What is Preeclampsia? Its Symptoms, Causes & Diagnosis

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Preeclampsia (havandeskapsförgiftning) is a serious medical complication affecting approximately 3% of pregnancies, typically occurring after week 20. It is primarily characterized by high blood pressure and protein in the urine, potentially impacting vital organs like the liver and kidneys. While the exact cause is unknown, it is linked to placental development, genetics, and immune responses. Monitoring symptoms such as headaches, visual disturbances, and swelling is vital for the safety of both mother and baby.

What is Preeclampsia?

Preeclampsia, also known as toxemia of pregnancy, is a serious medical complication that can occur after week 20 of pregnancy (most commonly during the second half). The condition is always characterized by high blood pressure (hypertension) combined with the involvement of one or more organ systems, such as the kidneys, liver, blood vessels, or brain.

Preeclampsia can range from mild to severe and is a potentially dangerous condition that can threaten the health of both the pregnant woman and the fetus if not properly monitored and managed.

Diagnosis and Symptoms of Preeclampsia

A diagnosis of preeclampsia is established after 20 weeks of gestation if a pregnant woman presents with high blood pressure (hypertension) AND at least one form of organ dysfunction.

The most common signs and symptoms of this organ involvement include:

Proteinuria (protein in the urine): A sign that the kidneys have been affected.
Severe headache: A headache that does not respond to common over-the-counter painkillers (a sign of central nervous system involvement).
Visual disturbances: Blurred vision, sensitivity to light, blurry spots, or flashing lights in front of the eyes.
Upper abdominal pain: Particularly under the right rib cage, which may indicate liver involvement or stretching of the hepatic capsule.
Nausea and vomiting: May occur as a result of liver involvement or general systemic effects.
Sudden swelling (edema): Rapidly onset swelling, particularly in the face, hands, and feet due to fluid retention. (Note: Mild swelling is normal during pregnancy, but sudden or pronounced swelling alongside high blood pressure is a warning sign).

If you experience any of these symptoms during your pregnancy, you should contact your midwife or maternity ward immediately for an evaluation.

Causes of Preeclampsia

The exact cause of preeclampsia is still not fully understood, but research points to two main interacting factors:

Placental Development: The prevailing theory is that the condition originates in the placenta. The blood vessels supplying the placenta do not develop optimally, leading to reduced blood flow and oxygen deprivation (hypoxia) in the placental tissue.
Immunological and Inflammatory Response: The oxygen shortage in the placenta causes it to release substances into the mother's bloodstream. This triggers a generalized inflammatory response and dysfunction in the mother's blood vessels (endothelial dysfunction), which in turn leads to high blood pressure and organ involvement.

Risk Factors

Although the root cause relates to placental vascular development, several factors increase the risk of developing preeclampsia:

First pregnancy: Primigravidas (first-time mothers) have a slightly higher risk.
Multiple pregnancy: Carrying twins or higher-order multiples increases stress on the placenta and the body.
Genetics and family history: A family history of preeclampsia (e.g., if a mother or sister had it) increases the risk.
Underlying health conditions: Chronic high blood pressure, kidney disease, diabetes, or autoimmune diseases prior to pregnancy.
Obesity (high BMI): Increases general systemic inflammation risk.
Previous preeclampsia: Having had the condition during a previous pregnancy.
Age: Pregnancy at an older age (over 35–40 years).

Preeclampsia