If you have pre-existing high blood pressure or gestational high blood pressure, you have a higher risk of developing preeclampsia during pregnancy.

“A complex condition, preeclampsia typically starts after the 20th week of pregnancy,” says Dr Tan Lay Kok, Senior Consultant, Department of Obstetrics & Gynaecology, Singapore General Hospital (SGH), a member of the SingHealth group.

Signs and symptoms of preeclampsia

  • High blood pressure
  • Protein in the mother’s urine (proteinuria)
  • A persistent headache
  • Vision changes
  • Intense pain or tenderness in the upper abdomen
  • Nausea and vomiting

At times, swelling, especially in the legs and feet, known as oedema may accompany preeclampsia. Oedema on its own is very common even in uncomplicated pregnancies. However, the oedema may be even more marked in cases of preeclampsia. This occurs when changes in your blood vessels cause your capillaries to “leak” fluid into your tissues.

Potential complications of preeclampsia

In mild cases, both mother and baby may continue to be fine. However, in moderate to severe cases, you may experience the following health problems:

  • Reduced blood flow to the placenta: “When there is less blood flow to your uterus, there is a reduced supply of oxygen and nutrients to the foetus,” adds Dr Tan. “This can lead to problems such as low birth weight and poor growth. If there is a need to deliver early to protect your health, your baby may suffer from the effects of prematurity.”
  • Placental abruption: “A condition where the placenta prematurely separates from the uterus, this can also deprive the baby of oxygen and cause heavy bleeding in the mother,” says Dr Tan.
  • Eclampsia (or seizures): “These can be preceded by symptoms such as severe or persistent headaches, vision changes, upper abdominal pain or mental confusion,” adds Dr Tan. When these happen, anti-seizure medications such as magnesium sulphate have to be prescribed.​

It is only by delivering your baby that you can eventually recover from preeclampsia.

Your doctor will be able to perform the necessary tests to detect the presence of these complications and determine the baby’s well-being, as well as advise you on the appropriate course of treatment to be undertaken.

Risk of premature birth

The only cure for preeclampsia is to deliver the patient.

If preeclampsia occurs after 37 weeks of pregnancy, the doctor will usually advise a planned delivery, either by induction of labour or caesarean section if there are other reasons for this.

However, if preeclampsia occurs before the baby is fully mature (before 37 weeks of pregnancy), there is a risk that the baby has to be born prematurely.

In this situation, depending on the severity of the preeclampsia, the gestational age of the pregnancy, and the conditions of the mother and baby, the doctor will first try to manage the condition for as long as is possible.

“This premature delivery is more usually done by caesarean section and the baby may need to stay in a neonatal intensive care,” explains Dr Tan. Once the baby’s growth and condition are stable, you will be able to bring your baby home.

Gestational high blood pressure is one of the risk factors for pre-eclampsia. Learn more about hypertension during pregnancy on the previous page.

Ref: S13