Preeclampsia is a condition that commonly presents in pregnancy, but can occur postpartum in some cases. It causes high blood pressure and possible organ failure.
It more commonly occurs after week 20 of pregnancy and can happen in women who didn’t have high blood pressure before pregnancy. It can lead to serious complications with you and your baby that can sometimes be fatal.
If left untreated in the mother, preeclampsia can lead to liver or kidney failure and potential cardiovascular problems in the future. It can also lead to a condition called eclampsia, which can cause seizures in the mother. The most severe outcome is stroke, which may lead to permanent brain damage or even maternal death.
For your baby, it can prevent them from receiving enough blood, giving your baby less oxygen and food, leading to slower development in the womb, a low birth weight, premature birth, and rarely stillbirth.
If you had preeclampsia in a previous pregnancy, you are at an increased risk of developing it in future pregnancies. Your degree of risk depends on the severity of the previous disorder and the time at which you developed it in your first pregnancy. In general, the earlier you develop it in pregnancy, the more severe it is and the more likely you are to develop it again.
Another condition that can be developed in pregnancy is called HELLP syndrome, which stands for hemolysis, elevated liver enzymes, and low platelet count. It affects your red blood cells, how your blood clots, and how your liver functions. HELLP is related to preeclampsia and about 4 to 12 percent of women diagnosed with preeclampsia develop HELLP.
HELLP syndrome can also cause complications in pregnancy, and if you had HELLP in a previous pregnancy, regardless of the time of onset, you have a greater risk for developing it in future pregnancies.
Causes of preeclampsia are unknown, but several factors in addition to having a history of preeclampsia can put you at a higher risk for it, including:
- having high blood pressure or kidney disease before pregnancy
- family history of preeclampsia or high blood pressure
- being under age 20 and over age 40
- having twins or multiples
- having a baby more than 10 years apart
- being obese or having a body mass index (BMI) over 30
Symptoms of preeclampsia include:
- blurred vision or loss of vision
- nausea or vomiting
- abdominal pain
- shortness of breath
- urinating in small amounts and infrequently
- swelling in the face
To diagnose preeclampsia, your doctor will most likely check your blood pressure and perform blood and urine tests.
Although preeclampsia can lead to serious issues during pregnancy, you still can deliver your baby.
Because preeclampsia is thought to result from problems developed by the pregnancy itself, delivery of the baby and placenta are the recommended treatment to stop progression of the disease and lead to resolution.
Your doctor will discuss the timing of delivery based on the severity of your disease and your baby’s gestational age. Most patients have resolution of the elevated blood pressure within days to weeks.
There is another condition called postpartum preeclampsia that occurs after childbirth, the symptoms of which are similar to preeclampsia. See your doctor immediately if you experience any preeclampsia symptoms after childbirth, as it can lead to serious issues.
If you do develop preeclampsia again, you and your baby will be monitored regularly. Treatment will focus on delaying the progression of disease, and delaying the delivery of your baby until they have matured in your womb long enough to minimize the risks of preterm delivery.
Your doctor may monitor you more closely, or you may be hospitalized for monitoring and certain treatments. This will depend on the severity of the disease, the gestational age of your baby, and your doctor’s recommendation.
Medications used to treat preeclampsia include:
- medications to lower your blood pressure
- corticosteroids, to help your baby’s lungs develop more fully
- anticonvulsant medications to prevent a seizure
If preeclampsia is detected early, you and your baby will be treated and managed for the best possible outcome. The following may decrease your chances of developing preeclampsia in a second pregnancy:
- After your first pregnancy and before a second one, ask your doctor to perform a thorough evaluation of your blood pressure and kidney function.
- If you or a close relative has had vein or lung blood clots before, ask your doctor about testing you for clotting abnormalities, or thrombophilias. These genetic defects may increase your risk for preeclampsia and placental blood clots.
- If you are obese, consider weight loss. Weight reduction may decrease your risk of developing preeclampsia again.
- If you have insulin-dependent diabetes mellitus, be sure to stabilize and control your blood sugar level before becoming pregnant and early in pregnancy to reduce your risk of developing preeclampsia again.
- If you have chronic high blood pressure, talk with your doctor about getting it well controlled prior to pregnancy.
To prevent preeclampsia in a second pregnancy, your doctor may recommend you take a low dose of aspirin late in your first trimester, between 60 and 81 milligrams.
The best way to improve the outcome of your pregnancy is to see your doctor regularly, to begin prenatal care at the onset of your pregnancy, and keep all your scheduled prenatal visits. Likely, your doctor will obtain baseline blood and urine tests during one of your initial visits.
Throughout your pregnancy, these tests may be repeated to aid in early detection of preeclampsia. You will need to see your doctor more frequently to monitor your pregnancy.
Preeclampsia is a serious condition that can lead to severe complications in both the mother and baby. It can lead to kidney, liver, heart, and brain problems in the mother and can cause slow development in the womb, a premature birth, and low birth weight in your baby.
Having it during your first pregnancy will increase your chances of having it during your second and subsequent pregnancies.
The best way to treat preeclampsia is to identify and diagnose it as early as possible and to monitor you and your baby closely throughout your pregnancy.
Medications are available to reduce blood pressure and manage the symptoms of the disease, but ultimately, the delivery of your baby is recommended to stop progression of preeclampsia and lead to resolution.
Some women develop postpartum preeclampsia after childbirth. You should seek immediate medical care if this happens to you.