Preeclampsia and High Blood Pressure During Pregnancy

Introduction
Preeclampsia is a serious condition that affects a small percentage of pregnant women, usually after 20 weeks of pregnancy. It is characterized by high blood pressure (hypertension) and damage to other organs, especially the kidneys and liver. If left untreated, preeclampsia can lead to serious complications for both mother and fetus. While the exact cause of preeclampsia is not fully understood, some known risk factors include a history of preeclampsia, first pregnancy, multiple pregnancies, obesity, and health conditions such as diabetes or kidney disease.

High Blood Pressure in Pregnancy
Hypertension during pregnancy falls into two main categories:

1. Gestational Hypertension: High blood pressure that develops during pregnancy without any signs of other organ damage. This condition usually goes away after delivery.
2. Preeclampsia: A more serious condition than gestational hypertension, where high blood pressure is accompanied by signs of organ damage, such as protein in the urine (proteinuria), impaired kidney function, or liver problems.

Preeclampsia can progress to eclampsia, which is a condition where the pregnant woman experiences seizures. This is a life-threatening condition and requires immediate medical attention.

Symptoms of Preeclampsia
Some symptoms of preeclampsia include:

• High blood pressure (≥140/90 mmHg)
• Proteinuria (presence of protein in the urine)
• Swelling in the hands, feet, or face (edema)
• Pain in the upper abdomen
• Visual disturbances, such as blurred vision or seeing spots of light
• Severe headache that does not go away with treatment
• Decreased amount of urine
• Shortness of breath due to fluid in the lungs
• Not all women with preeclampsia will exhibit all of the above symptoms, so it is important for pregnant women to undergo regular check-ups to detect this condition early.

Risk Factors
Preeclampsia can happen to anyone, but there are some factors that increase the risk, namely:

• First pregnancy: Women who are pregnant for the first time have a higher risk.
• History of preeclampsia: If a person has experienced preeclampsia in a previous pregnancy, the risk will increase in subsequent pregnancies.
• Multiple pregnancy: Women carrying more than one baby (twins, triplets, etc.) are more vulnerable.
• Obesity: A high body mass index (BMI) before pregnancy is associated with an increased risk of preeclampsia.
• History of certain diseases: Women with a history of chronic diseases such as hypertension, diabetes, or kidney disease are more prone to developing preeclampsia.

Complications of Preeclampsia
If not treated appropriately, preeclampsia can lead to a number of serious complications for both mother and fetus:

• Complications for the mother: Preeclampsia can cause organ damage, such as kidney failure or impaired liver function, and increases the risk of postpartum hemorrhage. It also increases the risk of developing heart disease and stroke later in life.
• Complications for the fetus: The baby may experience restricted growth, premature birth, or even fetal death.

Treatment of Preeclampsia
Treatment for preeclampsia depends on the severity of the condition and gestational age. In mild cases, the mother may only need to undergo close monitoring, such as blood pressure checks, urine analysis, and fetal growth checks. However, in severe preeclampsia or when the condition worsens, early delivery may be required, even if the baby is not yet full term.

Some of the steps that can be taken to manage preeclampsia include:

• Close monitoring: For mothers with mild preeclampsia, doctors may monitor blood pressure and fetal development more frequently.
• Medications: Administration of antihypertensive drugs to lower blood pressure and corticosteroids to accelerate fetal lung maturity if early labor is required.
• Early labor: If preeclampsia cannot be controlled or if the condition of the mother or fetus worsens, the doctor may decide to perform an early delivery.

Prevention
While there is no sure way to prevent preeclampsia, some steps can reduce the risk:

• Consult a doctor before pregnancy for women with high risk factors, such as a history of hypertension or obesity.
• Taking calcium supplements for women with low calcium intake during pregnancy may help reduce the risk of preeclampsia.
• A healthy diet and regular exercise can help maintain an ideal weight and lower the risk of hypertension during pregnancy.
• Low-dose aspirin: For women at high risk of preeclampsia, doctors may prescribe low-dose aspirin during the second and third trimester of pregnancy.

Conclusion
Preeclampsia is a serious condition during pregnancy that requires immediate medical attention and treatment. Early detection and close monitoring are essential to reduce the risk of more severe complications, both for the mother and the fetus. Regular antenatal check-ups, management of risk factors, and a healthy lifestyle can help prevent and manage preeclampsia.

 

Referensi

1. Cunningham, F. G., et al. (2014). Williams Obstetrics. 24th Edition. McGraw-Hill Education.
2. American College of Obstetricians and Gynecologists (ACOG). (2020). Hypertension in Pregnancy: ACOG Practice Bulletin.
3. WHO. (2011). Recommendations for Prevention and Treatment of Pre-eclampsia and Eclampsia. Geneva: World Health Organization.
4. Sibai, B. M. (2003). "Diagnosis and Management of Gestational Hypertension and Preeclampsia". Obstetrics & Gynecology, 102(1), 181-192.