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World Hypertension Day: How Preeclampsia Turns High Blood Pressure Into A Deadly Pregnancy Crisis
Preeclampsia, a serious hypertensive disorder remains a leading cause of maternal and newborn deaths. Early detection, vigilant screening and timely treatment are crucial to prevent life-threatening complications. Firstpost brings out a doctor's view on how to deal with it and live a healthier life read more
Preeclampsia, a serious hypertensive disorder of pregnancy, affects 2–8% of pregnancies globally and remains a leading cause of maternal and new-born deaths, claiming around 46,000 maternal lives and 500,000 fatal or neonatal deaths each year.
Despite being preventable and treatable, particularly with magnesium sulphate, its use remains limited in many low-resource settings. Preeclampsia and eclampsia are responsible for up to 25% of maternal deaths in Latin America and around 10% in Asia and Africa, underlining the urgent need for early detection and awareness.
STORY CONTINUES BELOW THIS ADFirstpost spoke with Dr. Neha Gupta, Additional Director – Obstetrics and Gynecology at Fortis Hospital (Noida) who shared critical insights into the condition and why vigilant screening and postnatal care are essential.
How does preeclampsia put mothers at risk?Dr Neha: Patients often come to me saying, "Doctor, I just thought it was swelling—isn't that normal in pregnancy?" Yes, mild swelling can be normal. But sometimes, it's not—and that's exactly what makes preeclampsia so deceptive. Unless we're monitoring closely, it can take a sudden turn for the worse.
Most people assume preeclampsia is simply "high BP during pregnancy," but it's much more. It's a multisystem disorder that can escalate rapidly and unpredictably.
What is preeclampsia?Dr Neha: Preeclampsia typically occurs after the 20th week of pregnancy. It's marked by high blood pressure (140/90 mmHg or higher), protein in the urine (proteinuria), or signs of organ damage such as elevated liver enzymes and low platelet counts.
Globally, preeclampsia and related hypertensive disorders are among the leading causes of maternal mortality, contributing to nearly 10–15% of maternal deaths worldwide. And this isn't limited to low-resource settings—even hospitals with good care can see tragic outcomes if it's not detected and treated early.
Who is at risk?Dr Neha: Some women have a higher likelihood of developing preeclampsia due to specific risk factors. The more of these you have, the higher your risk.
Some risk factors are modifiable, like obesity, high blood pressure, or poorly controlled diabetes—things that can be addressed before pregnancy. Others are non-modifiable, like a family history or having had preeclampsia in a previous pregnancy.
But it's crucial to understand that even women with no known risk factors can still develop the condition.
Why is it dangerous?Dr Neha: The danger lies in what preeclampsia does to the body. It can affect multiple organs and systems. Potential complications include stroke, kidney failure, liver rupture, fluid accumulation in the lungs (pulmonary edema), placental abruption, and in severe cases, eclampsia—characterised by seizures and an elevated risk of maternal death.
A particularly severe form, HELLP syndrome, can lead to liver damage, internal bleeding, and clotting disorders. If not identified and treated promptly, these complications can become life-threatening within hours.
From a medical perspective, preeclampsia originates in the placenta. Blood vessels in the placenta don't develop normally, leading to poor blood flow, systemic inflammation, and widespread endothelial damage (to the lining of blood vessels). This results in rising blood pressure, organ dysfunction, and heightened risk for both mother and baby.
STORY CONTINUES BELOW THIS ADThe problem is that preeclampsia doesn't always show clear symptoms. We typically watch for signs like swelling, headaches, upper abdominal pain, rapid weight gain, and vision changes—but in some cases, it progresses silently. That's why routine blood pressure checks and urine tests during antenatal visits are essential.
Management usually involves medications to control blood pressure and prevent seizures. But in many cases, the only definitive treatment is delivery. Sometimes, the baby must be delivered early to save the mother's life.
Importantly, the risk doesn't end after childbirth. Some women can develop postpartum preeclampsia, and maternal deaths can occur days or even weeks after delivery. That's why postnatal monitoring is just as important.
If you're pregnant or planning a pregnancy, take preeclampsia seriously. Know the warning signs, attend your prenatal checkups, monitor your blood pressure, and don't hesitate to seek medical attention if anything feels off.
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What Is Persistent Pulmonary Hypertension Of The Newborn (PPHN)?
Persistent pulmonary hypertension of the newborn (PPHN) is a circulatory condition that occurs soon after birth. It happens to new babies whose lung vessels aren't open wide enough and have difficulty breathing once they've left the womb.
What is persistent pulmonary hypertension of the newborn? In short, PPHN is a serious breathing problem that affects very young babies. It usually affects babies born at full term or at 34 weeks or later. The lungs develop during this part of pregnancy, so it's common for babies with PPHN to have other breathing conditions too. PPHN is also known as persistent pulmonary hypertension in the newborn and persistent fetal circulation syndrome.
While in the womb, a baby receives oxygen from its mother and the placenta. Blood vessels in the baby's lungs are almost completely closed, so not much blood actually makes it to the lungs. Those blood vessels will open more after the baby is born and starts to take breaths. Only then will blood be able to travel to the lungs to receive oxygen. When PPHN happens, though, blood vessels in a baby's lungs don't open up enough, limiting the amount of oxygen passed along to the baby's organs and brain.
In addition to the brain and body not receiving the oxygen they need, pressure starts to build in the lungs' blood vessels. This high blood pressure, also known as pulmonary hypertension, is harmful to the baby's lungs and heart.
Exact PPHN causes aren't known. It's possible that underdeveloped or incorrectly developed blood vessels in the lungs cause PPHN. Another possible cause is the blood vessels' inability to adjust to breathing air once the baby is born.
Although the causes of PPHN aren't clear, there are definite risk factors that increase the likelihood of developing this condition. These can include:
Symptoms of PPHN can be different in every newborn. Look out for any of the following:
Health care providers will be quick to diagnose PPHN once a baby is born. In addition to the standard checks done after birth, they may perform the following tests on a baby that might have PPHN:
When treating PPHN, a health care provider will try to raise blood oxygen levels, regulate blood pressure, and open the blood vessels in the lungs wider. They might try medicine, fluids, or oxygen:
Another treatment method is giving the baby nitric oxide. Nitric oxide helps the blood vessels in the baby's lungs expand.
Once the baby has received initial treatment for PPHN, their lungs could take weeks or months to fully recover. They should be protected from colds, the flu, and other illnesses to avoid making their condition worse. The better they're able to heal, the less likely it is they'll have persistent pulmonary hypertension of the newborn long-term effects.
When blood doesn't make it all the way to a baby's lungs, they can't swap oxygen for carbon dioxide. This happens even when receiving 100% oxygen. This is a serious issue because all of the baby's organs need a steady stream of blood rich in oxygen. If the organs don't get what they need, serious long-term damage can be done.
Stay in close contact with the baby's health care provider as they recover from PPHN. Trust your instincts as you care for your child, and reach out if you have serious concerns about your baby's health.
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