One of the questions that our MummyNatal teachers sometimes get asked is whether our weekly classes are safe for mums-to-be who have been diagnosed with pre-eclampsia. We would say that as long as you haven’t been hospitalised, our MummyNatal classes are suitable for all expectant mums, at any stage of their pregnancy, and no matter what type of birth they’re planning, as long as you’re comfortable attending a class and that if you are experiencing any medical issues, that you have been given the go ahead by your midwife or GP.
We understand that if you’ve been told that you’re either at risk of pre-eclampsia, or you’ve been diagnosed with the condition, you may feel worried about what this means for you and for your baby. So here is some information that you may find useful.
What is pre-eclampsia?
Pre-eclampsia is a condition that can affect a small number of pregnant women, usually during the second half of their pregnancy (from around 20 weeks), or postnatally, i.e. soon after the baby is born. If not diagnosed, treated, and monitored, the condition can lead to serious complications for both mother and baby, so the earliest in the pregnancy it is diagnosed, the better.
Although the exact cause of pre-eclampsia isn’t known or fully understood, the condition seems to occur when the blood vessels that supply blood to the placenta do not develop properly. In order to support the growing baby, the placenta needs a large and constant supply of blood from the mother, but in pre-eclampsia, the placenta doesn’t seem to get enough blood.
Who is most at risk?
Mild pre-eclampsia can affect around 5-6% of all pregnancies (although stats do vary depending on the source), while severe cases develop in about 1-2% of all pregnancies. Some of the known factors that can increase a mum’s chances of developing pre-eclampsia include:
- Having an existing medical problem – such as diabetes, kidney disease, or high blood pressure;
- Previously having pre-eclampsia – there’s an approximately 16% chance that someone will develop the condition again in later pregnancies if they have experienced it before.
Some factors also increase chances by a small amount. Someone who falls into two or more of these categories together will have a higher chance to develop pre-eclampsia:
- It is Mum’s first pregnancy – pre-eclampsia is more likely to happen during the first pregnancy than during any subsequent pregnancies;
- It’s been at least 10 years since Mum’s last pregnancy;
- The condition runs in the family – i.e. either Mum’s mum or sister also had it, for example.
- Mum is over the age of 40;
- Mum was overweight at the start of the pregnancy, with a BMI (or Body Mass Index) of 35 or more.
- Mum is expecting multiple babies, such as twins or triplets.
If you’re considered to be at high risk of developing pre-eclampsia, you may be advised by your GP to take a low dose of aspirin every day during your pregnancy from when you’re 12 weeks pregnant until your baby is born. Evidence suggests this can lower your chances of developing the condition. If you think you may be at risk of pre-eclampsia based on the above factors, be sure to contact your GP or midwife immediately. Please refrain from taking any medication, unless they have been prescribed to you by your health professional.
What are the signs and symptoms?
While it is possible that an expectant mum with pre-eclampsia may not develop any symptoms at first, early signs of the condition are high blood pressure (hypertension) and traces of protein in the urine. Because it’s extremely unlikely that a woman spots these signs independently, blood pressure and urine are tested at each antenatal appointment.
When the condition goes undiagnosed or untreated for longer however, further symptoms may develop. These include:
- Swelling of the feet, ankles, face, eyes, and hands;
- Pain just below the ribs;
- Difficulty breathing – gasping, or panting;
- Changes in vision, like spots or light flashes, for example;
- Nausea after mid-pregnancy;
- Severe headache that will not go away, not even with medication.
- Excessive weight gain.
If you experience any of these symptoms, call your midwife or GP immediately, or contact NHS 111.
What happens when you have been diagnosed with pre-eclampsia?
If you’ve been diagnosed with pre-eclampsia, you will most likely be referred to a specialist in hospital for further tests and more frequent monitoring. Depending on the severity of your condition, you may be able to go home after an initial assessment and have frequent outpatient appointments. Only in severe cases, you may need to stay in hospital for closer observation and until it is safe for your baby to be born. For more information on what type of medications you may be asked to take, or on how you and your baby will be monitored in hospital, check the NHS Choices website.
Your birth choices
In most cases of pre-eclampsia, to reduce the risk of complications for you and your baby, your consultant will very likely recommend that you have your baby at about the 37th to 38th week of pregnancy. If you accept this advice, you can choose to have your labour started through an induction, or to have a caesarean section. If your condition becomes more severe before 37 weeks, and there are serious concerns about your health or the health of your baby, earlier delivery may be necessary. If this happens to you, don’t forget to ask for information about the risks of both premature birth and pre-eclampsia in your particular case and circumstances, so that you and your family can make an informed decision about what choices to make. A way to do this is to ask questions following the B.R.A.I.N. acronym.
After your baby is born
Although pre-eclampsia usually improves soon after your baby is born, you may need to stay in hospital after the birth of your baby, so that both yourself and your baby can be monitored for a little longer to make sure you are both well. You’ll usually need to have your blood pressure checked regularly after leaving hospital, and you may need to continue taking medication to lower your blood pressure for several weeks.
You should be offered a postnatal appointment six to eight weeks after your baby is born to check your progress and decide if any treatment needs to continue. This appointment will usually be with your GP.
If you would like more information on pre-eclampsia, you can head over to the NHS Choices website.