Common questions about preclampsia:
- What is preeclampsia?
- What are the risk factors and causes of preeclampsia?
- What are the symptoms of preeclampsia?
- Who’s at risk for preeclampsia?
- How does preeclampsia affect my pregnancy and body?
- How severe can preeclampsia get?
- When does preeclampsia occur?
- How does preeclampsia affect the baby?
- What’s the cure for preeclampsia?
- Will I develop preeclampsia in a subsequent pregnancy?
- What can I do to prevent preeclampsia?
- What can I ask my doctor?
What is preeclampsia?
Preeclampsia (pre-e-CLAMP-si-a) is a condition that occurs during pregnancy and is characterized by high blood pressure. It occurs in 5 to 8 percent of pregnant women in the United States. According to The Preeclampsia Foundation, the condition is diagnosed based on the elevated blood pressure of the expectant mother generally after 20 weeks of pregnancy or during the postpartum period with proteinuria (protein in the urine).
Other symptoms include elevated liver functions or decreased blood platelets and issues with the kidneys (decreased urine output) and/or fluid in the lungs (edema). Other symptoms include abdominal pain, nausea and vomiting, headaches, shortness of breath, confusion, burning behind the sternum, and/or visual sensitivity including oversensitivity to light or blurred vision. These symptoms are presented in more detail below.
What are the risk factors and causes of preeclampsia?
Women struggling with chronic hypertension, obesity, certain metabolic diseases like diabetes and who are over the age of 35 are more at risk, as well as those with deficiencies in essential nutrients and minerals (like low calcium). Obesity can be controlled by the current standards of MyPlate from the United States Department of Agriculture: half fruits and vegetables, half grains and protein with a small serving of dairy on the side. It’s best to cut back on processed sugars and foods and avoid caffeine and alcohol.
What are the symptoms of preeclampsia?
Sometimes there are no symptoms of preeclampsia or they can be written off as typical pregnancy pains. Even when there are no symptoms, the following tests are critical at your regular check-ups: blood pressure checks, weigh in, and urine dip. It’s important to keep up with your medical appointments, particularly after you hit the 20-week mark of pregnancy.
Talk with a medical professional before taking any supplements, whether they are herbal or not.
The main symptoms of preeclampsia are:
- Hypertension: High blood pressure is measured as blood pressure at or over 140/90 when measured in two separate instances at least 4 hours apart. It’s also considered severe if your blood pressure is equal to or exceeds 160/110. You may also have to do a daily kick count of the baby’s movements.
- It’s also important to keep track of your baseline blood pressure. You can buy your own blood pressure monitor to know your numbers outside of the doctor’s office.
- Swelling or edema: Although some swelling is expected with pregnancy, edema is the collection of excess fluid. Talk to your doctor when you are feeling excessively puffy and if an indentation remains for a few seconds after you press on your skin. Drink water to stay hydrated, and be sure to put up your feet when you can during the day.
- Sudden weight gain: The amount of weight gain during pregnancy generally is 25-35 pounds. Any excess weight gain, especially in the third trimester, may indicate a potential problem. It’s important to note that the recommended weight varies based on your pre-pregnant weight/BMI. Underweight (BMI<18) 28-40 pounds. Normal weight (BMI 16-25) 25-35 pounds. Overweight (BMI 25-30) 15-25 pounds. Obese (BMI 30 or greater) 11-20 pounds.
- Headache: These headaches may be dull or throbbing, often migraine-like. If over the counter medication isn’t working, call your healthcare provider.
- Nausea or vomiting: Call your doctor if either or both of these symptoms become severe.
- Changes in vision: If you’re experiencing temporary loss of vision, auras, sensations of flashing lights, blurry vision, spots and/or light sensitivity, you may be developing preeclampsia. Call your healthcare provider immediately.
- Racing pulse, mental confusion, heightened anxiety, trouble catching breath. These symptoms could be a sign of severe preeclampsia.
- Stomach or right shoulder pain: This type of stomach pain is usually felt under the ribs and shoulder pain is often referred pain radiating from the liver under the right ribs. These symptoms may be a sign of HELLP Syndrome, one of the most severe forms of preeclampsia that often affects the liver. These symptoms require an immediate call to your doctor.
- Hyperreflexia: Your doctor may notice this symptom when they check your reflexes and your legs bounces back hard.
Who’s at risk for preeclampsia?
Women at risk for this condition may have the following:
- History of preeclampsia
- Multiple gestation (a pregnancy with more than one baby)
- History of chronic hypertension, diabetes, kidney disease or organ transplant
- First pregnancy
- Obesity, particularly with a BMI of 30 or greater
- Over 40 or under 18-years-old
- Family history of preeclampsia
- Polycystic ovarian syndrome
- Diabetes, either Type 1 or Type 2
- Lupus or other autoimmune disorders, including multiple sclerosis, sarcoidosis, and rheumatoid arthritis
- Had in-vitro fertilization
How does preeclampsia affect my pregnancy and body?
Preeclampsia will cause your blood pressure to spike and put you at risk for severe medical complications such as neurological/brain injury, impaired kidney and liver function, blood clotting problems, excess fluid in the lungs (called pulmonary edema) and seizures. In severe forms or left untreated, preeclampsia can lead to maternal and/or infant death. This is why regular medical check-ups are key to monitoring your pregnancy.
How severe can preeclampsia get?
An estimated 15 percent of pregnant women with preeclampsia may experience HELLP Syndrome, a life-threatening pregnancy complication. It occurs in 4 to 12 percent of women who have preeclampsia. The name stands for hemolysis (the breaking down of red blood cells), EL (elevated liver enzymes) and P (low platelet count). The morbidity rate around the world is as high as 25 percent with a maternal mortality rate of 1.1 percent. That rate is much higher for the baby, and the risks also include low birth weight and fetal death. Symptoms include headache, nausea/vomiting/indigestion with pain after eating, bleeding, vision changes, shoulder pain or pain associated with deep breaths, swelling, and abdominal or chest tenderness and upper right side pain.
When does preeclampsia occur?
Preeclampsia can happen at any time during pregnancy and even up to six weeks post-partum, but the most common time is during the final trimester and generally resolves within 48 hours of delivery. The condition can be diagnosed at any time and found during a routine test like a blood pressure check or urine dip. If you are diagnosed with the condition early in your pregnancy, your medical care provider may recommend bed rest, time off work, medication and hospitalization to control your blood pressure. If the medical provider is unable to control your blood pressure via medical treatment, and the mother’s and/or baby’s health is at risk, the doctor may prescribe steroids to lessen the severity of premature lung development if delivery is anticipated prior to 37 weeks gestation.
Preeclampsia can occur post-partum as late as 4-6 weeks, and can be severe for the mother. Almost 14 percent of maternal deaths are related to hypertensive disorders such as preeclampsia before, during and after pregnancy. Any signs and symptoms described earlier should be brought to your healthcare provider to be sure you do not have preeclampsia.
How does preeclampsia affect the baby?
Preeclampsia can cause babies to be born prematurely, which is considered anytime before the 37-week mark, or if born before 32 weeks there may be more severe issues related to prematurity. Problems related to prematurity include respiratory distress, feeding problems, increased risk of infections and bleeding inside the skull (known as intracranial hemorrhage). These problems may create short term issues that will resolve before the baby leaves the Neonatal Intensive Care Unit (NICU) or they may be lifelong disabilities such as blindness, seizures, learning disabilities and cerebral palsy. Women with preeclampsia have 4.5 times the risk of delivering a stillborn baby than a woman who does not have preeclampsia.
What’s the cure for preeclampsia?
The only cure for preeclampsia is the mother delivering the baby. The condition can escalate quickly if there are delays in diagnosing preeclampsia and it progresses into severe preeclampsia, which can lead to possibly life-threatening complications for the mother and/or baby. It must be monitored carefully by a health professional. There are medications and treatments to prolong pregnancy so the baby has time to develop. Sometimes, the baby must be delivered at any time during the pregnancy to save the mother and/or baby’s life. Key prevention measures include improving your diet, maintaining a healthy weight, and controlling chronic hypertension and diabetes.
Will I develop preeclampsia in a subsequent pregnancy?
A mother who had preeclampsia during her first pregnancy is 20 percent more likely to experience it during later pregnancies. The severity and time of the condition during your prior pregnancy will determine your risk factors, so it’s critical for a healthcare professional to closely monitor you and your baby for signs and symptoms of preeclampsia. Even if you’ve had a second pregnancy without preeclampsia, but had it in your first, you can still be at risk.
What can I do to prevent preeclampsia?
The American College of Obstetricians and Gynecologists recommend looking at your potential risk factors, including having hypertension, before becoming pregnant. It’s best to go to your doctor for a pre-pregnancy check-up to see if your hypertension is adversely affecting your health or could affect your pregnancy. Being overweight is another risk factor and you may have to lose weight before becoming pregnant. If you have a medical condition such as diabetes, it’s recommended to get your condition under control before becoming pregnant.
According to the U.S. Preventative Services Task Force (USPSTF) for the Agency for Healthcare Research and Quality (AHRQ), pregnant women at a high risk for preeclampsia should think about taking a low dose aspirin starting as early as the second trimester of pregnancy to possibly prevent the negative effects of potential preeclampsia. Studies with relatively large sample sizes in this review found an up to 5 percent risk reduction rate in preeclampsia.
What else can you do?
Whether you have had preeclampsia, are considering becoming pregnant again or are becoming pregnant for the first time, it’s critical to consult a healthcare professional. If you are diagnosed with preeclampsia, the doctor or healthcare provider will be able to monitor your symptoms and hopefully mitigate the negative consequences before they become severe.
Leaving your health to chance can mean the difference between being a part of your child’s life and potentially not, or succumbing to preeclampsia complications and being unable to do the things you once could, including taking care of your newborn baby.
What can I ask my doctor?
You can ask your doctor any of the following questions in this FAQ, including:
- What are my risk factors for developing preeclampsia?
- What are my test results for my blood pressure, urine test, and weigh-in, and how do they compare with my last visits?
- What else can I be doing to ensure a healthy pregnancy?