Lab Testing Related to Pre-Eclampsia

 Pre-eclampsia is among the more severe conditions that can impact women who are pregnant. This condition is diagnosed when a pregnant woman displays three different factors. The first is hypertension or high blood pressure. The second is proteinuria or protein in the urine output, and the third is swelling of her feet, hand, and/or face. In the most serious cases, there might even be evidence of liver and kidney damage, fluid accumulation in the lungs, and central nervous system disturbances. Pre-eclampsia rates among pregnant women range from 3 up to 7 percent, and it typically happens after week 20 of the pregnancy. 

Untreated pre-eclampsia can be very risky since it might hurt the physical organs of the mother’s body and also result in seizures. These seizures are known as eclampsia. If not treated immediately, they are typically fatal for both the mother and child. Both pre-eclampsia and eclampsia can result in premature delivery and low baby birth weight, either of which can result in health issues for the child. Also, placental abruption is another possibility, and this is where the placenta gets loose from its uterus prior to the birth of the baby, resulting in bleeding. 

Pre-eclampsia might also develop into HELLP syndrome, which is another condition that is life-threatening. It’s known as HELLP given how it’s defined by a breakdown in red blood cells, known as Hemolysis, along with Elevated Liver enzymes, as well as a Low Platelet count. 

One in  200 females that have untreated pre-eclampsia wind up progressing to full eclampsia. The majority of eclampsia cases happen in either the third trimester of the pregnancy or in the 4 days following the delivery of the child. In rare cases, it can develop as much as 6 weeks following delivery. 

Pre-eclampsia can result in symptoms very similar to what happens in a normal pregnancy. Also troubling is the fact that some women who have pre-eclampsia demonstrate no symptoms whatsoever. Thus, it’s crucial for pregnant women to attend all their routine prenatal checkups. In these checkups, healthcare professionals do both physical exams and laboratory tests where they look for the ‘quiet’ signs of the condition, including protein output in the urine stream and high blood pressure. 

Currently Known Risk Factors 

Medical and scientific researchers are still attempting to ascertain the specific reasons why pre-eclampsia happens. On the other hand, there are certain risk factors that are already known.

They include but are not always limited to the following: 

  • Any prior pregnancies involving pre-eclampsia 
  • Any family history of there being pre-eclampsia 
  • First-time pregnancy 
  • Pregnancy past the age of 35 
  • Overweight to the point of obesity 
  • Carrying more than one baby 
  • Personal history of other conditions, which include migraine headaches, chronic hypertension, both type 1 and 2 diabetes, lupus, antiphospholipid syndrome, kidney disease, and/or a hypercoagulable state meaning higher tendencies for blood clots 

Signs/Symptoms 

Pre-eclampsia can be a very serious complication for a pregnant woman, and there might not be any obvious symptoms to it. When symptoms are present, it can seem as if they’re just typical pregnancy symptoms. For instance, swelling and weight gain can both indicate pre-eclampsia, and yet they’re also present during otherwise normal pregnancies too. Hypertension is another warning sign of pre-eclampsia, which often goes unnoticed up to the point it’s detected by healthcare practitioners during regular prenatal visits. 

If you have any of the symptoms or signs related to pre-eclampsia, or you notice any sudden changes during your pregnancy, then it’s crucial that you inform your healthcare provider immediately. They will then look for any other signs of this condition and also help monitor all your symptoms. Pre-eclampsia that goes untreated can be a very serious condition that can even prove fatal for both you and your child. Make sure you get to all your prenatal checkups, and also seek medical attention if and when symptoms arise. 

Pre-eclampsia symptoms might include the following: 

  • Sudden gains in weight of more than 2 pounds per week 
  • Edema, a sudden swelling of the face and hands 
  • Headaches of a persistent nature 
  • Changes in vision, including sensitivity to light, temporary loss of vision, blurry vision, and sensations of flashing light 
  • Bluish skin due to poor circulation 
  • Vomiting or nausea, particularly if it happens suddenly past mid-pregnancy 
  • Reduced output of urine 
  • Shortness of breath due to higher blood pressure or fluid buildup in the lungs 
  • Shoulder or stomach pain and pinching, particularly along the upper right side of the abdomen or if laying down on your right side, as these might demonstrate liver problems 

Some pre-eclampsia signs can be detected during physical examination. Should you experience any of these, seek out medical care immediately. 

They include the following: 

  • Elevated blood pressure 
  • Atypically strong leg reflexes, like when your healthcare practitioner uses a rubber hammer to tap your knee 
  • Shortness of breath, abdominal pain, severe headaches, and blurred vision are all very serious pre-eclampsia symptoms

Complications 

When left untreated, the condition of pre-eclampsia can result in very serious and even potentially life-threatening complications for both mother and child. 

Potential complications include the following: 

  • Eclampsia/seizure 
  • Rupture of the liver 
  • Stroke 
  • Low baby birth weight 
  • Placental abruption where the placenta gets loose from its uterus prior to the delivery of the baby, resulting in bleeding 
  • Women that have a personal history of pre-eclampsia have higher odds of developing: 
  • Cardiovascular disease 
  • Diabetes 
  • Kidney disease 

Testing Related to Pre-Eclampsia 

At the time of this writing, there’s not a single test for reliably identifying pre-eclampsia during early pregnancy. As such, the ACOG, or American College of Obstetricians and Gynecologists, suggests that, instead, healthcare practitioners conduct pre-eclampsia screening during the first trimester by getting a thorough medical history of women, and assessing for known risk factors. 

During a regular prenatal exam, healthcare practitioners lookout for symptoms and signs of pre-eclampsia, including atypical weight gain, swelling of the face and hands, and high blood pressure. During the 2nd and 3rd trimesters, there are urine tests for high volumes of protein, which can be a potential warning sign of pre-eclampsia. 

If you have any symptoms or signs of pre-eclampsia, then your healthcare provider is likely to conduct additional imaging and laboratory tests in an attempt to first diagnose the condition and secondly ascertain its level of severity. 

Laboratory Testing 

Proteinuria, or protein in urine output, was once thought of as a pre-eclampsia diagnostic sign. On the other hand, not every woman with the condition of pre-eclampsia actually has proteinuria. ACOG doesn’t recognize proteinuria as a required sign of pre-eclampsia diagnosis any longer. These days, healthcare practitioners also look for high blood pressure on top of proteinuria. They might also look for high blood pressure and one of many other symptoms or signs, including edema, serious vision changes, poor function in the liver or kidneys, and/or low platelet count. 

The following tests are useful in the diagnosis of the condition, ascertaining its severity, and keeping up with its progression: 

Urine protein to creatinine ratio and urine protein tests are used to detect elevated levels of protein in urine output. 

Uric acidserum creatinine, and BUN tests all measure and analyze kidney functions to find pre-eclampsia organ damage and frequent measurements to monitor the condition. 

AST (or aspartate aminotransferase) and ALT (or serum alanine aminotransferase) are both liver function tests which look for elevated levels to indicate pre-eclampsia organ damage. 

CBC (or complete blood count) testing is ordered for detecting bloodstream changes like low platelet counts. 

PTT (or partial thromboplastin time) testing measures how long it takes for blood to clot, as pre-eclampsia might extend times for blood clotting. 

Antiphospholipid antibodies are looked for since this autoimmune disorder is a syndrome associated with a condition of pre-eclampsia, as well as other complications in pregnancy. Testing for such antibodies can ascertain if some autoimmune disorders might by underlying pre-eclampsia. 

HELLP syndrome can be a life-threatening variation of the condition of pre-eclampsia, as outlined earlier in this content. Should your healthcare provider suspect that you are afflicted with HELLP syndrome, then certain tests might happen, including: 

Total bilirubin, because elevated levels of this often indicate either red blood cell hemolysis or liver damage. 

Serum lactate dehydrogenase (or LD) testing looks for elevated LD levels that suggest cell or tissue damage, like the kind that happens when red blood cells breakdown. 

Peripheral blood smear testing examines red blood cells using a microscope to find abnormalities or damage.