Maternal and child health remains a critical global priority. With the 2025 World Health Day theme focusing on maternal and child well-being, attention is once again on ensuring safe pregnancies and healthy deliveries. One of the most pressing concerns in maternal health today is preeclampsia, a condition characterised by high blood pressure in pregnancy and a leading cause of maternal and neonatal complications worldwide.
If pregnancy is not a disease, why do so many women die from complications related to it? This question highlights the harsh reality that maternal mortality remains a major challenge, particularly in low-resource settings. One of the key targets of Sustainable Development Goal (SDG) 3 is to reduce the global maternal mortality ratio to fewer than 70 per 100,000 live births by 2030. Achieving this goal requires urgent action to address preeclampsia.
What is preeclampsia?
Preeclampsia is a hypertensive disorder of pregnancy that typically occurs after the 20th week of gestation. It is diagnosed when a pregnant woman develops high blood pressure (140/90 mmHg or higher) along with proteinuria (excess protein in the urine) or other organ dysfunction, such as liver or kidney issues.
Global impact and disease burden
Maternal Mortality: Preeclampsia and related hypertensive disorders cause approximately 76,000 maternal deaths annually.
Morbidity: The condition affects 2% to 8% of pregnancies globally, leading to significant maternal and perinatal complications.
Fetal Impact: Preeclampsia increases the risk of fetal growth restriction, preterm birth, and neonatal complications, including mortality.
Long-Term Health Risks: Women who experience preeclampsia, as well as their children, face an increased risk of chronic diseases such as cardiovascular disease and metabolic syndromes.
Incidence: The condition affects up to 15% of pregnancies globally, with higher rates in low- and middle-income countries (LMICs).
Geographic Distribution: The burden of preeclampsia is disproportionately high in developing regions, where severe cases are more common.
Causes of Death: Between 10% and 25% of preeclampsia cases result in maternal death.
Prevalence: Preeclampsia is seven times more common in developing countries than in high-income nations.
Maternal Deaths: Hypertensive disorders of pregnancy, including preeclampsia and eclampsia, contribute significantly to maternal mortality, with 99% of these deaths occurring in LMICs.
Causes and risk factors
The exact cause of preeclampsia remains unclear, but it is believed to stem from abnormal placental development and function. Several risk factors increase a woman’s likelihood of developing the condition, including:
First-time pregnancy
Previous history of preeclampsia
Chronic hypertension or kidney disease
Obesity and diabetes
Multiple pregnancies (twins or more)
Autoimmune diseases
Symptoms of preeclampsia
Preeclampsia often develops silently, making regular antenatal check-ups essential. When symptoms do appear, they may include:
Severe jeadaches
Blurred vision or sensitivity to light
Swelling in the hands, face, or feet
Sudden weight gain due to fluid retention
Upper abdominal pain, particularly under the ribs
Shortness of breath
Nausea or vomiting in late pregnancy
In severe cases, preeclampsia can progress to eclampsia, a life-threatening condition marked by seizures, organ failure, or stroke.
Effects on pregnancy
Preeclampsia poses serious risks for both mother and baby. It can lead to:
Preterm birth and low birth weight
Placental abruption (premature separation of the placenta from the uterus)
Fetal distress, stillbirth, or neonatal intensive care unit (NICU) admission
For the mother, preeclampsia increases the risk of:
Stroke and cardiovascular disease
Long-term hypertension
Recurrence in future pregnancies
Management and treatment
Currently, delivery of the baby and placenta is the only definitive cure for preeclampsia. However, when the condition arises too early in pregnancy, healthcare providers focus on managing symptoms and prolonging gestation safely. Treatment options include:
Antihypertensive medications to lower blood pressure
Corticosteroids to aid fetal lung development if early delivery is necessary
Magnesium sulphate to prevent seizures in severe cases
Frequent monitoring of fetal well-being using ultrasound and non-stress tests
Bed rest and hospitalisation for severe cases
Role of pharmacists and healthcare providers
Pharmacists and healthcare providers play a crucial role in managing and preventing preeclampsia by:
Educating pregnant women on the importance of prenatal care and recognising warning signs
Dispensing and advising on safe medications for managing hypertension in pregnancy
Encouraging adherence to:
Nutritional supplements (e.g., calcium and low-dose aspirin)
Regular antenatal check-ups for early blood pressure monitoring
Healthy lifestyle choices, including a balanced diet and regular exercise
Collaborating with obstetricians to ensure timely intervention when symptoms arise
Managing underlying conditions such as hypertension and diabetes before pregnancy.
By Pharm. (Dr) Onyinye Bridget Chiekwe, PharmD, MScPH, ABMP
pharmbree25@gmail.com
