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Preeclampsia is a serious medical problem that can happen during and after pregnancy. It causes blood pressure to go very high, which can be dangerous for the pregnant person and their fetus.

When does preeclampsia occur?

Preeclampsia usually occurs after 20 weeks of pregnancy. But it also can occur after childbirth. In some cases, preeclampsia can get worse and lead to eclampsia (seizures).
 

Who is at risk? 

Anyone can get preeclampsia. But the risk is higher in those with the following risk factors:

  • First pregnancy
  • Multiple pregnancy (twins, triplets or more)
  • Chronic high blood pressure (that existed before pregnancy)
  • Preeclampsia in a past pregnancy
  • Diabetes (either pre-existing or during pregnancy [gestational])
  • Having certain health problems like lupus, thrombophilia, antiphospholipid syndrome, kidney disease and obstructive sleep apnea
  • Obesity before pregnancy
  • Being age 35 years or older

 

What are the signs and symptoms?

Not everyone with preeclampsia has symptoms. But any of the following have been associated with preeclampsia:

  • Swelling of your face, hands or feet
  • Dull or severe throbbing headache
  • Nausea or vomiting
  • Pain in the abdomen and/or right shoulder
  • Changes in vision, like seeing spots or blurry vision
  • Low back pain, especially when it occurs with abdominal or right shoulder pain
  • Sudden weight gain (3-5 pounds in a week)
  • Shortness of breath or difficulty breathing
     

How can preeclampsia affect the mother?

High blood pressure can temporarily affect the kidneys, liver, lungs, blood and brain. Most of the effects of preeclampsia go away soon after, or within, six weeks of delivery. Having preeclampsia increases your risk of heart disease for the rest of your life. 

 

How can preeclampsia affect the fetus?

  • The fetus can grow more slowly (fetal growth restriction).
  • The amount of amniotic fluid may be too low (oligohydramnios).
  • Early delivery may be needed to treat preeclampsia, which can result in the baby being born too early (preterm). Preterm babies are at risk of many health problems including breathing, eating and staying warm.
  • Preeclampsia can increase the risk of placental abruption, in which the placenta suddenly separates from the wall of the uterus. It can cause severe bleeding (hemorrhage) during delivery that can be life-threatening.
     

How is preeclampsia diagnosed?

Preeclampsia is diagnosed when you have high blood pressure (the top number is 140 or greater or the bottom number is 90 or greater) on two occasions in a woman with previously normal blood pressure, after 20 weeks of pregnancy plus one of the following:

  • Proteinuria, which is high levels of protein in your urine that impairs your kidneys’ ability to filter protein from your blood. Or, in the absence of proteinuria, new-onset hypertension with the new onset of any of the following:
    • Low platelet count (your blood may not clot properly)
    • High creatinine levels (your kidneys are not working properly)
    • High liver enzymes (your liver is not working properly)
    • Fluid in your lungs
    • New onset headache unresponsive to medication and not accounted for by alternative diagnosis or visual symptoms

Preeclampsia is diagnosed as severe when certain signs and symptoms are present. These are called “severe features.”  Signs and symptoms considered severe features include:

  • Low platelet count
  • High blood creatinine levels
  • High liver enzymes
  • Fluid in your lungs

Other severe features include:

  • Very high blood pressure (the top number is 160 or greater; bottom number is 110 or greater)
  • New severe headache that does not go away
  • Vision problems
  • Pain in your upper right abdomen

 

When should I see a doctor?

Make sure you attend your prenatal visits so that your physician can monitor your blood pressure. Contact your physician immediately or go to an emergency department if you have: 

  • Severe headaches
  • Blurred vision or other visual disturbances
  • Severe belly pain
  • Severe shortness of breath

Because headaches, nausea and aches and pains are common pregnancy complaints, it’s difficult to know when your symptoms are simply part of being pregnant and one day may indicate a serious problem—especially if it’s your first pregnancy. Contact your physician if you’re concerned about your symptoms. 

 

How is preeclampsia treated?

You and your physician will need to consider several factors when deciding on treatment.

At the initial evaluation, a complete blood count with platelet estimate, serum creatinine, LDH, AST, ALT and testing for proteinuria should be obtained in parallel with a comprehensive clinical maternal and fetal evaluation. Fetal evaluation should include ultrasonographic evaluation for estimated fetal weight and amount of amniotic fluid as well as fetal antepartum testing.

Subsequent management will depend on the results of the evaluation and gestational age. The decision to deliver must balance the maternal and fetal risks.

Factors include how far along in the pregnancy you are, whether you have severe features, how well you are doing and how well the fetus is doing. If you are still weeks away from your due date but you and the fetus are doing well, and you do not have severe features, you may be able to wait until your pregnancy is further along before having your baby. You’ll have regular blood pressure checks, lab tests and ultrasounds.

If you have severe features, you may need to have your baby right away. You and your physician will weigh the risks and benefits of waiting versus delivery. The decision is based on your condition, the risks of waiting and how preterm your baby will be at delivery. If the decision is to wait then you will be watched in the hospital until delivery.

During delivery, you may receive medication to control seizures and control your blood pressure.

 

Can preeclampsia be prevented?

Daily low-dose aspirin used in pregnancy is considered safe and is associated with low likelihood of serious maternal or fetal complications (or both) related to use. Consult with your physician for the right plan for you.

 

Call (866) MY-LI-DOC (866-695-4362) to find a Catholic Health physician near you. 

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