World Preeclampsia Day is observed every year on May 22 to raise awareness about preeclampsia, a severe and dangerous pregnancy complication. The theme for World Preeclampsia Day this year is “Act Early! Screen Early!”, according to the European Foundation for the Care of Newborn Infants.
Preeclampsia is a serious hypertensive condition in which a woman, after her 20th week of pregnancy, has high blood pressure, shows signs of liver or kidney damage, has high levels of protein in urine, or exhibits other signs of organ damage. Preeclampsia can lead to preterm delivery or death, and if left untreated, can result in complications for both the mother and baby.
How preeclampsia affects foetuses and newborn babies
The exact cause of preeclampsia is not known, but it is believed to start in the placenta, the organ that develops in the uterus during pregnancy, and which provides oxygen and nutrients to the foetus.
When a pregnant woman has preeclampsia, the blood vessels of the placenta do not develop or work properly, and problems with blood circulation in the placenta may result in irregular regulation of blood pressure in the mother, according to Mayo Clinic.
When the woman’s placenta does not receive enough blood, the foetus also receives insufficient blood and oxygen, and a reduced amount of nutrients, which, in turn, can lead to a condition called foetal growth restriction.
The baby inside the womb of a woman with preeclampsia may not gain enough weight during the gestational period. The condition in which the rate of foetal growth is less than normal is called intrauterine growth restriction.
“Preeclampsia affects the blood vessels of the placenta and compromises the delivery of oxygen to the foetus. If the placenta does not receive enough blood, the baby may experience reduced blood and oxygen supply, as well as fewer nutrients. This can result in slow growth, which is known as foetal growth restriction,” Dr Radhamany K, Clinical Professor & Head, Obstetrics and Gynaecology, Amrita Hospital, Kochi, told ABP Live.
Unplanned preterm birth, a term used to describe delivery before 37 weeks, is another complication of preeclampsia. However, preterm can also be a treatment for the condition, because delivery before 37 weeks may protect the mother as well as baby by reducing some risks.
But preterm birth can lead to complications for the baby, which include an increased risk of breathing and feeding difficulties, developmental delays, vision or hearing problems, and cerebral palsy, a group of disorders that affect a person’s ability to move and maintain balance and coordination, and is the most common motor disability in childhood.
“Preeclampsia increases the rate of preterm birth due to preterm induction of labour or Caesarean section to save the mother from morbidity and mortality and foetus from intrauterine death due to foetal growth restrictions. In cases of severe preeclampsia complications before 26 weeks, which pose a significant risk to the mother’s life, or if the foetus is experiencing growth restriction, the medical team may recommend terminating the pregnancy,” Dr K said.
A woman with preeclampsia may experience placental disruption, a condition in which the placenta separates from the inner wall of the uterus before delivery, leading to heavy bleeding. This can be life-threatening to both the mother and foetus.
“Intrauterine growth restriction is a common complication of preeclampsia. If the mother has high blood pressure, or placental abruption occurs, the child may suddenly die inside the womb,” Dr Parinita Kalita, Senior Consultant, Obstetrics & Gynaecology, Max Super Speciality Hospital, Patparganj, told ABP Live.
HELLP syndrome, which stands for hemolysis, elevated liver enzymes and low platelet count, is a severe form of preeclampsia which affects several organ systems, is life-threatening to both the mother and baby, and may lead to lifelong health problems for the mother. Hemolysis refers to the destruction of red blood cells. This can result in reduced blood flow to the foetus.
According to the US National Institutes of Health (NIH), preeclampsia poses several risks to the foetus, which include a lack of oxygen and nutrients that can impair foetal growth; preterm birth; stillbirth, a medical term for the death or loss of a baby before or during delivery; and infant death. Stillbirth can occur in the case of placental abruption, and is more likely to occur when the mother has a severe form of preeclampsia, and suffers from the HELLP syndrome.
Even if newborn babies are born at full term (after 39 weeks of pregnancy), they are at increased risk for later problems. When infants are born preterm, they are at increased risk of long-term health issues such as learning disorders, epilepsy, blindness, cerebral palsy, and deafness. After birth, these infants may have to be hospitalised for a long time and may be smaller than babies born full term.
A baby in the womb of a mother who has preeclampsia experiences poor growth in the uterus, and after birth, the infant may be at higher risk of high blood pressure, congestive heart failure, and diabetes.
Therefore, women with risk factors for preeclampsia must be careful and take measures to reduce the risk of the disease, and prevent neonatal and foetal mortality and morbidity.
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