Questions and Answers About Preeclampsia

Introduction - Preeclampsia Screening

Preeclampsia is a condition that begins early in pregnancy.

Its diagnosis is based on signs and symptoms and is only possible once the condition manifests.

First-Trimester Preeclampsia Screening allows for the early identification of a pregnancy at high risk for preeclampsia.

In the following article, we aim to answer the most frequently asked questions about preeclampsia.

If you have any additional questions, please email us at prenatal@cm-lab.com or call 212 693 530. We also recommend reading the article on the preeclampsia screening test.

Table of Contents

• What Is Preeclampsia?
• What is Eclampsia?
• At what stage of pregnancy can preeclampsia occur?
• How is preeclampsia diagnosed? What are the symptoms and signs of preeclampsia?
• What Is First-Trimester Preeclampsia Screening?
• What factors should be considered for first-trimester preeclampsia screening?
• When should the biochemical test be performed?
• What is the detection rate for first-trimester preeclampsia screening?
• How long does it take to receive the results of the first-trimester preeclampsia screening?
• What is PlGF (Placental Growth Factor)?
• What maternal complications can occur with preeclampsia?
• Is preeclampsia common in pregnant women?
• What can happen if preeclampsia goes undiagnosed?
• What is HELLP syndrome?
• Are some people more prone to preeclampsia?
• Can newborns of women with preeclampsia have problems?
• After the baby is born, what can happen to the mother?
• What is the treatment for preeclampsia?
• What should you do to prevent preeclampsia?
• If you had preeclampsia during your first pregnancy, is there a risk of having it again?

What is preeclampsia?

Preeclampsia is a condition that begins early in pregnancy and is characterized by: New-onset hypertension > 140/90 mmHg (elevated blood pressure); Proteinuria (> 0.3 g/24 hours) (presence of protein in the urine) and newly developed edema.

What is eclampsia?

Eclampsia is a pregnancy-related condition resulting from dysfunction of the uteroplacental bed, involving remodeling of the spiral arteries and hemodynamic impairment, leading to vasoconstriction, platelet aggregation, and hypercoagulability.

It is a very serious complication of pregnancy characterized by the onset of seizures, preceded by increased albuminuria, high blood pressure, edema, oliguria, dizziness, ringing in the ears, persistent headaches, fatigue, drowsiness, and vomiting. The onset of this condition can lead to life-threatening complications for both the fetus and the mother.

At what stage of pregnancy can preeclampsia occur?

Clinical symptoms typically occur only in the second or third trimester.
Preeclampsia most commonly manifests after 20 weeks of gestation and can be subdivided into:- Early Preeclampsia if it occurs before 34 weeks, Intermediate Preeclampsia if it occurs between 34 and 37 weeks, and Late Preeclampsia if it occurs after 37 weeks.

How is preeclampsia diagnosed? What are the symptoms and signs of preeclampsia?

The diagnosis of preeclampsia (PE) is based on signs (hypertension, tachycardia, and tachypnea; crackles or wheezing on auscultation; neurological deficits [focal signs]; hyperreflexia; petechiae, intracranial hemorrhages, generalized edema) and symptoms (headaches, visual disturbances, amnesia, seizures, anxiety, abdominal pain).
A diagnosis is only possible once the condition manifests.

What is First-Trimester Preeclampsia Screening?

First-Trimester Preeclampsia Screening allows for the early identification of a pregnancy at high risk for preeclampsia and increases the likelihood of a better prognosis for that pregnancy.

Preeclampsia screening involves estimating the risk of developing the condition before any signs or symptoms appear.

What factors should be considered for first-trimester preeclampsia screening?

First-trimester preeclampsia screening primarily considers four factors: maternal history, biophysical markers, ultrasound markers, and biochemical markers.

• Maternal history should include a personal or family history of preeclampsia, parity, medically assisted reproduction, diabetes mellitus, ethnicity, and extreme reproductive ages (<18 years; >37 years).
• Biophysical markers include the Body Mass Index (BMI) and Mean Arterial Pressure (MAP).
• Ultrasound markers include the uterine artery pulsatility index (uA-PI).
• Biochemical markers include pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PlGF).

When should the biochemical test be performed?

Biochemical testing for PAPP-A and Placental Growth Factor (PlGF) should be performed at 10–13 weeks and 6 days of gestation.

What is the detection rate for first-trimester preeclampsia screening?

When biophysical, ultrasound, and biochemical markers are combined, the detection rate is 93%.

How long does it take to receive the preeclampsia screening results?

After the blood sample is collected, the results report with the preeclampsia risk calculation will be sent directly to the prescribing physician within 24 hours of the sample’s arrival at the laboratory.

What is PlGF (Placental Growth Factor)?

PlGF is produced by the placenta and is an angiogenic factor that acts as a vasodilator, increasing the diameter of existing arteries.

Low levels of PlGF contribute to vascular dysfunction, which is one of the symptoms of preeclampsia. PlGF levels are reduced in a high percentage of pregnancies that progress to preeclampsia. This reduction is most pronounced in the first trimester.

PlGF is the ideal marker for early screening of the risk of preeclampsia.

What maternal complications can occur with preeclampsia?

There are several maternal complications that can occur with preeclampsia, such as permanent neurological damage, kidney failure, an increased risk of essential hypertension, and premature placental abruption of a normally inserted placenta (DPPNI); death may occur, and recurrence is seen in 25% of pregnancies.

Is preeclampsia common among pregnant women?

The prevalence of preeclampsia in Portugal is 2% of pregnancies.

What can happen if preeclampsia is not diagnosed?

If preeclampsia is not diagnosed, it progresses to HELLP syndrome.

What is HELLP syndrome?

HELLP syndrome is a life-threatening obstetric complication.

HELLP is an acronym for the three main components of the syndrome

• Hemolysis
• Elevated Liver Enzymes
• Low Platelet Count

Are some people more prone to preeclampsia?

It is more common in first pregnancies and in women who already have high blood pressure or who have a blood vessel disorder.

Can newborns of women with preeclampsia have problems?

Yes, newborns of women with preeclampsia are 4 to 5 times more likely to have problems shortly after birth than those of women who do not have this condition. Newborns are usually small because the placenta did not function properly or because they are premature.

After the baby is born, what might happen to the mother?

Usually, blood pressure returns to normal after delivery, but it may take a few weeks.

The mother’s blood pressure is monitored during the first 48 hours after delivery, and she should continue to have her blood pressure checked during the following period.

What is the treatment for preeclampsia?

There is no specific treatment for preeclampsia; rest is recommended, along with managing high blood pressure, controlling seizures, and preventing their recurrence. The definitive treatment is the delivery of the baby and the removal of the placenta.

Preeclampsia does not respond to diuretics or low-salt diets.

It is important to rest and closely monitor blood pressure during follow-up visits.

In cases of severe preeclampsia, the patient should be hospitalized to assess the situation and determine the most appropriate treatment.

What can you do to prevent preeclampsia?

There is no way to prevent preeclampsia; attention should be paid to the pregnant woman’s medical questionnaire and family history, as well as her potential symptoms. Blood pressure should be checked regularly, and a qualitative evaluation of a urine sample should be performed.

If you had preeclampsia during your first pregnancy, is there a risk of having it again?

Preeclampsia is more common in multiple pregnancies, in women over 35, and in the presence of immune system disorders.

The risk of developing preeclampsia in a second pregnancy is much lower than in the first pregnancy.

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