Preeclampsia Complications in Mother during Pregnancy and Labor

As with most health conditions, preeclampsia too has its share of complications, some very serious. The difference is that the impact of these complications affects two individuals — the mother and the fetus (or baby).

The effects of these dangers can be short term or long term. They can be mild or life-threatening. They can occur during pregnancy, or during labor or after delivery.

According to the International Journal of Women’s Health, preeclampsia is the third largest cause of maternal death worldwide.

And again, worldwide, preeclampsia is responsible for 20% of the 13 million preterm births each year.

Complications set in, if preeclampsia is not treated and controlled. With proper management, complications can be averted.

Usually, preeclampsia sets in during the second half of pregnancy after 20 weeks into gestation.

If it sets in early, the risks of complications are greater. And, the more severe the preeclampsia, greater are the risks.

The severity of preeclampsia is gauged by the increased blood pressure. Systolic more than 160 mm Hg and diastolic more than 100 mm Hg classifies the condition as severe.

Another factor that affects the risk is that in developed countries, the risk of complications reduces because of proper prenatal and postnatal care.

Early and regular prenatal care is the most important factor to minimize the risk of complications for the mother and the baby.

Women with pre-eclampsia are more frequently associated with the caesarean section, preterm delivery, and placental abruption than normal pregnancies.

Reading the following will help:

Complications on mother during pregnancy

Placental abruption (the placenta separates from the uterus)

Placental abruption is a very serious condition in which the placenta partially or completely separates from the wall of your uterus before delivery.

The condition can deprive the baby of oxygen and nutrients and can result in severe bleeding that can be fatal to both mother and child.

Eclampsia (Seizures)

Eclampsia is a very severe form of preeclampsia characterized by seizures (fits). It is a very serious condition with fatal consequences for the both, the mother and the baby.

Because of this, delivery becomes necessary irrespective of the age of the gestation. However, eclampsia is rare affecting only 1 in 200 preeclampsia cases (rate of 0.5%).

Besides seizures, other symptoms of eclampsia include loss of consciousness during a seizure, headaches, muscle pain and upper right abdominal pain.

HELLP syndrome

As explained in what is preeclampsia, this pregnancy complication affects most systems of the body. One such manifestation is the HELLP syndrome.

Ten to 20% of patients with severe preeclampsia will develop the HELLP syndrome. Most cases occur between 27 to 37 weeks of gestation with a few occurring 48 hours after delivery.

It is a rare disorder affecting the liver and blood. It most likely affects the pregnant woman after delivery but is also seen to develop after 20 weeks of gestation in the pregnant woman. That is the period when preeclampsia usually develops in the pregnant woman.

However, preeclampsia is known to develop even before 20 weeks. In such cases, the HELLP syndrome may also set in. But, this is still rare.

You should know that these complications of preeclampsia develop when proper management to control it is not being given.

The name HELLP, summarizes its complications and its full form stands thus:

  • “H” stands for hemolysis (haemo means blood and lysis means rupture). Hemolysis is the premature rupture or breakdown of the red blood cells in the blood leading to the release of their contents such as hemoglobin into the blood plasma.
  • “EL” stands for elevated liver enzymes. This indicates liver damage.
  • “LP” stands for low platelet count. Platelets are responsible for the clotting of blood in case of any bleeding.

The HELLP syndrome is potentially dangerous as can be seen by the complications it causes. Like in eclampsia, an urgent induced delivery of the baby becomes necessary to protect the mother.

At times, diagnosis can be difficult. Blood tests for liver function and the complete blood count picture help to identify red blood cell hemolysis and the low platelet count.

Stroke

Stroke is brain damage due to lack of blood supply to a part of the brain. Because of high blood pressure in preeclampsia, a blood vessel in the brain can rupture. This is called cerebral hemorrhage and the stroke is defined as a hemorrhagic stroke. Most strokes occur in the third trimester.

This results in a lack of blood to the part of the brain the artery supplies. Accordingly, further complications develop such as paralysis of one side of the body, difficulty in speech and visual disturbances.

If the area of the brain involved is large and critical, instant death can occur.

Organ problems

Pulmonary edema is the abnormal accumulation of excess fluid in the interstitial and alveolar spaces of the lung. This can adversely impact the gaseous exchange of oxygen and carbon dioxide in the alveoli of the lungs.

This causes less oxygen and more retention of carbon dioxide in the blood. If severe in nature, this can be life threatening.

Kidney damage is a common complication of preeclampsia as indicated by the fact that proteinuria can be an important factor along with high blood pressure for diagnosing preeclampsia.

PE-triggered metabolic stress may cause vascular injury leading to endothelial dysfunction. Chronic arterial hypertension and endothelial dysfunction potentially contribute to the development chronic kidney disease (CKD) in preeclampsia.

Liver failure

Preeclampsia-induced liver disease is unique to pregnancy and is frequently seen in the third trimester. Liver involvement in preeclampsia is not common, but, if present signifies severe liver disease. Liver damage presents as pain in the upper right quadrant of the abdomen.

Blood clotting disorder

Blood clotting disorders are mostly associated with the early, severe, and complicated forms of preeclampsia.

Though the risk of this complication is very small, women with preeclampsia were more than twice at risk to be admitted to the hospital with blood clots than non-preeclampsia patients.

These hemostatic blood disorders can come on suddenly and therefore, a patient of preeclampsia requires frequent blood tests.

These venous blood clots can form anywhere in the body, but usually, they form in the legs. Rarely, these clots can travel upwards to the lungs and cause pulmonary embolism, a fatal condition.

Delivery of the baby remains the only curative remedy for these blood disturbances.

Preeclampsia maternal complications during labor

Being diagnosed with preeclampsia calls for an immediate delivery of the baby. That is the only way to cure preeclampsia and avoid its risky complications.

If you are less than 30 weeks into your gestation period, your doctor will go in for a cesarean section (also called C-section) to deliver your baby because the opening of the cervix will not be dilated at that point of time. That is nature’s way to protect the baby and keep it in the womb till it is ready for delivery.

Instead of subsiding, if your hypertension worsens, you, as a mother, are at a great risk of certain life-threatening preeclampsia-related complications during labor.

  • You could suffer a hemorrhagic stroke, which is bleeding in the brain due to rupture of an artery or capillary due to the high blood pressure.
  • An onset of eclampsia, which can cause seizures and loss of consciousness.
  • You could slip into a coma.
  • Development of the HELLP syndrome, which is described above. It essentially causes hemolysis (destruction of red blood cells), elevates the liver enzyme levels in the blood indicating liver damage and reduces blood platelet count. It can also cause permanent damage to the brain, the lungs, and kidneys.

 

468