Pre-eclampsia is a hypertensive disorder that affects 3-8% of women who give birth worldwide, the World Health Organisation has said.
But it does not end there, as according to the agency’s fact sheet, Pre-eclampsia can progress to eclampsia which involves seizures and can be life-threatening.
Pre-eclampsia and eclampsia contribute significantly to maternal and perinatal morbidity and mortality.
Hypertensive disorders are responsible for around 16% of maternal deaths globally, in 2023 this was the equivalent to around 42 000 deaths (2, 3).
In women with pre-eclampsia magnesium sulfate injections can be given to reduce the risk of eclampsia by more than half. Despite the availability of magnesium sulfate, its use is still limited in many low-resource settings.
Overview
Pre-eclampsia is a high blood pressure disorder that typically develops after 20 weeks into pregnancy. It can present serious risks to both mother and baby. Early detection and management are crucial to prevent progression to eclampsia, which involves seizures. Both conditions can be life-threatening.
Diagnosis
Pre-eclampsia is diagnosed based on the onset of hypertension (blood pressure ≥140/90 mm Hg) proteinuria (protein in the urine) (≥0.3 g/24 hours) after 20 weeks of gestation. Severe pre-eclampsia may include symptoms such as severe headaches, visual disturbances and upper abdominal pain.
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Risk factors
Several factors can increase the risk of developing pre-eclampsia during pregnancy. Understanding these risk factors is essential for proactive monitoring and management. Having a risk factor doesn’t always mean pre-eclampsia will occur, but closer medical supervision beyond routine screening is recommended.
Several factors can increase the risk of developing pre-eclampsia, including:
- first-time pregnancies
- multiple pregnancies (twins, triplets, etc.)
- obesity
- pre-existing conditions such as hypertension, diabetes, or kidney disease
- family history of pre-eclampsia.
Symptoms
Symptoms of pre-eclampsia can vary significantly among individuals, but common ones include:
include:
- persistent high blood pressure
- proteinuria
- severe headaches
- visual disturbances (e.g., blurred vision, seeing spots)
- upper abdominal painnausea and vomiting (after the first trimester)
- swelling in the hands and face.
Treatment and management
persistent high blood pressure
severe headaches
visual disturbances (e.g., blurred vision, seeing spots)
upper abdominal pain
nausea and vomiting (after the first trimester)
swelling in the hands and face.
Treatment and management
The primary treatment for pre-eclampsia is the administration of magnesium sulfate to prevent seizures.
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Key WHO recommendations include:
calcium supplementation during pregnancy in areas with low dietary calcium intake
low-dose aspirin during pregnancy for women at high risk of pre-eclampsia
use of magnesium sulfate for the prevention of eclampsia
training healthcare providers in the early detection and management of pre-eclampsia
strengthening health systems to ensure timely and effective care for pregnant women.
By implementing these guidelines, WHO aims to address the profound inequities in maternal and perinatal health globally and achieve the health targets of the Sustainable Development Goals (SDGs).
-WHO
