The Causes of Preeclampsia

Dr. Mills recalls the causes and symptoms associated with preeclampsia.

Well at this point we are not entirely sure. We do believe that it is related to blood flow to the placenta. The placenta, we think of as, we often think of as primarily a structure that’s a conduit to and from baby and mother; provides oxygen, removes respiratory gases, provides nutrition, removes waste, but the placenta itself is also very metabolically active. It makes a number of hormones and number of compounds, enzymes, structures that promote and support the course of the pregnancy. In preeclampsia, features of those compounds of the placenta make become altered in a way that then affects the entire maternal vascular system and organ system. It can affect mother’s brain, liver, kidneys in ways that have to do with what were once described toxins, hence the term ‘toxemia’ that’s often used in this condition, but really related to compounds that an organ that is not getting good blood supply may release. There are compounds like tumor necrosis factors, cytokines, things that will affect the cells of those organ structures that become affected in a way that’s not normal in mothers with preeclampsia. The primary symptoms of preeclampsia that women are going to experience, the first is often edema and although edema, or swelling, fluid accumulation is not present in all patients with preeclampsia, it is present in most. So that’s often the most common initial symptom. Then symptoms related to the organ systems that can be affected; very commonly headache, vision changes, particularly seeing what we call scotomata, which are often little white flashes or little dark spots that come from alterations in light reflecting on the retina. Symptoms of upper abdominal pain; if the liver begins to swell the stretch of the capsule around the liver begins to hurt so it’s often pain in the upper middle portion of the liver, sometimes a little on the right side, sometimes in the back – those are the primary symptoms that one is going to experience.