I'm sure you've heard these terms more times than you remember right now, but maybe you've never known for sure. the differences that exist between one term and another, do not worry because it is something very common. Today I want to help you identify these two diseases so that as of today you will be able to identify what each one is.
What you may know is that both terms occur or can occur during pregnancy and depending on the degree, can put both mother and baby at risk of death. So neither of these two diseases is to be taken as a joke, they are two very serious diseases.
What is preeclampsia?
Preeclampsia is the presence of high blood pressure and protein in the urine that can begin to develop after the 20th week of pregnancy. The only way to cure and overcome this disease is to give birth to the baby, but if this has to happen too soon, the baby will have to be in the incubator with complete rest and a thorough medical control. Labor would be induced as much as possible. From preeclampsia it can progress to eclampsia, By having the pre in front of the term, it is already understood that it can go before.
In addition, preeclampsia can appear in the early postpartum period (usually within the first week) and sometimes with few symptoms at first. Medical criteria include levels of blood pressure ≥ 140/90 mmHg in at least two separate shots and the presence of significant proteinuria (e.g., ≥300 mg in 24-hour urine or protein/creatinine ratio ≥0,3). There are forms with “severe features” when signs such as blood pressure ≥160/110 mmHg, low platelets, elevated liver enzymes, kidney failure, pulmonary edema, or neurological symptoms (severe headache, visual disturbances).
What is eclampsia?
Eclampsia is the seizure occurrence is a pregnant woman, something that can also happen after the 20th week of pregnancy. As in pre-eclampsia, labor must be induced since both mother and baby are at risk of death.
In practice, eclampsia is the neurological complication of preeclampsia when they occur seizures or even coma without any other cause. It may manifest during pregnancy, childbirth, or in the early postpartum period. It is usually preceded by intense headache, distorted vision, confusion or hyperreflexia. Urgent management includes maternal stabilization, administration of magnesium sulphate to prevent further seizures, blood pressure control and termination of pregnancy when it is safe.
There is no preventive method for these diseases, but it is very important that all women undergo all prenatal controls, which will allow a timely diagnosis and treatment to try to prevent (although if it has to appear it will do the same) pre-eclampsia, to avoid eclampsia from occurring.
Today we know that there is no method that guarantees 100% prevention, but there are measures that can reduce the risk in selected women, such as the use of low-dose aspirin prescribed by a doctor for pregnant women at high risk, and close monitoring with blood pressure checks and urine tests. Prenatal follow-up is key to detecting warning signs early and taking timely action.
But next I want to give you a little more detail about what each of these diseases is about because they are something that women should take ourselves very seriously.
Signs and Symptoms of Preeclampsia
Doctors emphasize the fact that pregnant women should always be vigilant and call immediately in any emergency situation or any strange symptoms they observe. Something that seems strange to us should never be normalized, you will have to call the doctor immediately for the following symptoms of pre-eclampsia:
- Sudden swelling of hands, face and feet
- Severe pain in the upper abdominal region
- Severe headaches that don't go away even if your doctor has prescribed safe pain medication for your pregnancy.
- Blurred vision or appearance of dark spots in vision
- Vomiting
If you detect that you may have preeclampsia in the early stages, you will need to see your doctor immediately so that treatment can be provided. treat as effectively as possible because if it is detected in time It can be prevented from getting worse.
In addition, it is important to know that some women with preeclampsia do not present obvious symptoms at first. In others, it is observed edema showy on hands, fingers and face, with rings that stop fitting, and rapid weight gain (e.g., more than 2 kg in one week) due to fluid accumulation. If preeclampsia progresses, serious symptoms may occur: severe headaches persistent, distorted vision, confusion, hyperactive reflexes, pain in the upper right quadrant of the abdomen, respiratory distress, lower urine volume and very high blood pressure. Rarely, it can trigger a stroke.
Effects on the baby include growth restriction due to decreased placental function, premature birth if early termination of pregnancy is required and, in severe cases, placental abruption. Therefore, if you experience any unusual signs, it is recommended that you seek medical advice immediately.
Signs and symptoms of eclampsia
The characteristic symptoms of eclampsia are seizures. The rest of the signs and symptoms are more or less the same as preeclampsia, although it can vary depending on the degree of involvement. Here is a list of the symptoms that can develop in pregnant women who have pre-eclampsia and develop eclampsia:
- Increased high blood pressure
- Increased amount of protein in the urine
- Abdominal pain
- Cortical blindness
- Nausea and vomiting
- Muscle pains
- Loss of consciousness
Eclampsia can occur suddenly even in women with mild prior symptoms. Sometimes, seizures occur before the onset of symptoms. aura with severe headache, visual changes and general malaise. The priority is maternal stabilization, protect the airway, administer magnesium sulphate to prevent recurrences, control hypertension, and assess the need to safely terminate the pregnancy for mother and baby.
Diagnosis and classification
The diagnosis is based on the combination of high blood pressure and laboratory abnormalities or symptoms. Proteinuria is usually confirmed with 24-hour analysis (≥ 300 mg) or with a positive urine protein/creatinine ratio. Preeclampsia can be classified as mild or with serious features based on blood pressure levels and associated signs (thrombocytopenia, liver or kidney disorders, pulmonary edema, neurological disorders). Even without proteinuria, the presence of these signs with sustained hypertension is a guide to diagnosis.
In consultation, professionals will check the voltage measurements repeatedly to rule out an isolated value. stress situationSymptoms, reflexes, weight, diuresis are also evaluated and tests are performed. blood tests (platelets, liver enzymes, creatinine) and periodic urine. In pregnancies with previous or gestational hypertension, evidence of superadded preeclampsia using these same criteria.
Fetal monitoring includes fetal counting. fetal movements, ultrasound with biometry and Doppler, assessment of growth and amniotic fluid volume. In moderate or severe cases, biophysical profiles and more frequent monitoring are added to anticipate any signs of distress.
Causes of preeclampsia
The exact causes of preeclampsia and eclampsia are unknown But there are certain factors that can be causes or triggers, including:
- La poor blood circulation towards the uterus
- Damaged blood vessels
- Nutrient deficient diet
- Immune system problems
Today it is considered that the key is in a anomalous placental implantation with endothelial dysfunction. Genetic, vascular, and immunological mechanisms are postulated that alter the caliber of the uterine arteries and placental perfusion. The result is a reduced oxygen and nutrient supply for the fetus and a cascade of systemic changes in the mother that raise blood pressure and damage other organs.
Causes of eclampsia
Eclampsia is marked by the onset of seizures, and has similar factors to preeclampsia, although other factors include:
- Obesity
- Mothers with preeclampsia
- Inheritance
- Bad nutrition
- Central nervous system with problems
- Neurological problems
In practical terms, eclampsia is the neurological evolution of preeclampsia when endothelial damage and hypertension affect the brain, causing edema, cortical irritability, and seizures. Although it may occur without severe proteinuria, there is usually a progressive deterioration which requires monitoring and early action.
Risk factors for both diseases
Preeclampsia and eclampsia can attack women who conceive at an early age or above the 40 years in the Making. Although there may be other risk factors such as:
- Genetics
- First pregnancy
- New partners for every pregnancy
- Multiple pregnancies
- Obesity
- Diabetes and gestational diabetes
- Long interval between one pregnancy and another
- The risk of developing eclampsia is higher in nulliparous women (without previous pregnancies) than in those who have already had children.
- Overweight
These factors are added to other well-recognized ones: chronic hypertension, renal disease, thrombophilias, lupus and other autoimmune disorders, family or personal history of preeclampsia, and assisted reproductive technologies. Having had preeclampsia in a previous pregnancy increases the likelihood of recurrence, especially if it occurred early. Those who suffer from untreated chronic hypertension or develop severe preeclampsia are also at greater risk. long-term cardiovascular risk, so postpartum follow-up and healthy lifestyle habits are essential.
HELLP syndrome
El HELLP syndrome It is a severe form related to preeclampsia, defined by hemolysis, elevated liver enzymes and low platelets. It can appear during pregnancy or in the first 48 hours postpartum and manifest with nausea, vomiting, headache, upper abdominal pain, and general malaise. It requires hospitalization, treatment similar to that for severe preeclampsia/eclampsia, possible transfusions and often, termination of pregnancy depending on the clinical situation and gestational age.
Can preeclampsia and eclampsia be treated?
Like all diseases, the best cure or treatment for a disease is prevention. That is why the treatment of pre-eclampsia is aimed primarily at preventing the development of eclampsia. Therefore it is necessary that the baby is born as soon as possible to save his life even if he has to be in the incubator for as long as necessary. However, if the pregnant woman contracts one or another disease in the early stages of pregnancy, delivering the baby early may not be the best option.
If preeclampsia is mild, then the doctor may prescribe medication to lower blood pressure and a relative restThe pregnant woman may even remain in the hospital so that her blood pressure can be closely monitored and her baby can be checked for safety.
If the preeclampsia is too severe and the baby cannot be delivered, then prescribe corticosteroids to the pregnant woman all with accelerate fetal lung maturation and, in some cases, help stabilize platelets in the context of HELLP, helping the pregnancy to resolve as safely as possible.
In the management of tension, safe drugs are prioritized in pregnancy such as labetalol, methyldopa o hydralazineContraindicated medications are avoided, such as ACE inhibitors o angiotensin receptor blockersIn mild preeclampsia, antihypertensives are not always used if the levels do not exceed certain thresholds; the objective is to keep the levels within safe ranges without compromising the placental fluid. It is not recommended to completely eliminate salt from the diet in most cases; it is recommended to maintain a adequate hydration and reduce physical stress, as directed by a doctor.
In the case of eclampsia, it is usually treated with magnesium sulphate which appears to be effective, and is also safe for both mother and baby. If medications fail to control blood pressure and the baby is in fetal distress, accelerate labor safely. When conditions are not suitable or the baby's lungs are not mature enough, then they are given corticoids to the mother. The route of delivery depends on the situation: often the preferred route is induction if possible, and reserves the right Caesarean section When the vaginal route is not viable or maternal/fetal stability dictates it. After induction, symptoms usually subside within hours; after cesarean section, they may persist for a few days.
The time to end the pregnancy is decided according to the gestational age, clinical evolution, and maternal-fetal monitoring results. After a certain point, the risk of continuing the pregnancy exceeds that of premature birth. Before key weeks, prolonging the pregnancy is considered under strict hospital supervision, with daily checks blood pressure, urine output, weight, platelets, liver enzymes and creatinine, as well as serial ultrasounds, biophysical profiles and Doppler.
After giving birth, the mother should stay in observation since preeclampsia can temporarily worsen or debut in the postpartum period. Follow-up is important because these women present a cardiovascular risk higher throughout life; therefore, it is advisable to regularly check blood pressure, cholesterol, and sugar levels and maintain a heart-healthy lifestyle.
When to consult urgently
A pregnant woman should contact her referring professional if she presents new headache that does not respond to permitted painkillers such as paracetamol, sudden swelling of hands or face, visual disturbances, severe pain in the upper right part of the abdomen, difficulty breathing, scanty urine or a sudden weight gainStrange symptoms during pregnancy shouldn't be normalized; early care can prevent complications.
These diseases are part of the hypertensive disorders of pregnancy, which include chronic hypertension, gestational hypertension, and preeclampsia with or without prior chronicity. Understanding the differences between them helps personalize follow-up: gestational hypertension does not present with proteinuria or organ damage and usually disappears after delivery; preeclampsia, on the other hand, is associated with proteinuria or organ involvement, and requires a much tighter control strategy.
Know the signs, comply with the prenatal checkups and following the medical team's instructions is the best way to protect you and your baby. Although its onset cannot always be avoided, early diagnosis and proper management significantly reduce the risk of complications such as eclampsia, placental abruption or restricted fetal growth. If you feel strange or have any symptoms that are not normal, do not hesitate for a second to go to the doctor.
