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High(er) Blood Pressure & PRE-ECLAMPSIA

What is it? Pre-eclampsia is a disease of pregnancy that shows symptoms including swelling, visual disturbances, headaches,

high blood pressure, spilling protein in the urine (proteinuria), sudden and excessive weight gain, and a general feeling of

illness or malaise. If pre-eclampsia advances to eclampsia, symptoms include placental abruption, convulsions or seizures,

coma, and sometimes even death for both mother and baby. Both pre-eclampsia and eclampsia are diagnosed with blood tests,

urine tests, and assessment of vital signs and put mother and baby in a high-risk category, making care in a hospital with an

obstetrician necessary.

 

What role do the kidneys and liver play in this complication of pregnancy? The symptoms of pre-eclampsia are caused when inadequate amounts of protein prevent the production of albumin. The woman’s blood volume does not expand, so the kidneys and liver are taxed. An imbalance of protein and salt causes swelling and high blood pressure, both controlled by the kidneys. High blood pressure causes tiny clots to form, which stretch the filters in the kidneys and cause holes to form. Protein is then spilled into the urine, and in some cases, the tiny clots cause severe epigastric pain in the liver area. In addition, inadequate nutrition or foods high in toxins tax the liver because the liver detoxifies the blood and absorbs nutrients.[1]

 

Who is most at risk? First time mothers, mothers with a new partner with this particular pregnancy, mothers with hydatiform moles, mothers of Asian or African ethnicity, mothers younger than 19 or older than 40, personal or family history of pre-eclampsia, multifetal gestation, a long interval between pregnancies, lower socioeconomic class, polycystic ovary syndrome, obesity, a history of lupus or rheumatoid arthritis, urinary tract infection during pregnancy, a poor outcome in previous pregnancies including intrauterine growth restriction, fetal death, or placental abruption, and pre-existing medical or genetic conditions such as chronic hypertension, renal disease, type 1 diabetes, collagen disease, thrombophilias, antiphospholipid antibody syndrome, protein C, S, antithrombin deficiency, factor V Leiden Mutation, or Periodontal disease, or any mother with malnutrition or an inadequate diet.

 

Can it be prevented? There are several theories as to how and why pre-eclampsia develops. They include abnormal trophoblast invasion at conception, coagulation abnormalities, vascular endothelial damage, cardiovascular maladaptation, dietary deficiencies or excesses, immunologic factors, and genetic disposition. While some of these causes cannot be controlled, how we care for ourselves in the present can be controlled. Because of the nature of the disease, what we put into our mouths and how we take care of ourselves and support our body’s health during pregnancy can prevent or reduce the severity of the disease.

 

In a study of 2,855 women in an intentional community in Tennessee, only 11 developed pre-eclampsia. This is a rate of 0.4% vs our national average of 6-8%![2] Their diet was regulated, and there were rules about what could be brought into the community. They grew their own food, which meant their diet mainly consisted of unprocessed, organic food, with the majority being vegetables, fruits, whole grains, and vegetarian protein sources. In addition, their main beverage was water. Other midwives who recommend similar diets of clean foods and adequate water have had the same low rates of pre-eclampsia.[3]

 

How can a woman decrease her chance of having pre-eclampsia?

  • Drink plenty of clean water. You should be getting half your body weight in ounces daily! Consider adding some lemon to your water, as it aids the kidneys in the filtration work they must do.

  • Eat clean and a wide rainbow of colors. Avoid GMO foods and processed foods, and try to eat organic as much as possible. The less the liver and kidneys must filter out of your blood, the better. Chemicals in and on your food are hard on your body. Your goal is to eat foods as close to their whole state as possible. Avoid packages. Choose fresh and frozen over juiced, dried, and packaged. Look up paleo or ‘whole food’ recipes online to replace your favorite family recipes. This will show you how to switch out less than ideal ingredients with better ones. For example, you can still have ice cream! Just make your own with real milk and cream and natural sweeteners, like honey or maple syrup, instead.

  • Eat plenty of protein. An inadequate blood supply during pregnancy is tough on the kidneys and liver. Eat enough protein and drink plenty of water to build your blood supply, baby, and healthy placenta. Consuming 60-80 grams of protein per day is recommended.

  • Salt your food to taste. If you are not getting enough salt in your diet, your body will begin to hold fluid, causing edema (swelling).

  • If you begin to have a history of pre-eclampsia, immediate familial history, swelling, or your blood pressure begins to rise, take appropriate supplements to aid your body in maintaining homeostasis.

What labs will I need? If your blood pressure begins to rise or other symptoms begin to present themselves, we will discuss the benefit of doing labs to help guide your care. The following labs are what may be recommended.

 

 

  • Complete Blood Count

  • Comprehensive Metabolic Panel

  • Protein/Creatinine Ration

  • 24-hour Urine Catch

  • Biophysical Profile

 

What are the symptoms, and when should I call my midwife?

 

  • Severe headaches

  • Excessive swelling of the feet and hands

  • Smaller amounts of urine or no urine

  • Double vision

  • Blurred vision

  • Sudden blindness

  • Pain in your upper right abdomen

You will need to contact your midwife if you begin to have swelling in your legs, hands, or face. Mild swelling in your feet is usually not an issue, but excessive swelling is a concern. Headaches, especially with visual disturbances (flashing lights, spots, etc.). Pain in your upper right abdomen. If your baby’s movements are reduced (less than 10 movements in an hour).

 

 

[1] Holistic Midwifery Vol. 1 by Anne Frye pg 194-196

Heart and Hands by Elizabeth Davis 4th ed. pg. 76-77

[2] Preeclampsia Foundation:

http://www.preeclampsia.org/health-information/149-advocacy-awareness/332-preeclampsia-and-materna

l-mortality-a-global-burden

[3] http://www.thefarmmidwives.org/preliminary_statistics.html

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