Causes of pre-eclampsia

Placenta

The placenta is the organ that links the mother's blood supply to her unborn baby's blood supply. Food and oxygen pass through the placenta from mother to baby. Waste products can pass from the baby back into the mother.

To support the growing baby, the placenta needs a large and constant supply of blood from the mother. In pre-eclampsia, the placenta doesn't get enough blood. This could be because the placenta didn't develop properly as it was forming during the first half of thepregnancy.

The problem with the placenta means the blood supply between mother and baby is disrupted. Signals or substances from the damaged placenta affect the mother's blood vessels, causing high blood pressure (hypertension) .

At the same time, problems in the kidneys may cause important proteins that should remain inthe mother'sblood to leak into her urine, resulting in protein in the urine(proteinuria).

What causes problems with the placenta?

In the initial stages of pregnancy, the fertilised egg implants itself into the wall of the womb (uterus).The womb isthe organ a baby grows inside during pregnancy. The fertilised egg produces root-like growths called villi, which help to anchor it to the lining of the womb.

The villi are fed nutrients through blood vessels in the womb and eventually grow into the placenta. During the early stages of pregnancy, theseblood vesselschange shape and become wider.

If the blood vessels don't fully transform, it's likely that the placenta won't develop properly because it won't get enough nutrients. This may lead to pre-eclampsia.

It's still unclear why the blood vessels don't transform as they should.It's likely that inherited changes in your genes have some sort of role, as the condition often runs in families. However, this only explains some cases.

Who's most at risk?

Some factors have been identified that could increase your chances of developing pre-eclampsia. These include:

• having an existing medical problem such as diabetes , kidney disease , high blood pressure , lupus or antiphospholipid syndrome
• previously having pre-eclampsia there's anapproximately16% chance you'll develop the condition again in later pregnancies

Some factors also increase your chances by a small amount. If you have two or more of these together, then your chances are higher:

• it's your first pregnancy pre-eclampsia is more likely to happen during the first pregnancy than during any subsequent pregnancies
• it's been at least 10 years since your last pregnancy
• you have a family history of the condition for example, your mother or sister has had pre-eclampsia
• you're over the age of 40
• you were obese at the start of your pregnancy (you had a body mass index of 35 or more)
• you're expecting multiple babies , such as twins or triplets

If you 're considered to be at a high risk of developing pre-eclampsia, you may be advised to take a 75mg dose of aspirin(baby aspirin or low-dose aspirin ) every day during your pregnancy from when you're 12 weeks pregnant until your baby is born. Evidence suggests this can lower your chances of developing the condition.