Understanding Preeclampsia and the Warning Signs
Preeclampsia may be one of the most well-known complications when it comes to pregnancy. That being said, it’s thankfully quite rare — impacting only about 5 to 8 percent of all pregnancies. But what exactly is it and what are the warning signs?
“Preeclampsia is a condition characterized by a new-onset of elevated blood pressures, swelling or water retention and protein in the urine,” says Rita Wood, D.O., an OB/GYN and physician on the medical staff at Texas Health Fort Worth. “It can lead to neurologic complications such as headaches, vision changes or even seizures (called eclampsia).”
While the condition can occur after 20 weeks’ gestation, it most commonly develops late in your third trimester.
Risk Factors and Symptoms for Preeclampsia
While Wood notes that there still is no definitive cause or risk factors for developing preeclampsia, she says there are some circumstances that allow for a higher risk of developing it. Those circumstances include:
- Your first time being pregnant
- Previous experience with gestational hypertension or preeclampsia
- Women whose sisters and mothers had preeclampsia
- Women carrying multiple babies
- Women younger than 20 years and older than age 40
- Women who had high blood pressure or kidney disease prior to pregnancy
- Women who are obese or have a BMI of 30 or greater
Wood says that race or ethnicity is also a risk factor, as Black women tend to have a higher risk of developing preeclampsia when compared to other races.
“Even with our best and most current research, the exact cause of preeclampsia is not well understood. It can be difficult to explain why it affects some women and not others,” she explains. “That’s why it is important to be aware of preeclampsia because many women who develop the condition are healthy without any risk factors.”
The most common symptoms include elevated blood pressures (140/90 or higher), headaches, vision changes, pain in the upper right abdominal area and swelling or water retention. But severe preeclampsia can also include the inability to tolerate bright light, fatigue, nausea/vomiting, urinating small amounts, shortness of breath and a tendency to bruise easily.
Diagnosis and Treatment
While high blood pressure during pregnancy does not necessarily indicate preeclampsia, it may be a sign of the condition. That’s why it’s important that your health care provider checks your blood pressure at every prenatal appointment.
“At each prenatal visit, I do a physical exam to check for signs of swelling and evidence for appropriate fetal growth,” Wood explains. “A urine dipstick is collected to check for signs of protein in the urine. Blood pressure is also taken at each visit and screening questions are asked to assess for developing symptoms of preeclampsia. If there is a suspicion or diagnosis of preeclampsia, it is important to follow up closely with your health care provider to monitor your symptoms closely.”
In addition to checking your urine and blood pressure, as Wood noted, there additional tests that help to diagnose preeclampsia, including checking blood counts, and liver and kidney function tests. Electronic fetal heart rate monitoring and ultrasounds are also done to monitor blood flow to the placenta, amniotic fluid volume and growth of the baby.
Treatment depends on how close you are to your due date. If you are close to your due date, and the baby is developed enough, your health care provider will most likely deliver your baby as soon as possible.
“Many patients are candidates to receive steroid injections to promote accelerated growth of the baby’s lungs in a case where there is a likely chance of having to deliver the baby early,” Wood adds. “In a case of preeclampsia early in pregnancy, we also involve maternal-fetal medicine doctors and the neonatology team who are experienced with high-risk pregnancies to coordinate an individualized care plan for the patient.”
If you have a mild case and your baby has not reached full development, your doctor will probably recommend you do the following:
- Rest, lying on your left side to take the weight of the baby off your major blood vessels
- Increase prenatal checkups
- Consume less salt
- Drink at least 8 glasses of water a day
- Change your diet to include more protein
If you have a severe case, your doctor may try to treat you with blood pressure medication until you are far enough along to deliver safely, along with possibly bed rest, dietary changes, and supplements.
If preeclampsia is not treated quickly and properly, it can lead to serious complications for the mother such as liver or renal failure and future cardiovascular issues.
Maternal complications may include:
- Kidney or liver damage
- Blood cell abnormalities
- Fluid in the lungs
- Neurologic damage including the possibility of stroke or seizures in severe cases
Fetal complications may include poor blood flow through the placenta, decreased amniotic fluid, fetal distress and poor fetal growth, which can result in the need for the baby to be delivered prematurely.
While most women who develop preeclampsia during pregnancy typically see a reduction in symptoms and a disappearance of the condition after delivery, in very rare cases some mothers can develop preeclampsia within a day or two of giving birth, and in even more unlikely cases, up to six weeks postpartum.
“While delivery of the baby is often the treatment for severe preeclampsia, it can take a few days to start improving,” Wood says. “Then, some women never develop severe symptoms of the condition until they are postpartum. For this reason, it is important to be aware of the signs and symptoms even after your baby has been delivered.”
The signs of postpartum preeclampsia are the same as preeclampsia symptoms during pregnancy.
After delivery, it can be hard to be totally in tune with your body, especially when you’re tired, recovering and busy taking care of your newborn, but if you think you may be exhibiting symptoms, it’s important to get it checked out right away. As in pregnancy, if you leave postpartum preeclampsia untreated, it can lead to seizures, organ damage, stroke or death.
You may be eager to do everything it takes to avoid preeclampsia, but unfortunately, there’s no surefire way to guarantee prevention, especially because some contributing factors to high blood pressure can’t be controlled, such as genetics, family history or the number of babies you’re carrying.
But Wood says following general healthy guidelines throughout your pregnancy can give you the best chance of having a complication-free pregnancy. These include:
- Using little or no added salt in your meals
- Drinking 6-8 glasses of water a day
- Avoiding fried foods and junk food
- Getting enough rest
- Exercising regularly and safely
- Elevating your feet several times during the day
- Avoiding alcohol
- Taking all prescribed medications and supplements as directed
While it can be nerve-wracking not being able to have complete control over if you develop preeclampsia or not, attending all prenatal appointments, following healthy habits, being in tune with your body and learning about the warning signs it may give you, and talking with your doctor about things you can do to reduce your risk of preeclampsia can help you catch the condition early. And remember, your health care team is always there to make sure you have the best outcome possible.
Finding support and guidance you can trust throughout your pregnancy can help relieve anxiety or stress and make sure you’re staying healthy and safe. Texas Health is here for you every step of the way. For more information for moms-to-be, visit TexasHealth.org.