Last week one of the most popular shows on television, “Downtown Abbey,” had one of its main characters, sweet Lady Sybil, die suddenly and without warning as a result of preeclampsia. Those of us who work in Obstetrics are well aware of the dangers of preeclampsia. We have patients who call and complain of headaches, swelling, and “the baby hasn’t been moving today.” This definitely gets our attention. We know the potential harm it can cause, and the risks to the baby and mother. But most people don’t think about it much, even women who are pregnant. So it’s a great public service to call attention to this problem and raise consciousness about it.
Preeclampsia is a life-threatening disorder that occurs only during pregnancy and the immediate post-partum period. It is characterized by a rapid progression of high blood pressure, swelling and protein in the urine that can lead to liver damage, bleeding, seizures, stroke and death.
The condition affects as many as 8% of pregnant women in the US every year. It’s one of the main reasons we see pregnant women every week at the end of the pregnancy and check their urine every visit. The condition causes stillbirths and can be a great risk to the mother’s health. Unfortunately, the symptoms can easily be overlooked, as was the case in the “Downtown Abbey” episode where the swelling of Lady Sybil’s feet and changes in her mental status were not given proper attention. Sometimes the pregnant woman may be advised to “not make a big deal about it.” Recognizing this condition early and treating it properly can make all the difference in the world.
If a pregnant woman notices problems with high blood pressure, swelling, sudden weight gain, nausea or vomiting, headaches, changes in vision, changes in mental status, or a decrease in the baby’s movement it is always best to tell your obstetrician about it.
Fortunately, there’s so much more that can be done for women who have this condition today compared to what was available one hundred years ago. The medications to control high blood pressure are much improved, and, as was recommended in the episode, delivery is usually the best treatment. Other medications such as Magnesium sulfate are administered in a hospital setting, usually with excellent results.
Becoming aware of this problem is the first step in detecting it and starting early treatment. If you suspect you may be developing preeclampsia, make sure your health care provider is aware too!