia.” March of Dimes, March of Dimes, Dec. 2017,

www.marchofdimes.org/complications/preeclampsia.aspx. Accessed 5 April 2019.

“Preeclampsia Research at the NICHD.” Eunice Kennedy Shriver National Institute of

Child Health and Human Development, U.S. Department of Health and Human

Services, 18 Oct. 2012,

www.nichd.nih.gov/newsroom/resources/spotlight/101812-preeclampsia. Web. 1

March 2019.

Saito, Shigeru. Preeclampsia Basic, Genomic, and Clinical. Springer Singapore, 2018.

https://doi-org.proxy.ohiolink.edu:9100/10.1007/978-981-10-5891-2. Accessed 1

March 2019.