There are things you can do to lower your risk of developing preeclampsia (high blood pressure in pregnancy). Read up on them now, as May is Preeclampsia Awareness Month.
Preeclampsia is the leading cause of deaths in mothers and babies in poor countries, and affects around 3 to 8% percent of all pregnancies. In South Africa it may be more frequent and occurs in 12% of all first pregnancies, says Dr Jack Moodley, Professor Emeritus in the Department of Obstetrics and Gynaecology at the Nelson R Mandela School of Medicine, University of KwaZulu-Natal.
Known to our moms’ generation as “toxemia”, its exact cause is still not known – but it seems tissue within your placenta doesn’t develop as it should, and your blood vessels constrict, raising your blood pressure while reducing blood flow.
Unchecked, this can cut off important nutrients and oxygen to your unborn baby, affecting their development, and to your own vital organs, including your liver, kidneys, heart, lungs and brain. Preeclampsia usually sets in after 20 weeks of pregnancy, but the earlier you recognise the signs and get help, the better.
Watch for high blood pressure, high protein levels in your urine (your health professional should monitor these, says Moodley), reduced urine, water retention (swollen hands and feet), headaches, intense pain in your upper abdomen, dizziness, tiredness, persistent nausea and vomiting (more than morning sickness), rapid weight gain (one or two kg in just a week or so), blurred vision and vaginal bleeding (a warning that the placenta is separating from your uterus).
Eventually, if eclampsia itself sets in (fits, seizures or convulsions in pregnancy), you can have heart failure and fall into a coma.
Be alert, and take smart steps early
1. Plan your pregnancy
Aim to achieve a healthy body weight (BMI of 19-25 or at least under 30), and get in good physical shape before you conceive. Obesity and yo-yo dieting can harm your hormone levels and metabolism, raising your risk for preeclampsia. “It’s important to visit your doctor before conceiving because if you have a family history of high blood pressure, or have had high blood pressure in a previous pregnancy, or a baby died for unexplained reasons during the pregnancy or after birth, the doctor may prescribe a calcium-rich diet before pregnancy and start low dose aspirin from about the fourth month of pregnancy,” says Dr Moodley.
2. Eat to keep both your weight and your blood pressure in check
Cut back on salt and have a variety of wholesome foods high in vitamins, minerals like potassium, and antioxidants – this means fruit and vegetables (especially leafy greens, sweet potatoes, bananas and avocados); a little meat, oily fish (high in omega fatty acids) and eggs (well cooked) for protein; and dairy products for calcium. Your health-care provider may suggest additional supplements.
3. Stay well hydrated
Drink six to eight glasses of water a day and cut back on caffeine (coffee, fizzy drinks).
4 .Get plenty of rest
Aim for at least seven hours of sleep a night, and take time to put your feet up and unwind with music, yoga or supportive friends, to help combat stress.
5. Get checked regularly
Most importantly, see a health-care professional from the start of your pregnancy, to establish if you have blood pressure problems and manage them – keep up regular visits to monitor them. You are at special risk of preeclampsia if you have high blood pressure or if an immediate family member does, and if you smoke, take drugs, eat badly, are obese or have chronic stress. Having IVF or carrying multiple babies also raises your risk, as does a history of autoimmune or other disorders, such as diabetes, lupus, rheumatoid arthritis and kidney disease. Studies suggest age too is a factor: if you are over 40 or under 20, you may be more prone to preeclampsia.
6. Monitor baby
If you develop signs of preeclampsia (especially severe headaches that don’t respond to painkillers, abdominal pain, blurred vision or swelling of your feet or face, or if you notice a change in your baby’s movements, see your health-care professional straight away. “Monitor your baby’s movements regularly,” says Moodley.
7. What to do
Finally, if you do develop preeclampsia, know that the chances of having an induction of labour or Caesarean section before term are much higher than for women who don’t have high blood pressure. And you will need to be seen frequently and have blood investigations during the antenatal period. “A modern trend is to measure your own blood pressure at home, and the prices of these machines have dropped in the last five years,” Moodley says. “It puts you at an advantage, because if your blood pressure spikes, you can contact your doctor immediately.”
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