Pre-eclampsia / Eclampsia

Pre-eclampsia is a pregnancy-specific condition characterised by new-onset high blood pressure and signs of organ damage (commonly affecting the kidneys and liver), usually developing after 20 weeks of pregnancy. If untreated, it can progress to eclampsia — the onset of seizures — a life-threatening emergency for both mother and baby. Hypertensive disorders of pregnancy, including pre-eclampsia and eclampsia, remain a leading cause of maternal death in Nigeria, making early detection through regular antenatal care essential.

Pre-eclampsia can develop gradually and, in its early stages, may cause no symptoms at all — which is why routine blood pressure and urine checks at every antenatal visit are so important. When symptoms occur, they can include: • High blood pressure, often detected first at a routine antenatal visit • Protein in the urine (detected on a urine dipstick test) • Swelling of the face, hands, or feet (some swelling is normal in pregnancy, but sudden or severe swelling is a warning sign) • Persistent headache that doesn't improve with simple painkillers • Visual disturbances: blurred vision, flashing lights, or spots • Upper abdominal pain, usually under the ribs on the right side • Nausea or vomiting in the second half of pregnancy • Sudden weight gain over a few days • Reduced urine output

The exact cause of pre-eclampsia is not fully understood, but it is thought to begin with abnormal development of the blood vessels supplying the placenta early in pregnancy, leading to reduced blood flow and the release of substances that damage the mother's blood vessels and organs. Eclampsia occurs when pre-eclampsia progresses and affects the brain, triggering seizures.

• First pregnancy • Previous pre-eclampsia in an earlier pregnancy • Multiple pregnancy (twins or more) • Pre-existing hypertension, diabetes, or kidney disease • Obesity • Age under 20 or over 35 • Family history of pre-eclampsia • Long interval between pregnancies • Limited or late antenatal care

• Eclampsia (seizures), a life-threatening emergency • HELLP syndrome (a severe complication involving the liver and blood clotting) • Stroke • Placental abruption (the placenta separating from the womb early) • Restricted growth of the baby, and premature birth • Stillbirth or newborn death in severe, untreated cases • Long-term cardiovascular risk for the mother after pregnancy

Pre-eclampsia cannot always be prevented, but risk can be reduced and complications minimised through: • Attending all scheduled antenatal appointments for early detection • Taking low-dose aspirin from early pregnancy if advised by a doctor for high-risk pregnancies • Managing pre-existing conditions such as hypertension and diabetes before and during pregnancy • Maintaining a healthy weight before pregnancy where possible • Reporting any warning symptoms to a healthcare provider immediately, rather than waiting