Preeclampsia

What is preeclampsia?

Preeclampsia is a condition women can get when pregnant. It is sometimes called toxemia. It occurs when women who are pregnant have an increase in blood pressure along with signs of organ damage (most often to the kidneys or liver, but sometimes the lungs or other organs). Preeclampsia usually begins after the 20th week of pregnancy.

Preeclampsia can prevent the placenta (which gives oxygen and nutrients to your baby) from getting enough blood. If the placenta doesn’t get enough blood, your baby gets less oxygen and nutrients. This can cause low birth weight and other problems for the baby.

In some cases, women can get preeclampsia after having their baby. This is called postpartum preeclampsia.

It’s very important to see your doctor for routine prenatal visits. Preeclampsia is usually detected early in women who get regular prenatal care, and most problems can be prevented. However, if the condition doesn’t get diagnosed or treated, it can have harmful effects on the mother and/or baby.

Note: Just because you have high blood pressure while pregnant doesn’t mean you have preeclampsia. If your doctor sees your blood pressure is high, they will watch you closely for changes. In addition to high blood pressure, preeclampsia sometimes also causes excessive swelling. Women with preeclampsia may also have protein in their urine. Many women who have high blood pressure during pregnancy don’t have protein in their urine or extreme swelling, and don’t get preeclampsia.

Symptoms of preeclampsia

Most women who have preeclampsia don’t know they have it. Symptoms either don’t exist or are mild. They include swelling and rapid weight gain (more than 2 pounds a week).

Other symptoms can include:

• Headache
• Abdominal pain
• Shortness of breath
• Chest pain
• Dizziness
• Confusion

Severe symptoms are less common and can be confused with normal pregnancy symptoms.

Call your doctor if you have:

• Nausea and vomiting
• Constant headache
• Trouble breathing
• Smaller amounts of urine, or no urine
• Vision changes, such as blurry vision, light sensitivity, flashing lights, spots, or brief blindness
• Stomach pain on the right side below your ribs

What causes preeclampsia?

There is no exact cause of preeclampsia. Women who have autoimmune disorders or blood vessel problems may be more likely to develop preeclampsia. Doctors believe it may also be related to a woman’s genes and diet.

The following conditions could put you at greater risk:

• First pregnancy
• Multiples pregnancy (two babies or more)
• 35 years of age or older
• Personal history of preeclampsia
• Family history of preeclampsia
• History of high blood pressure, diabetes, or kidney disease
• Autoimmune disorders
• Blood vessel problems
• Obesity
• IVF (in vitro fertilization) or fertility treatments

How is preeclampsia diagnosed?

During pregnancy, you should visit your doctor for regular checkups and exams. The doctor will check for signs of preeclampsia. This includes checking your blood pressure and weight. You also will be asked to leave a urine sample. Your doctor may also do a blood test.  Other tests may be done to check your and the baby’s health, if needed. These can determine if your condition is mild or severe.

Warning signs of severe preeclampsia may include:

• Vaginal bleeding (sign of placental abruption)
• Buildup of fluid in the mother’s lungs
• High levels of protein in urine, as well as low urine output
• Poor kidney function
• Abnormal liver function
• Low platelet count

Can preeclampsia be prevented or avoided?

You cannot avoid preeclampsia. You may be able to help prevent it by focusing on better health before you get pregnant. This includes managing chronic conditions, maintaining a healthy weight, and avoiding use of tobacco, illicit drugs, and alcohol.

Preeclampsia treatment

Most women who have preeclampsia still deliver healthy babies. A few develop a condition called eclampsia (preeclampsia with seizures), which is very serious for the mother and baby, or other serious problems.

The only way to cure preeclampsia is to deliver your baby. However, that might not always be possible. Your doctor will discuss the best option based on your length of pregnancy and the state of your condition.

If you are less than 34 weeks along and your condition is mild, the doctor likely will monitor your symptoms. This may mean more frequent doctor visits to check your blood pressure and urine. The doctor may give you orders to help manage symptoms at home. For example:

• Drink more water.
• Eat less salt.

In some cases, your doctor may want to monitor you and your baby from the hospital. The doctor may prescribe steroid injections to speed up the growth of your baby’s lungs. Once the doctor thinks your baby is developed enough, they will schedule delivery.

If you are 37 weeks or more along and/or have severe preeclampsia, your doctor likely will want to deliver your baby right away. To do this, they may induce you (give you medicine or break your water) to start labor or order a C-section.

Living with preeclampsia

Sometimes your high blood pressure may get worse after delivering your baby. But in most cases, preeclampsia usually goes away within 6 weeks of delivery. You may need to take medicine during this time to manage your blood pressure or prevent seizures. Women who have preeclampsia once are more likely to have it in future pregnancies. If you have high blood pressure during pregnancy, you are at risk of having high blood pressure when you are older. You also are at an increased risk of kidney disease, heart disease, diabetes, and HELLP syndrome.

Complications of preeclampsia (for the mother) are rare but include:

• Seizures
• Bleeding
• Stroke
• Coma
• Death

Questions to ask your doctor

• Am I at risk of having preeclampsia?
• Is there anything I can do to prevent preeclampsia?
• If I have preeclampsia in one pregnancy, will I have it in the rest?
• How often will I need to see my doctor?
• What are my treatment options? What is the best treatment for me?
• Is my health or my baby’s health at risk?
• What are the risks if I need early delivery for my baby?
• Can I still breastfeed while taking medicine?
• After delivery, how long will I need to take medicine for preeclampsia?
• What are the side effects or risks of the medicine?
• Once preeclampsia goes away, am I at risk for future health problems?