Women with Preeclampsia during Pregnancy: Higher Risk for Heart Thickening

As presented at the American Heart Association’s (AHA) Council on Hypertension, women who develop preeclampsia during pregnancy are more at risk for developing left ventricular thickening within one month after delivery. According to the Mayo Clinic, left ventricular thickening – also known as left ventricular hypertrophy – can result in the failure of the heart to pump adequately. This can lead to serious complications such as stroke, sudden cardiac arrest, or death.

Some women develop preeclampsia during the second half of their pregnancy (late-onset) and others develop it earlier, which is referred to as early-onset preeclampsia. The condition is marked by an increase in blood pressure, swelling in the hands, feet and legs as well as an increased amount of protein present in the urine. Preeclampsia can affect women with or without a previous history of high blood pressure. Some common complications that often accompany preeclampsia are preterm birth, placental abruption, cardiovascular disease and fetal growth restriction.

According to the National Center for Biotechnology Information (NCBI), there are some risk factors that contribute to the likelihood of developing preeclampsia. Although some women have no history of high blood pressure, those who do have a family history are at a significantly higher risk. The National Institutes of Health (NIH) report that having diabetes, being over 40, having a history of kidney disease or being obese also increase the risks for developing early or late-term preeclampsia throughout pregnancy.

This condition may affect a baby’s overall health and development. It can prevent a child from receiving an adequate amount of blood through the placenta. Decreased placental blood flow can prevent a baby from receiving enough nutrition and oxygen, resulting in low birth weight or other issues. In severe cases, untreated preeclampsia can lead to cases of infant and maternal mortality.

According to information from the American Pregnancy Association, pregnant women who develop preeclampsia should be wary of HELLP Syndrome as well as eclampsia. HELLP stands for hemolysis (destruction of red blood cells), elevated liver enzymes and a low platelet count. This syndrome can destroy red blood cells and cause liver damage. Eclampsia develops after a pregnant woman experiences preeclampsia accompanied by seizures. The condition can also cause other serious medical complications, like intracranial bleeding (bleeding inside the skull), renal insufficiency and renal failure.

Because some women who develop preeclampsia during pregnancy have no history of high blood pressure, they may be unaware of what the symptoms can be. Some of the typical warning signs of preeclampsia that pregnant women should watch out for include:

• Proteinuria (protein in the urine), which may be expressed in foamy urine;
• Severe headaches;
• Rapid weight changes caused by an increase in fluid;
• Vision changes;
• Reduced urine or no urine output;
• Changes in reflexes;
• Nausea and/or excessive vomiting, and:
• Dizziness

If you are a pregnant woman who is experiencing any of these preeclampsia symptoms, you should make an appointment with your obstetrician or primary care physician right away.

A recent study conducted by researchers at the University of Udine in Italy found that women who develop early-onset preeclampsia (or preeclampsia that develops before the 34^th week of pregnancy) are at the highest risk for subsequent cardiovascular disease, although ones with late-onset preeclampsia also face an increase of medical complications. Although the exact number of women who develop early or late-onset preeclampsia during pregnancy is unknown, the NIH estimates that somewhere between 3 to 4% of all American women do.

The researchers found that pregnant participants with preeclampsia were not only at an increased risk for left ventricular hypertrophy but also for developing various cardiovascular disorders and diastolic dysfunction. Diastolic dysfunction is a condition that can affect the ability of the heart to relax and fill with blood properly due to compromised heart muscle tissue. Other common complications of left ventricular thickening include the development of arrhythmia, atrial fibrillation, ischemic heart disease and aortic root dilation.

Although there is no known cure for preeclampsia, depending on how far along the pregnancy is there are some different courses of maintenance and treatment that a doctor may recommend. If the baby has reached full development, a doctor may recommend inducing labor. For women suffering from severe preeclampsia, your care provider might prescribe blood pressure medication. If the child has not fully developed, a doctor may advise:

• Decreasing salt consumption;
• Resting and lying on your side to restrict the weight on the baby as well as blood vessels;
• Increasing protein intake;
• Drinking a minimum of 8 glasses of water per day, and:
• Increasing prenatal checkups

The findings of the study show how important it is for doctors to conduct comprehensive cardiovascular screenings on pregnant women who are experiencing preeclampsia. Because these women are at an increased risk for cardiovascular problems after delivery, they should continue to be closely monitored in the months following giving birth. Although additional research is necessary, current findings confirm that various forms of prevention, supervision and treatment can help to set the foundation for a positive medical outcome for these at-risk patients.

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