Preeclampsia (or gestosis) diagnosis, signs and treatments

Preeclampsia (or gestosis)

Preeclampsia is a medical condition that occurs only after the 20th week of pregnancy characterized by high blood pressure, swelling, and the presence of protein in the urine.

It is a serious complication that affects at least 5-8% of pregnant women. Screening for preeclampsia is done in the first trimester. Its causes are not yet well known.

Gestational hypertension and preeclampsia

Gestational hypertension is defined as the onset of systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg after 20 weeks of gestational age in women who are otherwise normotensive.

If hypertension is also associated with proteinuria (presence of protein in the urine) with 300 mg of protein in a 24-hour sample, it is called preeclampsia. 

During pregnancy, other forms of hypertension may be present, such as,

  • chronic hypertension : hypertension arising before pregnancy or found in the first half of it. It is considered essential, if no causes of hypertension are identified.
  • a preeclampsia superimposed on chronic hypertension : which consists in the development, after the 20th week, of a preeclampsia in a woman already affected by chronic hypertension.

Criteria for the diagnosis of preeclampsia

According to the Australasian Society for the Study of Hypertension in Pregnancy (ASSHP) , the criteria for the clinical diagnosis of preeclampsia are as follows:

  • hypertension that appears “de novo” after the 20th week, together with other symptoms such as:
  • proteinuria (>300 mg/day or protein/creatinine ratio greater than 30 mmol);
  • renal insufficiency (creatininemia > 1.5 mg / dl or oliguria);
  • hepatic insufficiency (increased transaminases associated with or without pain in the epigastric or right upper quadrant);
  • some neurological symptoms: convulsions (eclampsia), hyperreflexia (abnormal accentuation of tendon reflexes) with clonus (jerk-like muscle contractions), severe headache with hyperreflexia, persistent visual disturbances (scotomas);
  • blood pathologies: thrombocytopenia, disseminated intravascular coagulation, hemolysis;
  • hypo-development of the fetus.

Note: Within 3 months of delivery, blood pressure should return to normal. The presence of edema is no longer to be considered a diagnostic criterion.

The ASSHP recognizes that preeclampsia involves multiple systems, incorporating this concept into the diagnosis. However, for research purposes he suggests a narrower “definition of preeclampsia,” the diagnosis of which is based only on the presence of hypertension after 20 weeks associated with proteinuria. 

Who is at risk of preeclampsia

The following conditions can increase your risk of developing preeclampsia:

  • the fact that you are in your first pregnancy,
  • a previous experience of gestational hypertension or preeclampsia,
  • having sisters or mothers who have had preeclampsia;
  • the fact of having a twin pregnancy,
  • being under the age of 20, and being over the age of 40,
  • the fact that you had high blood pressure or kidney disease before pregnancy,
  • being obese or having a body mass index (BMI) of 30 or higher.


symptoms of mild preeclampsia:

  • high blood pressure, water retention, protein in the urine.

symptoms of severe preeclampsia  

  • the headache ,
  • a blurred vision,
  • an inability to tolerate bright light,
  • fatigue,
  • nausea / vomiting,
  • urinating small amounts of urine,
  • pain in the right upper abdomen,
  • shortness of breath,
  • the tendency to bruise easily.

See your doctor right away if you have blurred vision, severe headache, abdominal pain, and/or infrequent urination. However, at each prenatal visit, your doctor checks your blood pressure, urine levels, and may also order blood tests that can show whether or not you have preeclampsia.

Your doctor may also do other tests: check your kidney function and blood clotting; ultrasound to check the baby’s growth; and Doppler ultrasound to measure the efficiency of blood flow to the placenta.

Preeclampsia cures and treatments

Treatment for this disease depends on how close you are to your due date.

If you are close to your due date and the baby is quite developed, your doctor will probably want to deliver the baby as soon as possible.

If you have mild preeclampsia and your baby is underdeveloped, your doctor will likely recommend you do the following:

  • to rest, lying on your left to take the weight of the baby off the most important blood vessels,
  • to increase the frequency of prenatal visits,
  • to consume less salt,
  • to drink at least 8 glasses of water a day,
  • to change your diet to get more protein.

If you have severe preeclampsia, along with bed rest, dietary changes, and dietary supplements, your doctor may try to treat it with blood pressure medications until it’s within range to give birth safely.

The consequences of preeclampsia on the mother

If preeclampsia is not treated quickly and correctly, it can lead to serious complications for the mother, such as liver or kidney failure and, in the future, cardiovascular problems.

It can also lead to the following complications, which can even be life threatening:

  • an eclampsia: a severe form of preeclampsia that leads to seizures in the mother.
  • HELLP syndrome (haemolysis, increased liver enzymes and low platelet count). It is a condition that usually occurs in late pregnancy, and affects the breakdown of red blood cells, blood clotting, and liver function of the pregnant woman.

The consequences on the child

Preeclampsia can prevent the placenta from getting enough blood, so if the placenta doesn’t get enough blood supply, the baby gets less oxygen and less food.

This may result in you being born less than normal.

If preeclampsia is diagnosed early and treated with regular prenatal care, most women can still deliver a healthy baby.

Its prevention

Currently, there is no way to prevent preeclampsia.

Some factors that contribute to high blood pressure can be controlled, others not. Anyway,

  • follow your doctor’s instructions regarding diet and exercise,
  • do not add salt to meals,
  • drink 6-8 glasses of water a day,
  • do not eat fried food and junk food,
  • get enough rest,
  • train regularly,
  • during the day, elevate the feet several times,
  • avoid drinking alcohol,
  • avoid beverages that contain caffeine.

Depending on your health and in relation to any other factors, your doctor may possibly suggest that you take prescription medicines and supplements.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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