Pre-eclampsia can only be cured by delivering the baby. The mother is closely monitored and her blood pressure managed until delivery of the baby is possible.
If you have been diagnosed with pre-eclampsia, you will be referred for further tests. Depending on how severe your symptoms are, this could be another appointment with the GP or midwife in a week’s time, a referral to a hospital within 48 hours or a referral to a hospital on the same day.
Further tests will determine the severity of the pre-eclampsia and whether a hospital stay is necessary.
Mild pre-eclampsia
Mild pre-eclampsia is monitored with frequent antenatal appointments. At these appointments:
- your blood pressure will be checked for any increase (hypertension)
- your urine will be tested for protein (proteinuria)
- you will be asked about any other symptoms you have
Depending on your symptoms and situation, you will be asked to attend an antenatal appointment at least every three weeks if you are 24-32 weeks into your pregnancy. After 32 weeks of pregnancy, these appointments will be every two weeks.
The National Institute for Health and Clinical Excellence (NICE) and the Pre-eclampsia Community Guideline (PRECOG) have developed recommendations for healthcare professionals to use when treating pre-eclampsia. These include:
- giving the mother information about the condition based on current evidence, including the signs and symptoms of pre-eclampsia, how it may develop and how serious her case is
- providing support to enable the mother to make informed decisions about her care
- arranging a medical review with the mother after any abnormal blood tests, so she can discuss the results and be given a summary of the assessment
- arranging a new antenatal care plan with the mother, including a follow-up appointment
- allocating a consultant (a specialist doctor) to the mother
- providing a way for the mother to report and act on any new symptoms – for example, a direct number to call
- arranging a convenient way to inform the mother of any future test results
Severe pre-eclampsia
If pre-eclampsia is severe, you may need to be admitted to hospital for closer monitoring and treatment. As pre-eclampsia tends to get worse rather than better, it is unlikely you will be able to go home until after the baby is born.
Monitoring
You and your unborn baby will be monitored in the following ways:
- your blood pressure will be checked every four to six hours for any abnormal increases
- urine samples will be taken at least every 24 hours to measure protein levels
- you will be asked about any other symptoms you are having
- your blood may be tested for the proteins aspartate aminotransferase (AST) and alanine aminotransferase (ALT), which can be a sign of liver damage if found in the blood
- a blood test may be taken to provide information about the blood cells
- you may have ultrasound scans, which create an image of the baby to check blood flow through the placenta, measure the size of the baby and observe the baby’s breathing and movements
- the baby’s growth rate will be closely monitored to check for slow growth
- the baby’s heart rate may be monitored electronically in a process called cardiotocography, which can detect any distress in the baby
Treatment
Bed rest and medication such as calcium channel blockers can be used to lower blood pressure. This will reduce the likelihood of complications caused by high blood pressure, such as stroke (when the blood supply to the brain is disturbed).
You may also be prescribed anticonvulsant medication to prevent the convulsions (fits) of eclampsia. Injections of magnesium sulphate can halve the risk of pregnant women developing eclampsia. They can also be used to treat convulsions if they occur.
Premature birth
A baby born before the 37th week of pregnancy is premature and may not be fully developed. However, if the baby is seriously affected by pre-eclampsia or there is a strong risk of further complications, it may be necessary to deliver the baby prematurely, as this is the only way to cure pre-eclampsia.
Attempts will be made to manage pre-eclampsia until after 36 weeks of pregnancy. Some recent research has suggested that once the baby reaches 37 weeks, it may be better to induce labour (start labour artificially), rather than wait and carefully monitor the baby until it is born naturally. This reduces the risk of complications from pre-eclampsia, including HELLP syndrome and eclampsia.
The premature delivery of the baby will usually be done by caesarean section (through an incision in the abdomen). You should be given information about the risks of both premature birth and pre-eclampsia, so that the best decision regarding treatment can be made.
The baby might need to stay in a neonatal intensive care unit. This can replicate the functions of the womb and allow the baby to develop fully. Once it is safe to do so you will be able to take your baby home.
Comments are closed.