pre-eclampsia & HELLP syndrome:
symptoms, diagnosis and treatment

Finding out that there are complications either in your pregnancy or the birth of your little one can be scary, especially if you are a first-time parent. But the earlier that these problems are diagnosed by a healthcare expert, the earlier they can help you to decide what to do next.

Pre-eclampsia is a reasonably common complication that affects around one in ten first-time mums, and in many cases, it’s very mild. The earlier it’s diagnosed and treated, the better the outcome for both you and baby.

what is pre-eclampsia?

Pre-eclampsia is thought to develop when there’s a problem with the placenta. If the placenta isn’t working properly, your baby may not be getting enough oxygen and nutrients, which may restrict their growth. When this happens, the blood supply between mother and baby is affected, causing high blood pressure for mum.

At the same time, proteins from mum’s blood leak into the urine causing proteinuria – a warning sign that all is not well with kidney function.

Pre-eclampsia ranges from mild to severe, and if you develop it, you may not even feel unwell. However, all cases need careful monitoring and treatment to ensure your baby is growing well, and to make sure that the eclampsia doesn't fully develop (more about this later).

what are the symptoms of pre-eclampsia?

Pre-eclampsia usually occurs during the second half of pregnancy. It may be picked up during a routine midwife check, as you may have high blood pressure or protein in your urine (this is why you have to bring a pot of wee to each antenatal appointment).

Symptoms of pre-eclampsia that you may notice yourself include:

  • a severe headache possibly with vomiting
  • vision problems, such as flashing lights
  • swollen feet, ankles, hands and face
  • pain below your ribs

If you experience any of these, contacting your midwife can lead to an early diagnosis.

who is affected by pre-eclampsia?

It can be hard to tell why someone develops pre-eclampsia. However, here is a list of a few medical conditions which, if you have had them prior to your pregnancy, could increase the risk:

  • diabetes
  • high blood pressure
  • kidney disease
  • lupus
  • pre-eclampsia in a previous pregnancy

Your chances are also slightly increased if:

  • it’s your first baby
  • you are over 40
  • you’re pregnant with twins or triplets
  • your body mass index is over 35
  • it’s been at least ten years since your last pregnancy

If you have two or more of these factors, your chances are higher.

what is the treatment for pre-eclampsia?

Even mild pre-eclampsia needs monitoring to make sure both you and your baby are healthy. If you’re diagnosed with the condition, you’ll be referred to a specialist, usually in hospital. You’ll be assessed and monitored to work out how mild it is, and this will determine the level of treatment you receive.

There is no cure for pre-eclampsia – the only way is to give birth. You’ll be monitored for the rest of your pregnancy, and if at any point it seems like the condition is worsening significantly, your baby may be induced or delivered by C-section. Mums-to-be with severe pre-eclampsia may need a hospital stay, and milder cases will be seen as outpatients. Often, medication is prescribed to lower your blood pressure.

If your midwife thinks you are at risk of developing pre-eclampsia, they may prescribe a daily dose of low-dose aspirin from 12 weeks onwards.

does pre-eclampsia affect the baby?

Your baby is not poorly during this time, but they may be growing slower than other babies. This is because the problems with the placenta reduce the amount of oxygen and nutrients passed from mum to baby. Babies born to mums who had pre-eclampsia are often smaller.

If your pre-eclampsia is severe, your baby may need to be delivered early. This can mean that their little lungs aren’t fully developed, and they may need to be looked after in the neonatal intensive care unit (NICU) or special care baby unit (SCBU) for a while after the birth. Stillbirths are rare but can occur – which is why all pregnant mums are so carefully monitored for symptoms of pre-eclampsia.

the complications of pre-eclampsia, including HELLP

Pre-eclampsia can develop into eclampsia, which is a fit or seizure that affects pregnant women or mums who have just given birth. It’s uncommon in the UK these days, and is extremely rarely fatal. Most women make a full recovery; however, there is a small risk of some permanent brain damage if the fit is severe.

HELLP is a rare liver and blood clotting disorder, most likely to happen immediately after delivery but which can occur during pregnancy. HELLP stands for:

  • h: haemolysis (the breaking down of red blood cells)
  • el: elevated liver enzymes (a sign that your liver is not working properly)
  • lp: low platelet count (which means your blood can’t clot properly)

Again, with care and close monitoring by healthcare professionals, you should make a full recovery from HELLP.

after delivery

After your little one has arrived, you’ll need a bit of time in hospital to rest and recover, and have your blood pressure monitored. If you didn’t have high blood pressure before pregnancy, you’ll gradually come off medication while being regularly checked by your midwife or GP, and everything will return to normal (or as normal as life can be with a newborn!).

You’ve had a tricky journey to motherhood, but you’re here now – it’s time to enjoy your new baby.

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