By Pre-eclampsia is a potentially life-threatening pregnancy complication that results in approximately 46 000 maternal deaths and around 500 000 foetal or newborn deaths according to The World Health Organization . Characterised by high blood pressure and signs of damage to organs, liver and kidneys, pre-eclampsia typically arises after the 20th week of pregnancy and, if left untreated, can lead to serious, even fatal, complications for both mother and baby. Even though the exact cause of pre-eclampsia remains unknown, it is believed to stem from abnormal development of blood vessels in the placenta. Common symptoms may include elevated blood pressure (140/90 mmHG or higher on more than two occasions), protein in the urine (more than 300 mg per 24 hours), severe headaches, blurred vision, sudden weight gain (1-2kg/week), vomiting and swelling of the hands and face.
Routine monitoring of blood pressure during pregnancy is essential, as early detection is key to managing the condition effectively, according to Lizeth Kruger, Clinic Executive at Dis-Chem, who is calling on all pregnant women to stay alert to the signs.
“Pre-eclampsia doesn’t always announce itself loudly, but the consequences of missing it can be fatal,” she warns. “Understanding what to look out for and seeking medical care early can save lives.” As part of a commitment to preventative care and maternal wellbeing, Kruger is raising awareness about pre-eclampsia and equipping expectant mothers with the knowledge needed to protect their health and that of their babies. Below, Kruger outlines the range of complications that can arise when the condition is left unchecked and why proactive care makes all the difference.
Maternal complications of pre-eclampsia
Often developing silently, pre-eclampsia can have devastating effects if left untreated or poorly controlled. Maternal complications include the following:
· Seizures (Eclampsia):
The most severe form of pre-eclampsia, eclampsia is marked by seizures not linked to other neurological conditions. Caused by high blood pressure affecting the brain, seizures can lead to unconsciousness or coma. It requires immediate stabilisation, emergency delivery, and intensive care. Though rare in developed systems, eclampsia remains a global cause of maternal death.
· Stroke:
Pre-eclampsia’s high blood pressure significantly raises stroke risk during pregnancy, especially haemorrhagic stroke. This can lead to brain damage, paralysis, or death. Even with treatment, strokes may cause lasting disabilities, highlighting the importance of blood pressure control.
· Kidney failure:
High blood pressure and reduced blood flow in pre-eclampsia can impair kidney function, causing acute injury. This may result in waste build-up, reduced urine, and swelling. Severe cases may need dialysis. Kidney function often improves post-delivery, but lasting damage is possible.
· Liver damage:
Pre-eclampsia can inflame the liver, potentially leading to liver haematoma or rupture both emergencies with high mortality risk. Symptoms like upper abdominal pain, nausea, or vomiting require urgent evaluation.
· HELLP Syndrome (Haemolysis, Elevated Liver Enzymes, Low Platelets):
A life-threatening complication, HELLP affects the blood and liver, marked by red cell destruction, liver dysfunction, and low platelets. Symptoms can mimic other conditions, complicating diagnosis. Without quick treatment, HELLP can cause liver rupture, bleeding, stroke, or death.
· Postpartum pre-eclampsia:
This can develop after delivery, typically within 48 hours, but up to six weeks post-birth. Symptoms include headache, vision changes, abdominal pain, and swelling. It carries the same risks as prenatal pre-eclampsia, including seizures and stroke. Early recognition and urgent care are vital.
Foetal complications of pre-eclampsia
As much as people may think that pre-eclampsia is only dangerous to the mother, this also greatly affects the baby. Pre-eclampsia not only puts the mother at risk but also significantly compromises foetal health and development. One of the key challenges with this condition is its impact on placental function, which is crucial for delivering oxygen and nutrients to the developing baby. When blood flow to the placenta is reduced, as is often the case with pre-eclampsia, the baby may face a range of serious health complications mentioned below.
· Premature birth:
Pre-eclampsia is a major cause of medically indicated preterm birth, often prompting doctors to recommend early delivery to safeguard the health of the mother or baby if the condition deteriorates. This can occur before 37 weeks of gestation and, in more severe cases, even before 34 weeks. Babies born prematurely face an increased risk of complications such as respiratory distress syndrome due to underdeveloped lungs, feeding difficulties, problems maintaining body temperature, infections, and potential long-term developmental delays or disabilities.
These infants often require intensive care in a neonatal intensive care unit (NICU) for days or weeks after birth.
· Low birth weight:
Restricted placental blood flow can result in intrauterine growth restriction (IUGR), a condition in which the baby does not grow at the expected rate during pregnancy. This is commonly seen in babies born to mothers with pre-eclampsia, who often weigh less than 2,5 kilograms at birth. Low birth weight is linked to a range of health challenges, including difficulty feeding and gaining weight, low blood sugar levels, problems maintaining body temperature, and compromised immune function.
These infants face an increased risk of developing chronic conditions later in life, such as diabetes and heart disease. Babies with low birth weight may require specialised care and extended hospital stays after birth.
· Placental abruption:
Placental abruption is a rare but highly dangerous complication of pre-eclampsia, characterised by the premature separation of the placenta from the uterine wall. Since the placenta is responsible for delivering oxygen and nutrients to the foetus, this separation severely disrupts the baby’s supply of both. As a result, the condition can lead to several serious outcomes, including severe uterine pain accompanied by signs of foetal distress or a noticeable absence of foetal movement, and the risk of preterm birth. In the most severe cases, placental abruption can result in stillbirth.
“Pre-eclampsia may be a complex condition, but with consistent prenatal care, early detection, and the right medical support, we can significantly reduce its serious risks. I always urge expectant mothers to attend every checkup, speak up about any unusual symptoms, and prioritise a healthy lifestyle,” said Lizeth Kruger