Preeclampsia

What is Preeclampsia?

Preeclampsia is a dangerous complication of pregnancy that can appear after the first trimester- usually after the 20th week. It may also occur during labor or right after your baby is born. It’s relatively uncommon, affecting around 5%-8% of pregnant women.

It’s characterized by high blood pressure and signs of damage to other organs, such as the:

• Kidneys
• Liver
• Brain
• Eyes
• Placenta. The placenta is the organ that brings oxygen and nutrients to your baby.

If left untreated, preeclampsia can lead to serious, even life-threatening complications for both you and your baby.

Preeclampsia Symptoms

Preeclampsia often develops without any noticeable symptoms unless it is severe. Some common signs for the mom include:

• High blood pressure or hypertension consistently 140/90 mm Hg or higher is a key sign.
• Protein in the urine, or proteinuria, which is often detected during routine urine tests at prenatal appointments.
• A decrease in blood platelets.
• Bad headaches that don’t go away.
• Blurred vision, seeing spots, or light sensitivity.
• Upper abdominal pain, typically under your ribs on the right side. This pain is often mistaken for heartburn or indigestion.
• Fluid in your lungs.
• Nausea or vomiting which can occur suddenly and may be severe.
• Swelling or edema in your face and hands that is more pronounced than typical pregnancy swelling.
• Rapid weight gain, more than 2 pounds in a week, which can be a sign of fluid retention related to preeclampsia.

Some ways preeclampsia can affect your baby are:

• Slowed growth, which can be seen during an ultrasound check.
• Less amniotic fluid around your baby.
• Reduced blood flow through the umbilical cord.
• Abnormal results on tests that check your baby’s well-being, such as a nonstress test.

It is important to know that preeclampsia doesn’t improve on its own during pregnancy and can actually get worse. This usually happens gradually over a few days or weeks but can also progress quickly. Since its symptoms can be subtle, it’s crucial to immediately share any concerns with your doctor.

Causes of Preeclampsia

Preeclampsia is likely caused by a combination of factors related to how the placenta develops and how your body responds to pregnancy. The exact reason why this occurs in some women and not others is still not fully understood. Potential causes for preeclampsia include:

• Placenta problems: If the placenta doesn’t develop properly, it can release substances that may cause high blood pressure and organ issues.
• Immune response: Your body might see the placenta as foreign, triggering inflammation.
• Cardiovascular issues: Pre-existing heart or blood vessel problems may worsen during pregnancy.
• Hormones and proteins: Imbalances can affect how your blood vessels and organs function.
• Nutrient deficiencies: Lack of essential nutrients may increase the risk of developing preeclampsia.

Diagnosing and Monitoring Preeclampsia

Diagnosing and monitoring preeclampsia involves a lot of testing during and after pregnancy. Because we don’t always know which women will develop preeclampsia, your OB/GYN will check for signs throughout your pregnancy.

To diagnose the condition or keep an eye on how it affects your organs and baby’s health, your doctor will perform following tests:

1. Blood pressure

Your doctor will check your blood pressure at every prenatal visit. This should be done after you’ve been sitting comfortably for a few minutes. High blood pressure is 140/90 or higher, and severe high blood pressure is 160/110 or above, which needs immediate attention.

2. Urine test or urinalysis

At each appointment, you’ll provide a urine sample. Healthy kidneys don’t pass much protein into urine. If protein is found, you might need to collect your urine for 12 or 24 hours for further testing. Protein levels over 300 mg in a day could indicate preeclampsia, but this doesn’t necessarily show how severe it is. Your doctor may also do a quick “spot check” to compare protein to creatinine levels, another kidney health indicator.

3. Blood tests.

Blood tests may be done to check your blood count, kidney function, and liver enzyme levels. These tests help your doctor monitor your health and detect any issues early. If you have symptoms of severe preeclampsia, like HELLP syndrome—a serious complication that affects the blood and liver—your doctor might order more blood tests to check your liver and platelet levels, which can indicate how your body is coping.

4. Weight

Your weight will also be monitored to ensure you’re gaining within the normal range. While some swelling is normal, sudden weight gain or swelling in your face and hands can be early signs of preeclampsia.

5. Ultrasound

This imaging test monitors your baby’s growth, as preeclampsia can affect their development.

6. Non-stress test or biophysical profile

These tests check your baby’s heart rate and movements to ensure they’re doing well.

Preeclampsia Treatment

The only way to cure preeclampsia is by delivering your baby and placenta. Reducing your physical activity and taking medication to lower blood pressure can help manage symptoms but won’t stop preeclampsia from getting worse or prevent its complications.

If tests show that your condition or your baby’s condition is worsening, your doctor may recommend delivering the baby. In many cases, a vaginal delivery is still possible.

Women with severe preeclampsia are at risk of having seizures, known as eclampsia. To prevent this, most women are given anticonvulsant medication during labor and for about 24 hours after delivery. The most commonly used medication is intravenous magnesium sulfate, which is safe for both you and your baby.

Prevention of Preeclampsia

We don’t yet know why some women develop preeclampsia while others don’t. There are currently no reliable tests to predict who will get it, and there isn’t a way to fully prevent it. For this reason, it is essential to keep all your prenatal appointments so your doctor can monitor your blood pressure and catch any signs of preeclampsia early.

Preeclampsia FAQs

Is preeclampsia dangerous for my baby?

Preeclampsia can restrict blood flow to the placenta, leading to growth problems for the baby. In severe cases, it can cause premature birth, which carries its own risks for the baby.

What happens after delivery?

High blood pressure and protein in your urine usually return to normal after giving birth, often within a few days or weeks. However, some women might still need medication to help control their blood pressure after they leave the hospital. Your doctor will want to continue monitoring, as some women who have had preeclampsia are at higher risk for cardiovascular diseases, including high blood pressure, later in life.