Preeclampsia is a condition marked by high blood pressure and possibly elevated levels of protein in urine or impaired liver or clotting function. Though it commonly develops in later pregnancy, it can develop earlier in the pregnancy, or rarely, after giving birth.
If you experience preeclampsia, your doctor may need to induce labor and deliver your baby. This decision is based on the severity of the preeclampsia and on how far along your pregnancy is.
Read on to learn more about what to expect if you experience mild to severe preeclampsia.
If you are diagnosed with mild preeclampsia, your doctor may:
- induce labor between your 37th and 40th week. Your doctor can give you medication to prepare your cervix for labor if needed.
- delay delivery if your diagnosis is made before your 37th week, the severity is not progressing, you are not in labor, and the wellbeing of you and your baby can be closely monitored and ensured.
Severe preeclampsia requires hospitalization and close monitoring. Your doctor will likely induce labor if:
- Your pregnancy is at or over 34 weeks.
- The severity of your condition progresses.
- Your baby's health declines.
To help control blood pressure, your doctor may prescribe medications such as:
If you develop severe preeclampsia before the 28th week of pregnancy, you and your baby are at high risk of serious complications.
Complications of severe preeclampsia before the 28th week of pregnancy
|Maternal complications||• seizures (eclampsia)|
• pulmonary edema
• kidney failure
|Fetal complications||• death|
• pre-term delivery
• admission to neonatal intensive care
• growth retardation
|Other potential fetal complications:||• bleeding in the brain|
• injury to the bowels
• chronic lung disease
Severe preeclampsia rarely develops during the second trimester of pregnancy. When it does occur, it’s usually in women who have a history of conditions that include:
- chronic hypertension
- kidney disease
- preeclampsia with a prior pregnancy
The cause of preeclampsia may be due to abnormal attachment of the placenta to the uterine wall or a molar pregnancy (growth of abnormal gestational tissue in the uterus).
Molar pregnancies are associated with fetuses that don’t develop normally.
If you have preeclampsia at this stage of your pregnancy, you and your doctor must weigh the risks of carrying your baby to term against possible complications of extreme prematurity, which may include:
- fetal death
- neonatal complications
- neurologic deficits
There may also be increased risk of maternal complications including:
If severe preeclampsia develops at 28 to 36 weeks of pregnancy, the risks are similar to those that can occur prior to 28 weeks, but the rates are lower.
If you are 28 to 32 weeks pregnant and must deliver right away, your baby is at high risk of complications and possible death. Some surviving infants have long-term disabilities. Therefore, your doctor may wait a few days before starting delivery.
During this time, you may receive magnesium sulfate to prevent convulsions. You may also receive other medications to lower your blood pressure, such as hydralazine (Apresoline), and steroids, such as betamethasone to help your baby's lungs develop.
You’ll also need to stay in the hospital until delivery.
For severe preeclampsia at or beyond 34 weeks, doctors usually recommend immediate delivery. However, prior to 34 weeks, your doctor may prescribe steroids 48 hours before inducing labor to strengthen your baby's lungs.
The timing of delivery is determined by how severe the condition has become and the status of both maternal and fetal well-being.
There are still risks for the mother if preeclampsia develops at or after the 37th week, but the risks to the baby are reduced, as the baby is now considered term at delivery.
HELLP syndrome is thought to be a more progressed variant of severe preeclampsia. It gets its name from the first letters of some of its characteristics: hemolysis (breaking down of red blood cells), elevated liver enzymes, and low platelet count.
If you develop this condition, both you and your baby are at high risk for complications. Maternal risks include kidney failure, pulmonary edema, clotting dysfunction and stroke.
Fetal complications are strongly correlated to gestational age at delivery, but may also result from pregnancy-related issues such as placental abruption.
These problems are serious. Your doctor will likely recommend you deliver your baby within 24 to 48 hours of diagnosis, even if it means the baby will be born prematurely.
Your doctor will advise you on the timing of delivery given the gestational age of the baby and the severity of your condition.
In rare cases, preeclampsia can present after delivery.
Postpartum preeclampsia symptoms may include stomach pain, headaches, or swelling in your hands and face. They may be mistaken for typical postpartum symptoms, so it’s important determine the cause of your symptoms.
Talk to your doctor if you’re concerned about any of your symptoms after giving birth.
Preeclampsia is a serious medical condition that can affect both mother and baby. Immediate delivery is the recommended treatment for severe preeclampsia, but treatment depends on how far along you are in the pregnancy and how severe the preeclampsia is.
If you are exhibiting any concerning symptoms during pregnancy or after you deliver your baby, contact your healthcare provider.