Dr. Mills recalls the fetal risks present when a woman has preeclampsia.
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The primary fetal risk is a premature delivery. When preeclampsia occurs early, becomes more severe, and begins to affect the fetus then the pre-term delivery may be indicated to help the fetus in that regard. Remembering that this is a condition that affects the placenta and placental circulation it also therefore affects the placenta’s ability to support the fetus. So intrauterine growth restriction, babies that don’t grow as well during the pregnancy, risk of loss of the fetus prior to delivery because the placenta becomes so damaged and so affected that it can’t support fetal life, is a greater risk. Both of these conditions are one of the reasons that a pregnancy might have to be delivered early. Sometimes in women who have not developed symptoms of preeclampsia, one of the first signs that we see is a fetus or baby that is not growing adequately. So in mothers who are at risk, first time moms, mothers in those risk categories that we talked about where the fetus is under-grown or has what we call intrauterine growth restriction, then watching carefully for additional signs and symptoms of preeclampsia becomes important to do. Blood pressure elevation or hypertension can affect blood flow to the placenta and increases the risk of premature placental separation, bleeding behind the placenta, and what we call a placental abruption. Again, if that were to occur that can place the mother at risk for hemorrhage, the fetus at risk for not receiving enough oxygen, and can become an acute emergent cause for delivery often by cesarean delivery to protect those babies and those mothers.
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