Pregnancy and high blood pressure

Low Blood Pressure

Could Pre-eclampsia be an autoimmune disease?

Researchers at the University of Texas Medical School in Houston say they have found evidence that pre-eclampsia my be an autoimmune disease.  Scientists were able to induce symptoms similar to pre-eclampsia in pregnant mice by administering auto-antibodies that were isolated from women suffering from pre-eclampsia.

In animals at least, the researchers were able to prevent preeclampsia in pregnant mice leading to excitement that a treatment may be possible for humans.

Source: University of Texas

Pre-eclampsia

Signs and symptoms of Pre-eclampsia during pregnancy

High blood pressure is a problem for many people, but can be especially dangerous when a woman is pregnant, and can lead to life-threatening problems. High blood pressure affects all organs in the body, but when you are pregnant, you have an extra organ – the placenta, which connects you to your baby, so fetal problems can arise.

What is pre-eclampsia?

Pre-eclampsia is also called Toxemia and is a complex disorder.

Preeclampsia definition (source: Medical Terms and Definitions Website): A condition characterized by a sharp rise in blood pressure during the third trimester of pregnancy. High blood pressure may be accompanied by edema (swelling), and kidney problems, as evidenced by protein in the urine. Although preeclampsia is relatively common, occurring in about 5 percent of all pregnancies and more frequently in first pregnancies, it can be a sign of serious problems. In some cases, untreated preeclampsia can progress to eclampsia, a life-threatening situation for both mother and baby.

Who is at most risk?

• First pregnancy
• Women who suffered from high blood pressure before they got pregnant.
• Overweight women.
• Women under 20 or over 40.
• Those who have suffered pre-eclampsia in a previous pregnancy, or if your mother or sister suffered pre-eclampsia.
• Women with medical history of diabetes, kidney disease, rheumatoid arthritis or lupus.
• Multiple pregnancy

From week 20 onwards in your pregnancy, a rise in blood pressure can indicate pre-eclampsia, and you should contact your doctor immediately. The doctor will take your blood pressure and likely do tests including urine analysis to look for protein.

What are the risks?

Preeclampsia can cause low birth weight and other problems for your baby because it can stop the baby getting enough air or food through the placenta. Preeclampsia causes your blood vessels to constrict (getting smaller), which reduces the flow to the placenta and other organs of your body.

Preeclampsia can develop into eclampsia – which can be very serious. It is characterised by convulsions, and can lead to disability or death.

In a few cases, preeclampsia will develop into something called HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets). Women who develop HELLP syndrome usually have to deliver early to prevent serious complications.

What are the signs/symptoms of preeclampsia?

Symptoms include:

• Swelling in hands, feet and ankles.
• Puffiness around the eyes.
• Vision problems (light sensitive, blurred etc).
• Nausea and vomiting
• Tender upper abdomen, or pain.
• Weight gain

Some symptoms appear very much like normal pregnancy complaints, so do get checked up if in doubt.

HELLP Syndrome

What is HELLP Syndrome? HELLP Syndrome is a rare, but serious complication that occurs in up to 12 percent of the women who have preeclampsia.

The syndrome is named after the main characteristics of the disease, namely Hemolysis (break down of red blood cells), Elevated Liver enzymes, which can cause liver damage, and Low Platelet count (platelets are involved in blood clotting).

What are the symptoms of HELLP Syndrome?

Symptoms include:

• a gradual onset of headaches
• weakness & fatigue
• blurred vision
• nausea & vomiting
• pain around the upper abdomen
• jaundice
• diarrhea
• tingling in the extremities

One of the problems in diagnosing HELLP, is that not every woman exhibits all of these symptoms, so any woman showing a mixture of symptoms, should be evaluated for HELLP. Unfortunately, HELLP syndrome is often disdiagnosed in the early stages, increasing the risks of liver failure and death. If you are pregnant, and suffering from any of the above symptoms, please consult your doctor as soon as possible.

How is HELLP Syndrome Diagnosed?

Diagnosing HELLP syndrome may include:

• Full physical examination
• blood pressure measurement
• red blood cell count
• bilirubin level
• liver function tests
• platelet count
• urine tests for protein

Platelet counts are considered good indicators of HELLP severity (the Mississippi classification system). Class I is the most severe, with less than 50 million/l Class II is between 50 – 100 million/l Class III is greater than 100 million/l

How is HELLP Syndrome Treated?

Some medications have been looked at for treating HELLP, but the results of tests are inconclusive. Those treatments include:

• Magnesium sulphate which is throught to reduce the risk of seizures and slow the progress of eclampsia.
• fresh frozen plasma
• blood transfusion to treat anaemia.
• In mild cases, corticosteroids and antihypertensives may be sufficient.
• Intravenous fluids.

Cesarean delivery of the baby is the only effective treatment, even if it the baby is premature. The decision is usually made early because of deteriorating health (and liver function) of the mother becomes a threat to both moth and baby.

Complications of HELLP syndrome

Failure to effectively treat HELLP can lead to liver damage, and even death. Please consult your doctor if you have any of the symptoms listed above.