What Is Preeclampsia?

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Preeclampsia is high blood pressure that may occur after 20 weeks of pregnancy. Another feature of the condition is liver or kidney damage. Rarely, preeclampsia can occur within 48 hours of giving birth. This is called postpartum preeclampsia.

Most people with preeclampsia have healthy babies. However, left untreated, it can cause serious problems, like premature birth, which is defined as delivering the baby before 37 weeks of pregnancy, and even death.

Preeclampsia occurs in 8% of pregnancies around the world, and cases in the United States have risen by about 25% since the 1980s.

Doctor checking blood pressure of pregnant woman

Alistair Berg / Getty Images

Symptoms of Preeclampsia

Signs of preeclampsia include high blood pressure, also called hypertension, and proteinuria, where protein is detected in your urine. The amount of protein will be about 300 milligrams (mg) over a 24-hour urine collection in cases of preeclampsia.

Many people do not have symptoms. Even if they do, it's difficult to recognize them as signs of preeclampsia. They are usually picked up during a routine appointment with your obstetrician.

Other symptoms of preeclampsia may develop, including:

  • A headache that won't go away
  • Shortness of breath
  • Blurred vision, seeing spots, or other vision changes
  • Pain in the upper abdomen or shoulder
  • Nausea and vomiting
  • Sudden weight gain
  • Swelling in the hands or face
  • Lightheadedness

When preeclampsia progresses to more severe forms, additional symptoms may include:

  • Low platelet count
  • Abnormal kidney or liver function
  • Abdominal pain
  • Severe headache
  • Blood pressures of 140/90 mm Hg and higher
  • Vision changes
  • Fluid in the lungs
  • Seizures

When to Call Your Doctor

Some symptoms that occur with preeclampsia should prompt you to call your doctor immediately, including:

  • Swelling in the hands or face
  • Sudden weight gain over a day or two, or more than two pounds in a week
  • Headache that won't go away or gets worse
  • Trouble urinating
  • Nausea and vomiting
  • Vision changes
  • Dizziness
  • Stomach pain below your ribs, usually on the right
  • Right shoulder pain
  • Trouble breathing

Causes

It's not clear what causes preeclampsia. Changes in the placenta is a leading theory since the placenta creates proteins and a number of other substances that enter the pregnant person's bloodstream. Proteins and other substances generated by the placenta are believed to play a vital role in the progression of pregnancy and even labor.

Factors that may lead to preeclampsia include:

  • Autoimmune disorders
  • Blood vessel problems
  • Your diet
  • Your genes

You're more likely to develop preeclampsia during pregnancy if the following factors apply to you:

  • First pregnancy
  • Past history of preeclampsia
  • Multiple pregnancy (twins or more)
  • Family history of preeclampsia
  • Obesity
  • Being older than 35 years old
  • Being African American
  • History of diabetes, high blood pressure, or kidney disease
  • History of thyroid disease

Diagnosis

Your doctor will perform a physical exam to evaluate for high blood pressure, swelling in your hands and face, and weight gain. Expect to also provide urine and blood samples for testing.

Your test and exam will show the following if you have preeclampsia:

  • High blood pressure
  • Protein in your urine
  • Low platelet count (thrombocytopenia)
  • Poor liver function
  • Pain in the upper abdomen
  • Poor kidney function
  • Pulmonary edema
  • Persistent headache unrelieved by medications

Those who had low blood pressure at the start of their pregnancy, followed by a significant rise in blood pressure, need to be watched closely for other signs of preeclampsia.

Treatment

Preeclampsia often resolves after the baby is born and the placenta is delivered. However, it may persist or even begin after delivery.

Most often, at 37 weeks, your baby is developed enough to be healthy outside of the womb. Your provider may want your baby to be delivered early so the preeclampsia does not get worse.

If your baby is not fully developed and you have mild preeclampsia, the disease can be managed at home until your baby has matured.

Fetal monitoring will be done, and you may be given corticosteroids to help your baby's lungs reach maturity in case a hasty delivery is required. You may also be given magnesium sulfate to prevent seizures and medications to help control your blood pressure.

The baby must be delivered if there are signs of severe preeclampsia, including:

  • Tests that show your baby is not growing well or is not getting enough blood and oxygen
  • The bottom number of your blood pressure is over 110 mm Hg or is greater than 100 mm Hg consistently over a 24-hour period
  • Abnormal liver function test results
  • Severe headaches
  • Pain in the stomach
  • Seizures or changes in mental function
  • Fluid buildup in the pregnant person's lungs
  • HELLP syndrome, which refers to a group of symptoms including hemolysis (destruction of red blood cells), elevated liver enzymes, and low platelet counts
  • Low platelet count or bleeding
  • Low urine output, a lot of protein in the urine, and other signs that your kidneys are not working properly

Coping

Coping with preeclampsia can be difficult. Make sure you have a strong support system in place to help you and your baby stay safe. Talk to your doctor if you need help. If you have a difficult time managing your condition at home, your doctor may have you admitted to the hospital for better care.

Some people who develop preeclampsia during pregnancy are at higher risk of developing cardiovascular diseases later in life. Talk to your doctor about your risks and steps you can take to protect your health after delivery.

Summary

Some people may develop high blood pressure after 20 weeks of pregnancy. Knowing whether you have risk factors for preeclampsia can help you and your doctor prepare for it and identify it promptly if it does occur. It's relatively rare, and generally does not affect the health of the baby.

A Word From Verywell

Preeclampsia can be a scary complication of pregnancy, but your doctor can help you come up with a plan to manage it if it does occur. If you are at high risk of developing preeclampsia or if you have already been diagnosed, discuss next steps with your doctor. Seek out a good support system or tell your doctor if you need more help.

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