May is Pre-eclampsia Awareness Month, a time dedicated to raising awareness about one of the leading causes of pregnancy complications worldwide. Pre-eclampsia Awareness Week, observed annually in May, shines a light on the importance of early detection, research and support for families affected by this serious condition.
In honour of this important initiative, we’re sharing updated insights into pre-eclampsia and HELLP syndrome to help inform, educate and support our Earlybirds community.
Understanding Pre-eclampsia
Pre-eclampsia is a serious pregnancy complication characterised by high blood pressure and signs of damage to other organ systems, most often the liver and kidneys. It typically occurs after 20 weeks of pregnancy in women whose blood pressure had previously been normal. (aapec.org.au)
Prevalence and Impact
In Australia, pre-eclampsia affects approximately 5–10% of pregnancies. Severe cases can lead to significant health risks for both mother and baby, including preterm birth and, in rare instances, maternal or fetal death.
Risk Factors
Recent guidelines have identified several risk factors for developing pre-eclampsia:
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First-time pregnancy
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Multiple gestation (twins or more)
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Maternal age over 40
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Obesity (BMI ≥ 30)
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Pre-existing conditions such as hypertension, diabetes, kidney disease, or autoimmune disorders
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Family history of pre-eclampsia
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Assisted reproductive technology (e.g., IVF)
Prevention and Management
Early prenatal care is crucial. Low-dose aspirin (150 mg daily) initiated before 16 weeks of gestation has been shown to reduce the risk in high-risk women. Calcium supplementation is also recommended for those with low dietary calcium intake.
Regular monitoring of blood pressure and urine protein levels during prenatal visits helps in early detection. Management strategies may include antihypertensive medications and, in severe cases, early delivery of the baby.
HELLP Syndrome: A Severe Variant
HELLP syndrome is a life-threatening liver disorder thought to be a variant of pre-eclampsia. The acronym stands for:
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Hemolysis (breakdown of red blood cells)
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Elevated Liver enzymes
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Low Platelet count
Symptoms and Diagnosis
Symptoms often overlap with pre-eclampsia and may include:
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Upper abdominal pain
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Nausea or vomiting
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Headache
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Visual disturbances
Notably, HELLP can occur without high blood pressure or proteinuria, making diagnosis challenging. Laboratory tests confirming hemolysis, elevated liver enzymes, and low platelet count are essential for diagnosis.
Treatment and Prognosis
Immediate hospitalisation is required. Management includes:
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Stabilisation of the mother's condition
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Administration of corticosteroids to improve liver and platelet function
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Blood pressure control
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Planning for prompt delivery, depending on gestational age and severity
Early detection and treatment are vital to improve outcomes for both mother and baby.
Conclusion
Pre-eclampsia and HELLP syndrome remain significant concerns in obstetric care. Advances in early detection and management have improved outcomes, but awareness and prompt medical attention are key. Pregnant women should attend all prenatal appointments and report any concerning symptoms to their healthcare provider immediately.
For more information, consult the latest guidelines from the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) and the Australian Pregnancy Care Guidelines.
Note: This information is intended for educational purposes and should not replace professional medical advice. Always consult with a healthcare provider for personalised care.
