How Preeclampsia Puts Mothers at Risk

Patients come to me asking, "Doctor, I just thought it was swelling, isn't that normal in pregnancy?" Yes, it is. But sometimes, it's not. And that's exactly what makes preeclampsia a deceptive condition. And unless we're watching closely, it can take a turn for the worse. 

Let's understand what preeclampsia actually is because most people think it's just "high BP in pregnancy", but it's not just that. It's a multi-system disorder that can escalate fast and unpredictably. 

What Is Preeclampsia?

Preeclampsia is a condition that can occur after the 20th week of pregnancy. It is usually marked with high blood pressure (140/90 mmHg or more) and proteinuria (protein in the urine) or signs of organ damage like increased liver enzymes and low platelets. 

Globally, preeclampsia and related hypertensive disorders of pregnancy are one of the leading causes of maternal mortality. In fact, they account for nearly 10 to 15 % of maternal deaths worldwide. And it's not just in low-resource settings. Even hospitals and clinics with standard care, if not detected and managed early, can have tragic outcomes. 

Who Is at Risk?

Some patients are more likely to develop preeclampsia because of certain risk factors. The more risk factors you have, the higher your personal chance of developing preeclampsia during pregnancy. This is known as your individual risk or in simpler terms, your unique, personal likelihood of getting the condition.

Some of these risk factors are modifiable, i.e. things you may be able to address before pregnancy, such as high blood pressure, obesity or poorly controlled diabetes. Others are completely out of your control, like family history or having had preeclampsia in a previous pregnancy.

But it's important to know that even people with no identifiable risk factors can still develop preeclampsia.

Now, Why Is It Dangerous?

The main threat lies in what preeclampsia does to the body. It affects the blood vessels and the organs. It can lead to stroke, kidney failure, liver rupture, fluid in the lungs (pulmonary edema), placental abruption and most fatally, eclampsia, which involves seizures and carries a higher risk of death if not immediately treated.

Another severe variant, HELLP syndrome, can cause internal bleeding, liver damage and clotting problems. If not caught and managed early, these complications can become life-threatening in a matter of hours. 

From a medical standpoint, the mechanisms are complex, but here’s what’s happening - preeclampsia originates in the placenta, where the blood vessels don’t develop properly. This leads to restricted blood flow, systemic inflammation and widespread damage to the endothelium (the lining of blood vessels). The result? Pressure builds, organs begin to fail and both the mother and baby are in danger.

The problem here is that preeclampsia doesn't always present with textbook symptoms. When checking patients, we look for swelling, headaches, upper abdominal pain, sudden weight gain and visual changes, but sometimes, there are no warning signs until it's already severe. And that is why routine blood pressure checks and urine tests during prenatal visits are so important. 

Management often involves medication to control blood pressure and prevent seizures. But in many cases, delivery remains the only definitive option. Sometimes, that means making the tough call to deliver the baby early to save the mother’s life.

The risk doesn’t disappear after birth, either. Some women can develop preeclampsia postpartum and maternal deaths can occur days or even weeks after the delivery. That’s why postnatal monitoring is just as critical. 

So, if you’re pregnant or planning to be, please take preeclampsia seriously. Know the symptoms. Keep up with antenatal check-ups. Check your blood pressure regularly and if something feels wrong, seek care immediately.