Complications of pre-eclampsia

If pre-eclampsia is not diagnosed and monitored, a number of serious complications can develop.

Although complications from pre-eclampsia are rare, having severe pre-eclampsia or continuing to smoke with pre-eclampsia increases the risk of complications.

Eclampsia

Eclampsia is a term that describes a type of convulsion (involuntary contraction of the muscles) that pregnant women can experience, usually from week 20 of the pregnancy, or immediately after the birth. Eclampsia is quite rare and in the UK there are around 5 cases of eclampsia for every 10,000 births.

During an eclamptic convulsion, the mother’s arms, legs, neck or jaw will twitch involuntarily in repetitive, jerky movements. She may lose consciousness and may wet herself. The convulsions usually last less than a minute.

While most women make a full recovery after having eclampsia, there is a small risk of permanent disability or brain damage if the convulsions are severe. Of thoses who have eclampsia, around 1 in 50 will die from the condition. Unborn babies can suffocate during a seizure, and 1 in 14 may die.

Research has found that magnesium sulphate can halve the risk of eclampsia and reduce the risk of the mother dying. It is now widely used to treat eclampsia after it has occurred, and to treat women who may be at risk of developing eclampsia.

HELLP syndrome

HELLP syndrome is a combined liver and blood clotting disorder that can affect pregnant women. It is most likely to occur immediately after the baby is delivered, but can appear any time after 20 weeks of the pregnancy, and in rare cases before 20 weeks of the pregnancy.

The letters in the name, HELLP, stand for each part of the condition:

• H is for haemolysis. This is where the red blood cells in the blood break down.
• EL is for elevated liver enzymes (proteins). A high number of enzymes in the liver is a sign of liver damage.
• LP is for low platelet count. Platelets are cells in the blood that help it to clot.

HELLP syndrome is potentially as dangerous as eclampsia, and it is slightly more common. The only way to treat the condition is to deliver the baby as soon as possible. Once the mother is in hospital and is receiving treatment, it is possible for her to make a full recovery. The main danger to the baby is from premature birth (being born before the 37th week of pregnancy).

Premature babies often have a low birth weight and find it hard to breathe on their own. It is likely they will need to stay in neonatal intensive care for close supervision. If the baby’s birth weight is less than 1,500g (3.5lbs), the baby has a one in six chance of dying before their first birthday.

Cerebral haemorrhage

Blood supply to the brain can be disturbed as a result of high blood pressure. This is known as a cerebral haemorrhage, more commonly stroke. If the brain does not get enough oxygen and nutrients from the blood, brain cells will start to die.

Organ problems

• Pulmonary oedema is where fluid builds up in and around the lungs. This stops them from working properly by preventing them from absorbing oxygen.
• Kidney failure is when the kidneys cannot filter waste products from the blood, causing toxins and fluids to build up in the body.
• Liver failure causes disruption to the functions of the liver. The liver has many functions, including digesting proteins and fats, producing bile, and removing toxins. Any damage that disrupts these functions could be fatal.

Blood clotting disorder

The mother’s blood clotting system can break down (known medically as disseminated intravascular coagulation) and the proteins that control blood clotting become abnormally active.