How preeclampsia turns hypertension into a deadly pregnancy crisis – Firstpost

Preeclampsia, a serious hypertensive disorder of pregnancy, affects 2–8% of pregnancies globally and remains a leading cause of maternal and new-born deaths, claiming around 46,000 maternal lives and 500,000 fatal or neonatal deaths each year.

Despite being preventable and treatable, particularly with magnesium sulphate, its use remains limited in many low-resource settings. Preeclampsia and eclampsia are responsible for up to 25% of maternal deaths in Latin America and around 10% in Asia and Africa, underlining the urgent need for early detection and awareness.

Firstpost spoke with Dr. Neha Gupta, Additional Director – Obstetrics and Gynecology at Fortis Hospital (Noida) who shared critical insights into the condition and why vigilant screening and postnatal care are essential.

How does preeclampsia put mothers at risk?

Dr Neha: Patients often come to me saying, “Doctor, I just thought it was swelling—isn’t that normal in pregnancy?” Yes, mild swelling can be normal. But sometimes, it’s not—and that’s exactly what makes preeclampsia so deceptive. Unless we’re monitoring closely, it can take a sudden turn for the worse.

Most people assume preeclampsia is simply “high BP during pregnancy,” but it’s much more. It’s a multisystem disorder that can escalate rapidly and unpredictably.

What is preeclampsia?

Dr Neha: Preeclampsia typically occurs after the 20th week of pregnancy. It’s marked by high blood pressure (140/90 mmHg or higher), protein in the urine (proteinuria), or signs of organ damage such as elevated liver enzymes and low platelet counts.

Globally, preeclampsia and related hypertensive disorders are among the leading causes of maternal mortality, contributing to nearly 10–15% of maternal deaths worldwide. And this isn’t limited to low-resource settings—even hospitals with good care can see tragic outcomes if it’s not detected and treated early.

Who is at risk?

Dr Neha: Some women have a higher likelihood of developing preeclampsia due to specific risk factors. The more of these you have, the higher your risk.

Some risk factors are modifiable, like obesity, high blood pressure, or poorly controlled diabetes—things that can be addressed before pregnancy. Others are non-modifiable, like a family history or having had preeclampsia in a previous pregnancy.

But it’s crucial to understand that even women with no known risk factors can still develop the condition.

Why is it dangerous?

Dr Neha: The danger lies in what preeclampsia does to the body. It can affect multiple organs and systems. Potential complications include stroke, kidney failure, liver rupture, fluid accumulation in the lungs (pulmonary edema), placental abruption, and in severe cases, eclampsia—characterised by seizures and an elevated risk of maternal death.

A particularly severe form, HELLP syndrome, can lead to liver damage, internal bleeding, and clotting disorders. If not identified and treated promptly, these complications can become life-threatening within hours.

From a medical perspective, preeclampsia originates in the placenta. Blood vessels in the placenta don’t develop normally, leading to poor blood flow, systemic inflammation, and widespread endothelial damage (to the lining of blood vessels). This results in rising blood pressure, organ dysfunction, and heightened risk for both mother and baby.

The problem is that preeclampsia doesn’t always show clear symptoms. We typically watch for signs like swelling, headaches, upper abdominal pain, rapid weight gain, and vision changes—but in some cases, it progresses silently. That’s why routine blood pressure checks and urine tests during antenatal visits are essential.

Management usually involves medications to control blood pressure and prevent seizures. But in many cases, the only definitive treatment is delivery. Sometimes, the baby must be delivered early to save the mother’s life.

Importantly, the risk doesn’t end after childbirth. Some women can develop postpartum preeclampsia, and maternal deaths can occur days or even weeks after delivery. That’s why postnatal monitoring is just as important.

If you’re pregnant or planning a pregnancy, take preeclampsia seriously. Know the warning signs, attend your prenatal checkups, monitor your blood pressure, and don’t hesitate to seek medical attention if anything feels off.