Back in the 1920's, little was known about pre-eclampsia (PE) and less was known how to survive from it. Over the last century, we have learned a great deal about this disease and much can be done to lessen it's effects on you or your baby. For many years, it has been taught in my midwifery circles that PE can be a nutritional disease. I do not believe that is the case for all PE moms. No matter how much protein or essential fatty acids you consume, if your placenta or baby is not growing well by 32 weeks, you may develop PE. One reason it can occur is when substances excreted by the placenta cause a dysfunction of the endothelial or inner walls of the blood vessels. Another cause can be an inflammatory response which occurs when the sperm meets the egg at conception. This leads to maternal damage of the kidneys, liver, and blood vessels.
In the last few months, I have known (or had aquaintences who knew of) three 1st time mothers who developed pre-eclampsia. I was taught that pre-eclampsia is a risk mostly for 1st time mothers. What I didn't know was that it could occur in any pregnancy. For this reason, I feel you should know the signs and symptoms of this disease. Your knowledge could be very helpful to another pregnant mom who is wondering if she should call her doctor.
Headaches, blurred vision, spots before the eyes, confusion, pain in your upper right abdomen, a feeling that something isn't quite right, and sometimes swelling in your hands, face or feet; all are reasons to call your doctor and be seen in his office that day.
A 24 hour urine sample needs to be collected as well as blood drawn to check for protein and liver enzymes. Your blood pressure will be monitored for any significant changes. The only cure is delivering the baby. Symptoms can be managed by medication until baby's lungs have matured with steroids but if that is not working, then delivery is your only option.
Women who went thru this ordeal are at high risk for Post Traumatic Stress Syndrome and Post Partum Depression. Be sure to stay in contact with your friend and offer your support, or refer your friend to a specialist who can offer medical treatment.
HELLP stands for hemolysis (the breakdown of red blood cells) Elevated Liver enzymes, Low Platelet count.
HELLP syndrome occurs in about 1 - 2 out of 1,000 pregnancies yet in 10-20% of pregnant women who also have severe preeclampsia or eclampsia. Fatigue, headaches, neck, shoulder or upper abdominal pain, swelling, bleeding gums, nausea & vomiting in your 3rd trimester are symptoms. You may or may not have moderately high blood pressure or protein in your urine. HELLP is hard to diagnose since it masks other diseases of pregnancy which may mean 8 days before your doctor knows for sure.
You're more likely to get HELLP syndrome if you're white and older than 25 years of age. You are also more likely to get it if you have had children before or if you had a problem with a PE in the past.
Treatment can be steroids, monitoring, blood transfusion, or delivery of your baby. Support groups and more information is widely found online.
The itching can begin in late second or early third trimester of your pregnancy with approximately 1% of pregnancies ending with ICP. Itching is one of the first indications, be sure to let your provider know right away.
There is no clear cause of this liver disorder although hormonal (high levels of estrogen), environmental (selenium deficiency) family history (gallstones & oral contraceptive use) and seasonal (higher incidence in winter months) can play an important role.
ICP also has a high recurrence rate suggesting that certain people are innately susceptible to developing ICP in subsequent pregnancies.Diagnosis of ICP comes after excluding all other diseases. It's important that treatment begins
immediately, for the baby's sake. Treatment is medicine to lower certain bile acids and, of course, delivery by 37 weeks gestation.