Preeclampsia is a problem that occurs in pregnant women. It is seen to affect 2 out of every 100 women.  It occurs during pregnancy associated with high blood pressure in the mother, and high protein levels in the urine. It is also known as toxemia of pregnancy.

Preeclampsia Symptoms:

The symptoms of preeclampsia include:

• sudden weight gain,
• severe headaches,
• visual disturbances,
• upper abdominal pain
• excessive swelling in face, hands, feet, and legs

Often, these are mistaken as the normal symptoms of pregnancy. Hence, it often goes untested in the first trimester of pregnancy. Tests like the dual marker help in the early identification of the risk for this condition. Usually, these symptoms start to be seen after 20 weeks of pregnancy. One of the important features of the disease is that it may impede blood flow, oxygen, and nutrient supply to the baby from the mother.

Types of Preeclampsia

There are several types of preeclampsia, depending on when it occurs during pregnancy. These are:

• Early-onset: This occurs when preeclampsia affects the mother less than 34 weeks of gestation. This progresses quickly and has severe complications.
• Late-onset: Occurs after 37 weeks of gestation, and has a less severe effect on the fetus.

Associated Issues

A positive preeclampsia diagnosis may also be accompanied by other issues. These include:

• Short term complications may include occasional seizures.
• Other long-term issues include cardiac problems.

Early preeclampsia screening (1st trimester)

Screening for preeclampsia in the beginning stages of pregnancy can save unfortunate events. It allows higher-risk patients to opt for immediate care. It also allows the effective usage of low-dose aspirin to combat the issue. Biomarkers used to study preeclampsia are:

• Pregnancy-associated plasma protein A
• Beta Hcg
• Placental growth factor protein (reduced levels seen in Down’s Syndrome diagnosis for child)

Abnormal levels of these may help to identify early preeclampsia.

Medications:

• The use of low dose aspirin (75-150mg daily) can reduce the chance of getting preeclampsia by 50-90%. However, it needs to be started at less than 16 weeks of gestation to have a significant effect.

2nd Trimester Screening for Preeclampsia

Blood pressure and the presence of urine can usually tell the Sureshot presence of preeclampsia. However, other markers include

• Soluble FMS like tyrosine kinase. This is useful in the formation of blood vessels.
• Placental growth factor protein

The ratio between sFlt and PIGF can predict preeclampsia pretty accurately, as it helps gauge hypertension, and also predict the possibility of an adverse outcome from preeclampsia (in women gestating less than 34 weeks, adverse outcomes from up to 2 weeks later can be predicted). A ratio of 38 or lower can predict the short-term absence of preeclampsia. Higher ratios may predict the disease, as well as the impediments placed on the growth of the fetus as a result of the issue.

Some Advice for Pregnant Mothers

• The first-trimester screening should be carried out at 11-13 weeks. This is especially recommended for early-onset preeclampsia. As mentioned earlier, 3 biomarkers are used in this test.
• The sFlt-1/PGIF ratio is to be done at 20 weeks of gestation, and if done after 24 weeks, can predict if any adverse outcomes can arise from preeclampsia. A ratio of 38 or lower can predict the short-term absence of the issue at 20 weeks, whereas higher ratios can predict growth restrictions for a fetus.