Pre-eclampsia is a pregnancy complication   usually characterized by elevated blood pressure in pregnancy and at times swelling of the feet and body.It affects about 5-8% of the pregnancies.

The severe forms of pre-eclampsia causes serious complications which may cause death of the mother and baby if not aggressively treated.Infact severe pre-eclampsia is deadly hence a major killer of women and their babies in our country. The survivors may suffer long term complications such as chronic kidney failure and paralysis.

The cause of this disease is not known. Its also very difficult to predict women who will develop preeclampsia. Every pregnant woman is usually at risk. However  certain groups of women seem to be at higher risk  of developing pre-eclampsia.Those at higher risk include women who have had pre-eclampsia in prior  pregnancy, those at extremes of age<20 years and > 35 years, women with pre-existing high blood  pressure and women with diabetes.

Mild forms of pre-eclampsia may have no symptoms. Severe forms at times may have symptoms due to complications involving major body organs. The symptoms include severe headache, blurred vision, upper abdominal pains and body swelling involving the legs and face. There may be a reduction in urine production when kidneys are affected. At times a pregnant woman may fit or loss consciousness. When pre-eclampsia is complicated by a fit it is referred as ECLAMPSIA. Eclampsia is a very severe form of the disease and can easily cause death.

Detection of pre-eclampsia requires quality antenatal care .Blood pressure must be checked during all the visits. Women at higher risk may require closer followup.Early detection allows early management and close surveillance for complications.

Treatment of severe cases involves blood pressure control, control and prevention of fits and delivery. Delivery is the ultimate treatment of pre-eclampsia.Control of blood pressure only prevents bleeding into the brain but does not prevent other complications. In severe forms delivery may be instituted much earlier before the expected date of delivery to save the life of the mother and at times that of the baby.

Complications associated with pre-eclampsia  include:  kidney failure which may necessitate lifetime dialysis,blindness,bleeding in the brain(stroke) which may cause death or paralysis, difficulties in breathing( pulmonary oedema) which may require intensive Care( ICU )care and rupture of the liver. The fetus may equally be affected and may fail to grow as expected and fetal death may occur in some cases. Pre-eclampsia is associated with very high fetal wastage.

Prevention involves good antenatal care to detect the complication early and institute treatment. Early detection and treatment is crucial to improve outcomes and prevent complications and death. Women at risk  of pre-eclampsia  should be  given  medication to  prevent pre-eclampsia from developing.