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Checking blood pressure is an important part of antenatal appointments.

Checking blood pressure is an important part of antenatal appointments.
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Pre-eclampsia or pregnancy induced hypertension (PIH)

4-minute read

Pre-eclampsia is a serious condition that can occur during pregnancy where there is high blood pressure and abnormal kidney function. During pregnancy your blood pressure will be checked at every antenatal appointment because a rise in blood pressure can be the first sign of pre-eclampsia, also called pregnancy-induced hypertension (PIH), pre-eclamptic toxemia and hypertensive disease of pregnancy.

Although most cases of pre-eclampsia are mild and cause no trouble, the condition can get worse and be serious for both mother and baby. It can cause fits (seizures) in the mother, which is called 'eclampsia', and can affect the baby’s growth. It is life-threatening for mother and baby if left untreated.

This is why routine antenatal checks are so important.


Who is at risk?

About 3% – 4% of pregnant women in Australia and New Zealand develop pre-eclampsia. The exact causes are not known but you may be at higher risk of developing pre-eclampsia if you:

  • have chronic hypertension, diabetes or a kidney disorder
  • have had it before
  • are having your first baby
  • are aged 40 years or more or aged under 18 years
  • are expecting twins or triplets
  • have a family history of pre-eclampsia (i.e. your mother had pre-eclampsia)
  • are very overweight at the beginning of your pregnancy (body mass index of 35 or more)
  • have had a gap of 10 years or more since your last pregnancy
  • conceived with in vitro fertilisation (IVF)
  • have an autoimmune disorder such as rheumatoid arthritis

Signs and symptoms

Pre-eclampsia can occur at any time during pregnancy, and up to 6 weeks after birth. It is most common after 20 weeks of pregnancy and in first pregnancies. It can develop gradually over many weeks, or come on suddenly over a few hours.

You can have pre-eclampsia and have no symptoms. It is therefore vital to have regular antenatal checks of blood pressure and urine to detect the condition before it becomes dangerous for mother and baby.

Early symptoms

The first signs of pre-eclampsia are a sudden rise in blood pressure (hypertension) and protein in the urine.

You probably won't notice these symptoms, but your doctor or midwife should pick them up during your antenatal appointments.

Progressive symptoms

As pre-eclampsia develops, it can cause fluid retention (oedema), which often causes sudden swelling of the feet, ankles, face and hands.

Oedema is another common symptom of pregnancy, but it tends to be in the lower parts of the body, such as the feet and ankles. It will gradually build up during the day. If the swelling is sudden, and it particularly affects the face and hands, it could be pre-eclampsia.

As pre-eclampsia progresses, it may cause:

  • severe headaches
  • vision problems, such as blurring or seeing flashing lights
  • pain in the upper abdomen (just below the ribs)
  • vomiting
  • excessive weight gain due to fluid retention
  • feeling generally unwell

However, you can also have severe pre-eclampsia without any symptoms. If you get any of the symptoms listed above, or have any reason to think you have pre-eclampsia, contact your midwife, doctor or the hospital immediately.

Pre-eclampsia can also develop soon after childbirth, and you should alert your doctor or midwife of any concerns you may have after your baby is born.

Symptoms in the unborn baby

The main sign of pre-eclampsia in the unborn baby is slow growth. This is caused by poor blood supply through the placenta to the baby. The growing baby is starved of oxygen and nutrients and this will affect its growth.

Treatment

Once pre-eclampsia develops, it does not go away until after the baby is born. Treatment may start with rest at home, but some women need to be admitted to hospital and to take medicines that lower high blood pressure. Occasionally, pre-eclampsia is a reason to deliver the baby early — you may be offered induction of labour or a caesarean section in this case.

Managing pre-eclampsia

It is vital to go to all your antenatal appointments, or to reschedule them if you can't make it, since severe pre-eclampsia can affect both your health and your baby’s health. If left untreated, it can put you at risk from a stroke, impaired kidney and liver function, blood clotting problems, fluid on the lungs and seizures. Your baby may also be born prematurely or small or even stillborn.

If you have any of the risk factors for developing pre-eclampsia mentioned above, attending regular check-ups to have your blood pressure and urine tested is even more important.

Not sure what to do next?

If you are still concerned about pre-eclampsia or pregnancy-induced hypertension, use healthdirect’s online Symptom Checker to get advice on when to seek medical attention. Ensure you attend regular antenatal visits as directed by your health professional and discuss then follow any professional advice given.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self-care, talking to a health professional, going to a hospital or calling triple zero (000).

Last reviewed: September 2018

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