Preeclampsia is a condition where women experience high blood pressure and an increased amount of protein in their urine during pregnancy. It involves reduced blood flow from the placenta and lack of oxygen and nutrients to the foetus, which can impair foetal growth.
It is one of the most common medical problems among pregnant women in Singapore, and is experienced by around four to five percent of them over the last five years, according to Professor Tan Kok Hian, who is the head of the Perinatal Audit and Epidemiology Unit at KK Women’s and Children’s Hospital (KKH). Prof Tan is also an alumnus of NUS Medicine.
“Usually, pregnant women with this severe condition will have symptoms such as severe headaches, nausea and vomiting, right-sided upper abdominal pain or visual disturbances,” said Prof Tan. Preeclampsia can also affect various organs and systems in a woman’s body, and can develop into eclampsia, where the woman experiences convulsions or seizures. Liver and kidney functions may also become impaired, occasionally resulting in acute kidney failure. Blood clotting may get affected, resulting in uncontrolled bleeding.
Preeclampsia is usually caused by a malfunction of the placenta, and an early, correct diagnosis is important in treating it. For instance, if high blood pressure is evident, but no protein is found in the urine, it does not mean that the woman does not have preeclampsia. A blood test should instead be run to identify hard-to-detect cases and predict its progression.
The condition is more common during a woman’s first pregnancy, and developing it then puts her at a higher risk of getting it again in her next pregnancy. It is also more common among women at the extremes of reproductive age groups, such as teenagers and those older than 40. Women carrying twins or triplets are at increased risk, along with those who are obese or have kidney disease, diabetes, hypertension, or autoimmune disorders such as systemic lupus erythematosus.
Preeclampsia can be managed by controlling the high blood pressure with medications and monitoring for any arising complications to ensure foetal well-being while awaiting the foetus to become mature enough for delivery. With proper management and treatment, it is completely reversible after the delivery of the baby and the placenta, potentially allowing the mother to regain all normal bodily functions.