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Should the mother read anything into oedema (or swelling) of limbs?
Not much. 80% of pregnant women have some degree of swelling of limbs, mostly the feet, ankles and fingers (rings are tight!). Some will have gross oedema without any hint of raised blood pressure.
The oedema is largely a function of the normal physiological changes happening during pregnancy.
However, patients with pre-eclampsia have an increased tendency to develop pronounced oedema which may also be more generalised, affecting such unusual areas as the face causing puffiness.
The bottom line, however, is that the presence of oedema does not diagnose pre-eclampsia, and, more significantly, its absence does not rule out the condition or lessen its severity.
The bottom line, however, is that the presence of oedema does not diagnose pre-eclampsia, and, more significantly, its absence does not rule out the condition or lessen its severity.
What will ultimately be done?
The aim is to ensure delivery of a healthy baby without putting the mother at risk.
If the condition is getting worse in spite of all the measures, immediate delivery is the only option. This is to prevent eclampsia, which could potentially seriously harm both the mother and the baby. It could even kill them.
If the mother is very far from term, the method of delivery is likely to be a caesarean section, as induction of labour is unlikely to be successful at least, not quickly enough. If she is nearer to term, let's say thirty-five weeks of gestation or more, induction of labour is a viable alternative. The mother's condition will be closely monitored all the time and, if it is seen to be worsening, the induction process may be halted and delivery achieved by caesarean section.
The decision on how to proceed will depend on a combination of factors including the severity of the condition, whether the mother can be induced, fetal condition (which may be compromised), and the mother's own wishes.
If the mother is very far from term, the method of delivery is likely to be a caesarean section, as induction of labour is unlikely to be successful at least, not quickly enough. If she is nearer to term, let's say thirty-five weeks of gestation or more, induction of labour is a viable alternative. The mother's condition will be closely monitored all the time and, if it is seen to be worsening, the induction process may be halted and delivery achieved by caesarean section.
The decision on how to proceed will depend on a combination of factors including the severity of the condition, whether the mother can be induced, fetal condition (which may be compromised), and the mother's own wishes.
Each individual case is unique and there are no fixed rules.
Overall, what are the potential complications of pre-eclampsia?
Apart from affecting the growing fetus, the disease affects various organs in the mother's body.
Apart from affecting the growing fetus, the disease affects various organs in the mother's body.
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There may be growth restriction in which case the baby will be very small with all the attendant potential problems.
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There is a high rate of prematurity which is associated with higher rates of morbidity and even mortality for the newborn.
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Premature separation of the afterbirth (placental abruption) may occur. The rate of fetal loss, as a consequence of this, is very high.
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The mother may suffer vital organ failure, such as liver or kidneys.
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Increased bleeding complications as a result of the inability of blood to clot. This is one of the less common but potentially very serious complications of severe pre-eclampsia.
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Stroke may result from severe pre-eclampsia.
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Eclampsia.
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Pre-eclampsia gets its name from the fact that, it is the condition which precedes eclampsia. Historically, eclampsia was an issue because, with less than perfect antenatal care, this was sadly a common culmination of this syndrome. Nowadays, it is not uncommon for a doctor to go through training and practice to retirement without seeing a case of eclampsia.
Basically, eclampsia is generalised convulsions or seizures with loss of consciousness, indistinguishable from an epileptic seizure. It is the ultimate complication of pre-eclampsia. All measures instituted in pre-eclampsia are geared towards preventing this from happening.
Basically, eclampsia is generalised convulsions or seizures with loss of consciousness, indistinguishable from an epileptic seizure. It is the ultimate complication of pre-eclampsia. All measures instituted in pre-eclampsia are geared towards preventing this from happening.