It is estimated that around 1,000 babies die each year as a result of the pregnancy condition pre-eclampsia.

Pre-eclampsia causes high blood pressure in the woman’s body during pregnancy and usually occurs from around 20 weeks, or after delivery.

No one knows what causes the condition but it is thought that it occurs when there is a problem with the placenta. It can be extremely dangerous for mother and child and can result in significant injury, including stillbirth. It is thankfully rare with mild cases occurring in around six per cent of pregnancies, and severe cases occurring in one to two per cent.

NHS maternity services should have robust systems for prompt diagnosis of pre-eclampsia, as well as monitoring and treatment to keep both mother and baby safe. The majority of incidences are picked up quickly and dealt with appropriately. However, sometimes things can go wrong and our team of clinical negligence solicitors at JMW has seen the catastrophic consequences this has.

Who’s at risk?

You might be at a higher risk of pre-eclampsia developing if:

• you have diabetes, high blood pressure, kidney disease or an auto immune condition
• this is your first pregnancy or your last pregnancy  was over 10 years ago
• you have a family history of the condition
• you are having twins or multiple babies
• you have a BMI of 35 or over
• you are over 40 years old

If you are at a significant risk of developing pre-eclampsia, your medical team may recommend low dose aspirin to lower your chance of developing this condition.

What are the signs and symptoms of pre-eclampsia?

Early symptoms of pre-eclampsia should be picked up at your community midwife checks. Having high blood pressure or high levels of protein in urine checks can be one of the first signs.

Signs and symptoms include:

• high blood pressure
• high levels of protein in urine
• swelling in the ankles, feet, face or hands.
• a bad headache that won’t clear with painkillers
• blurred vision.
• feeling very unwell.
• pain to the abdomen, just under the ribs, in severe cases.

The earlier pre-eclampsia is identified and managed, the better the likely outcome. If you have any concerns about symptoms of pre-eclampsia, discuss these with your midwife, GP or NHS 111.

Slow growth in your baby may also be a sign of pre-eclampsia. This can be picked up on scans or on measuring your bump at midwife appointments.

What complications can arise?

Whilst rare, in severe cases, mothers can suffer from fits or convulsions (eclampsia). Most women make a full recovery from eclampsia but they can cause brain damage if the fits are severe.

HELLP syndrome, which is a rare liver and blood clotting condition, can also develop in severe cases. Like pre-eclampsia, the only way to treat this is by delivering the baby.

Stroke, blood clotting disorders and other organ problems can also arise in rare cases.

 What can pre-eclampsia mean for my baby?

If untreated, pre-eclampsia can lead to complications for the baby as the placenta is not working as well as it should.

The baby’s growth may be affected, and fetal growth restriction can occur.  In severe cases, premature delivery may need to occur (before 37 weeks) and premature birth can cause complications. In very rare cases, babies may be stillborn.

How can pre-eclampsia be managed?

The only cure for pre-eclampsia is to deliver the baby. Your symptoms may need to be managed up until delivery.

Once pre-eclampsia is diagnosed, more regular appointments may be recommended and more regular growth scans, to monitor your baby closely.

Regular blood pressure checks, urine and blood tests may also be required. Electronically monitoring your baby’s well-being may also be carried out using a ‘CTG’ heart monitor.

In severe cases, you may need to be admitted to hospital for treatment. Early delivery may also be arranged, as this may be the only way to cure the condition and reduce the risks to you and your baby.

Induction may be offered or you may need to have a caesarean section delivery earlier than planned.

Following diagnosis, you and your baby may need further treatment or monitoring in hospital until symptoms resolve.

With early diagnosis and management, serious complications can usually be avoided and so it is important than any concerns about pre-eclampsia are raised and monitored as soon as possible.