Through: May 28, 2021• Published:
Preeclampsia is a condition unique to pregnancy. Every May is Preeclampsia Awareness Month. What is preeclampsia and how can it be prevented and treated?
What is preeclampsia?
Preeclampsia is a disorder that affects between 5% and 8% of pregnancies in the United States. It is becoming more and more common; there has been a 25% increase in this condition over the past two decades. The signs and symptoms of preeclampsia usually occur after the 20th week of pregnancy until your due date, and can also occur after childbirth for up to six weeks after giving birth.
The diagnosis of preeclampsia is made by your obstetric provider. It can occur on a spectrum, ranging from a simple rise in blood pressure to maternal attacks called eclampsia.
The American College of Obstetricians and Gynecologists (ACOG) recently updated its diagnostic criteria. Preeclampsia is diagnosed by the discovery of an increase in blood pressure after the 20th week of pregnancy with or without protein present in the urine. When measuring your blood pressure, systolic blood pressure (upper number) of 140 mmHg or more or diastolic blood pressure (lower number) of 90 mmHg or more is abnormal, and you should contact your obstetric service provider.
Signs of preeclampsia
While a majority of patients with preeclampsia will have healthy babies and make a full recovery, a few will experience serious complications. Since the disease can progress quickly, detecting the signs and symptoms of preeclampsia early could save you and your baby’s life.
Symptoms of preeclampsia can include:
- Upper abdominal pain
- Shortness of breath
- Chest pain
- Visual disturbances such as flashes of light or very blurred vision
If you experience any of these symptoms, you should contact your obstetrician or midwife.
Who is at risk for preeclampsia?
If you have any of the risk factors below, talk to your obstetrician, midwife or nurse practitioner about prevention strategies for preeclampsia.
Patients who have pre-existing conditions listed below:
- Kidney disease
- Thrombophilia (inherited bleeding disorders)
- Pregnancy conceived with assisted reproduction (IVF) technology
- Obstructive sleep apnea
Other risk factors may include:
- First pregnancy
- Multiple gestation (twins, triplets, quadruplets)
- History of preeclampsia
- Maternal age over 35
- Obesity (a body mass index greater than 30)
- People of color
A simple low dose (81 milligram) aspirin taken daily during pregnancy before the 16th week until childbirth has been shown to decrease the risk of developing preeclampsia by 30%.
How do we treat preeclampsia?
The ultimate cure for preeclampsia is childbirth. The mother’s blood pressure, kidney and liver function, and general well-being will improve after childbirth. Many times the diagnosis is made early in pregnancy. In this case, your doctor may prescribe medication for high blood pressure or a hospital stay with frequent lab tests and ultrasounds to monitor you and the baby. It becomes a balance to keep mother and baby as safe as possible.
After giving birth with a diagnosis of preeclampsia, you may need to stay in the hospital longer to monitor and control your blood pressure. When you go out, it’s important to rest, check your blood pressure, and keep taking your medication. Follow-up three to five days after discharge is very important, either by telemedicine or in person, to ensure that your blood pressure is improving. Your medications may also need to be adjusted.
Postpartum preeclampsia care
Preeclampsia can also develop postpartum in patients who did not have high blood pressure during pregnancy. The warning signs of postpartum preeclampsia can include:
- Chest pain
- Shortness of breath
- Extreme swelling of the hands and feet
If you are having these problems, contact your health care provider.
If you have had preeclampsia, you are three to four times more likely to have high blood pressure, heart disease, and stroke after giving birth or even later in life. After your postpartum period, you will need to tell your primary care provider (PCP) about your diagnosis of preeclampsia. Your PCP will continue to monitor your blood pressure and assess your risk for heart disease and stroke. Hope this will lead you to better health!
Lyndsey D. Neese, MD, MMM, FACOG, is an OB / GYN with Norton Children’s Maternal-Fetal Medicine and serves as a quality medical directory for women’s services at Norton Healthcare.