Pre-Eclampsia

Understanding Pre-Eclampsia and How It Affects Pregnancy

Pre-eclampsia is defined as the new onset of high blood pressure over 140/90 millimeters of mercury (mm Hg) during pregnancy, usually with higher-than-normal levels of protein found in the urine. The onset usually presents during the second or third trimester, after the 32nd week, although some women experience its onset as early week 20. When the onset occurs earlier than 32 weeks gestation, it carries even more risk. Pre-eclampsia may also occur as late as two weeks postpartum, a condition known as postpartum pre-eclampsia. In women with chronic hypertension, one out of four develops pre-eclampsia. It affects about five percent of all pregnancies and typically lasts for up to two weeks after delivery. However, there is concern that the woman will become hypertensive later in life. In its most severe form, pre-eclampsia is a life-threatening problem and would result in the blood pressure being 160/110 mm Hg.

Causes of Pre-Eclampsia

The causes of pre-eclampsia and elevated blood pressure during pregnancy are not well understood. Most experts believe that pre-eclampsia starts with a poorly developed or shallowly implanted placenta that doesn’t circulate blood normally, causing an inflammatory response and increased vascular pressure. Multiple factors are thought to play a part in pre-eclampsia, including:

• Family history
• An abnormal immune system response. This immune response is caused by exposure to an antigen from the father and can result in narrowing of the blood vessels throughout the body thus leading to high blood pressure.
• A biochemical factor that causes the blood vessels to narrow, raising blood pressure
• Underlying kidney disease, diabetes, or other diseases that cause blood vessel problems
• First time pregnancy
• Pregnancy with a new partner or husband
• Hypertension prior to pregnancy
• High cortisol or aldosterone levels that can lead to secondary hypertension
• Systemic Lupus
• Obesity
• Smoking during pregnancy
• Having a multiple birth

Symptoms of Pre-Eclampsia

• Elevated blood pressure
• High amounts of protein in the urine (proteinuria)
• Abdominal pain or tenderness, especially on upper right side
• Swollen hands, feet, and face that comes on sudden and persists
• Swollen ankles and rapid weight gain
• Visual disturbances and dizziness
• Headache localized more to the front
• Blood clotting problems
• Breathing problems especially when lying flat
• Decreased urination
• No symptoms at all (mild cases)
• Seizures (severe cases)

How Chinese Medicine and Acupuncture Treat Pre-Eclampsia

Chinese medicine diagnoses hypertension as a disturbance within the micro-climate of the organs. The over stimulation of the sympathetic nervous system allows the body to run hot, generating excess heat that can rise up to the head and lead to dizziness and headaches. This heat further drains the foundation of the body, depleting the kidneys which control the delicate balance of the renin-angiotensin aldosterone system– a system which regulates blood volume and contraction of the vessels. Research shows the effectiveness of Chinese medicine in regulating the immune and endocrine systems, adjusting cortisol levels, decreasing swelling and edema, reducing headaches, and improving abdominal pain. Also, acupuncture and nutritional modifications can help with obesity and diabetic factors that contribute to pre-eclampsia. Our protocol involves treating the underlying causes for and the symptoms associated with pre-eclampsia. We accomplish this with the use of acupuncture, Chinese herbs, and nutritional guidance.

Acupuncture can relax the body, leading it back into a parasympathetic state, while releasing accumulated heat from an over-strained system. As the body’s internal climate is re-balanced, the kidneys are able to regenerate and refocus, allowing for a smoother flow of blood and an increased tone of the vasculature. Acupuncture protocol for balancing blood pressure is fine tuned to the unique constitution and health of the individual. Often the liver meridian is imbalanced, due to the stress of modern life as well as the demands of pregnancy, and a phenomenon known as liver yang (excess energy) rises upward, contributing to hypertension. Numerous acupuncture points are renowned for subduing this tendency. At the same time, nurturing the quiescent qualities that balance this type of uprising energy is very important. Acupuncture regulates the endocrine system by easing tension which may impede its free-flowing functioning, as well as directly toning it via appropriate acupuncture treatments. The immune system benefits, as well, helping inhibit an improper inflammatory response and curb an autoimmune attack.

Chinese herbs focus on relieving the symptoms and treating the root cause of the pregnancy-induced hypertension. Just as Western diagnosis differentiates between subtypes of hypertension, so, too, does Chinese medicine, with herbal formulas structured accordingly. In pharmacological and clinical research, certain herbs have demonstrated a strong cardiovascular effect that, with proper formulations and under proper supervision, can strengthen the health of the fetus while helping establish proper placental boundaries. It is very important to only take Chinese herbal formulas during pregnancy prescribed specifically for you by a licensed Acupuncturist who is well experienced in the complex art of Chinese herbology.

Nutritional guidance in traditional Chinese medicine to reduce pre-eclampsic symptoms recommends eating whole organic foods rich in calcium and vitamin B6. It is best to reduce your intake of spicy foods, as well as lighten your use of salt. Sour flavors, found in rice or balsamic vinegars, are a good alternative to a relatively high salt diet. They can benefit women’s health by smoothing the liver qi (energy), which helps keep the body relaxed and the blood pressure normal.

In consideration of the theory that a shallowly implanted placenta may be at the root of an immune reaction that leads to an inflammatory response, a diet to nourish the health of the uterus, and placenta, is recommended. In Chinese medicine, a diet which builds healthy and vital blood, as well as strengthens the meridians and energies that support the tone and luxuriant lining of the uterus, would be recommended. The kidney’s meridian, viewed as the foundation of reproductive health, is strengthened by warm foods and beverages, and weakened by cold foods and liquids. Hot soups and stews, such as organic meat broths cooked with vegetables and grains, are very strengthening and blood building, and an ideal way to strengthen the kidney meridian. Frozen, chilled, and raw foods are best avoided. This diet will also strengthen the spleen meridian system, which is responsible for the tone of the body’s organs and tissues, and very important for the integrity of the uterus and the placenta. Eating yellow root vegetables and baked golden squashes can strengthen the spleen meridian.

How Western Medicine Treats Pre-Eclampsia

Western medicine practitioners typically monitor a woman’s blood pressure and, if blood pressure increases to 140/100 mm Hg, prescribe medication to reduce the hypertension. Severe high blood pressure of 160/110 can result in poor fetal growth and is treated with anti-hypertensive medication. Aspirin is sometimes given preventively to women who have a pre-existing condition that might put them at risk for eclampsia. In these cases, a low dose aspirin of 75 mg or less is prescribed, but never earlier than the second trimester, as it is an anti-platelet medication. Other protocols include a balanced diet, mild aerobic exercise, and calcium supplements, which have been found to reduce the risk of developing pre-eclampsia and the risk of having a low-birth-weight baby. Taking at least 1200 mg of calcium per day is recommended.

Medication Choices

High blood pressure medications commonly used during pregnancy include:

• Methyldopa: a first choice oral medication
• Hydralazine: intravenous medication for quickly lowering severely high blood pressure
• Labetalol: intravenous medication for quickly lowering severely high blood pressure
• Nifedipine: a first choice oral medication
• Magnesium Sulfate: safest and most effective anti-convulsant
• Magnesium Sulfate: safest and most effective anti-convulsant

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