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OVERVIEW

What is preeclampsia?

Preeclampsia is a rare condition that women can get during pregnancy. It is sometimes called toxemia or gestational hypertension. It occurs when pregnant women experience a sudden rise in blood pressure along with signs of organ damage (most often to the kidneys or liver, but sometimes to the lungs or other organs). Preeclampsia usually begins after the 20th week of pregnancy.

Pre-eclampsia can prevent the placenta (which provides your baby with oxygen and food) from getting enough blood. If the placenta doesn’t get enough blood, your baby gets less oxygen and food. This can lead to low birth weight and other problems for the baby.

In some cases, women can get preeclampsia after having their baby. This is called postpartum preeclampsia.

It is very important to see your healthcare provider for routine prenatal visits. Preeclampsia is usually found early in women who get regular prenatal care, and most problems can be prevented. However, if the condition is not diagnosed or treated, it can have detrimental effects on the mother and/or the baby.

Note: Just because you have high blood pressure during pregnancy doesn’t mean you have preeclampsia. If your healthcare provider thinks your blood pressure is high, they may monitor it closely for changes. In addition to high blood pressure, preeclampsia sometimes also causes excessive swelling. Women with preeclampsia may also have protein in their urine. Many women who have high blood pressure during pregnancy don’t have protein in their urine or extreme swelling, and they don’t get preeclampsia.

SYMPTOMS

Most women who have preeclampsia don’t know they have it. Symptoms are absent or mild. They include swelling and rapid weight gain (more than 2 pounds per week).

Symptoms of preeclampsia include:

• Headache
• Abdominal pain.
• Difficulty breathing.
• Chest pain.
• Dizziness
• Confusion

Severe symptoms are less common and can be confused with normal pregnancy symptoms. Contact your healthcare provider if you have:

• Nausea and vomiting.
• Constant headache.
• Difficulty breathing.
• Smaller amounts of urine, or no urine at all.
• Vision changes, such as blurred vision, sensitivity to light, flashing lights, spots, or brief blindness.
• Stomach pain on the right side below the ribs.

CAUSES

What causes preeclampsia?

There is no exact cause of preeclampsia. Women who have autoimmune disorders or problems with their blood vessels may be more likely to develop pre-eclampsia. Healthcare providers think it may also be related to a woman’s genes and diet.

Women who are in the following situations may be at higher risk:

• First pregnancy.
• Multiple pregnancy (two or more babies).
• More than 35 years of age.
• Personal history of preeclampsia.
• Family history of preeclampsia.
• History of high blood pressure, diabetes, or kidney disease.
• Immune system disorders.
• Blood vessel problems.
• Fertility treatments IVF (in vitro fertilization).

DIAGNOSIS

How is preeclampsia diagnosed?

During pregnancy, you should visit your healthcare provider for regular checkups and exams. The healthcare provider will check for signs of preeclampsia. This includes checking your blood pressure and weight. You may also be asked to leave a urine sample. Your healthcare provider may also do a blood test. Other tests may be done to check the health of you and your baby, if needed. These tests can determine if your condition is mild or severe.

Warning signs of severe preeclampsia may include:

• Vaginal bleeding (sign of placental abruption).
• Seizures in the mother.
• Accumulation of fluid in the mother’s lungs.
• High levels of protein in the urine, as well as low urine output.
• Poor kidney function.
• Abnormal liver function.
• Low platelet count.

PREVENTION

Can preeclampsia be prevented or avoided?

You cannot prevent preeclampsia. You may be able to help prevent it by focusing on improving your health before you get pregnant. This includes managing chronic diseases, maintaining a healthy weight, and avoiding the use of tobacco, illegal drugs, and alcohol.

TREATMENT

Most women who have preeclampsia give birth to healthy babies. Some develop a condition called eclampsia (pre-eclampsia with seizures), which is very serious for mother and baby, or other serious problems.

The only way to cure preeclampsia is to deliver your baby. However, that is not always possible. Your healthcare provider will discuss the best option based on the length of your pregnancy and the status of your condition.

If you are less than 34 weeks pregnant and your condition is mild, your healthcare provider will likely monitor your symptoms. This may mean more frequent healthcare provider visits to check your blood pressure and urine. Your healthcare provider may give you instructions to help manage your symptoms at home. For example:

• Drink more water.
• Eat less salt.

In some cases, your doctor may want to monitor you and your baby from the hospital. The healthcare provider may prescribe steroid medication to speed up your baby’s lung maturation. Once your healthcare provider considers that your baby is developed enough, they will schedule the delivery.

If you are 37 weeks or more pregnant and/or have severe pre-eclampsia, your healthcare provider may want to start your labour right away. To do this, they may induce labour (give you medicine or break your water) or order a caesarean section.

Living With Preeclampsia

Sometimes your high blood pressure can get worse after you deliver your baby. But in most cases, preeclampsia usually goes away within 6 weeks after delivery. You may need to take medication during this time to control your blood pressure or prevent seizures. Women who have preeclampsia once are more likely to have it in future pregnancies. If you have high blood pressure during pregnancy, you are at risk for high blood pressure when you are older. You are also at increased risk for kidney disease, heart disease, diabetes, and HELLP syndrome (hemolysis, elevated liver enzymes, thrombocytopenia).

Complications of pre-eclampsia (for the mother) are rare, but include:

• Seizures (eclampsia);
• Hemorrhage;
• Stroke;
• Coma;
• Death