What is the Treatment for Pre-Eclampsia?
Ultimately the only treatment is delivery of the baby. This may be fine if a woman is, say, 38 weeks gestation, but at 30 weeks, it becomes much more of a dilemma.
In the later stages of pregnancy, it is normal to induce labour, but early on if delivery is decided upon, caesarean section is more usual. It's an individual decision and must be tailored to the patient and her disease severity.
For mild to moderate pre-eclampsia when a woman is prior to term, admission to hospital is needed and assessment of the severity of the disease carried out.
In addition to regular examinations, the following tests are commonly arranged:
- 4-6 hourly blood pressure checks - BP in preeclampsia can go up and down very quickly. It might be fine when you're first admitted, but if it shot up high and you were in hospital, at least we would know about it.
- 24 hour urine collection - to estimate total protein. Also checks on each specimen are done to see if its suddenly getting worse (eg. 1+ to 3+ over a day, maybe associated with increasing BP)
- Blood tests - more guides to the severity of the disease - blood count, kidney & liver function tests.
- Ultrasound scan - to check on the growth of baby. Pre-eclampsia can cause small babies, and it is important to identify this if its present. Also we check on the water around the baby (liquor volume). If the placenta isn't working as well as it might, the liquor volume may be reduced. A watch on the baby's movements & breathing can be made to see if its still as active as usual.
- CTG's - or monitoring of the baby's heart with the belt straps and doppler pick-up. Usually done once daily.
By repeating these tests over a few days, your obstetrician can get an idea of how the disease is progressing, if it is getting worse or staying the same and plan when delivery might be best. Also staying in hospital encourages rest, which helps the blood pressure to settle.
I've had Pre-Eclampsia/Eclampsia. Will it happen again?
Pre-eclampsia is more likely to happen in a second pregnancy if one has suffered it before. Mild pre-eclampsia at term is less likely to recur (5-10%) and when it does, it's usually mild again.
After severe pre-eclampsia, recurrence rate is about 20-25% in subsequent pregnancies. After eclampsia, about 25-30% of subsequent pregnancies will be complicated by pre-eclampsia, but only 2% with eclampsia again.
Chronic hypertension is more common after pre-eclampsia, affecting about 15% at 2 years. It is more likely after eclampsia or severe pre-eclampsia (especially if recurrent or occuring during the 2nd trimester), affecting 30-50% of women.