Adverse changes in the central nervous system in pregnant women are often accompanied by cerebral edema and increased intracranial pressure. It is also characterized by narrowing of the blood vessels of the brain. Cerebral ischemia due to a combination of the above factors can cause attacks of eclampsia. Bleeding in the brain develops as a consequence of hypertension.
Pathological changes in the blood of pregnant women can be so:
- Hemolysis and anemia.
- Coagulopathy – usually with severe forms of the disease with hepatic insufficiency.
- ICE (problems with blood clotting) is rare, usually in combination with bleeding and placental abruption.
Placental disorders in pregnancy characterized by intrauterine growth retardation (IUGR), which occurs quite often in pre-eclampsia. Also, there is an increased risk of placental abruption. To reduce the risk of preeclampsia – doctors use low-dose aspirin to reduce the risk of preeclampsia in general about 19%. 1 g calcium daily as a dietary supplement can reduce the incidence of pre-eclampsia – the benefits were seen in women with low calcium content in the diet. Antioxidants (Vitamins C and E) have demonstrated promising results in studies, but they can be the cause of preterm birth.
In secondary prevention or early treatment are used antihypertensive drugs that are intended for the treatment of mild to moderate preeclampsia. There is ample evidence that oral antihypertensive drugs reduce the frequency of severe hypertension by 50%. However, their ability to influence the progression of pre-eclampsia, cerebrovascular event, or the fetus is unproven. Also there is no evidence that the regular intake of antihypertensive drugs worsens IUGR.
Methyldopa in preeclampsia is often used for the treatment of mild to moderate hypertension, and has a long history of safe use. A frequent side effect is drowsiness. Alternative drugs are oral labetalol or ACC, such as nifedipine. At the moment, there is no evidence of the benefits of one drug over the other, but avoid the use of labetalol in female patients with asthma. Infants born to mothers who use labetalol, are at increased risk of hypoglycemia. Other blockers not be used during pregnancy because of the risk of IUGR. Diuretics are not applicable, since they are connected with the development of intravascular volume depletion and a risk of kidney damage.
If you suspect preeclampsia – doctors often check the condition of the mother and fetus for some time to see the progression of the disease. Early treatment of high blood pressure prolongs pregnancy and helps to achieve the required degree of maturity of the fetus. However, there are no clear criteria to identify women at risk of severe pre-eclampsia today because some women develop eclampsia without prior symptoms. In such cases, the diagnosis is based on clinical suspicion and probabilities.