Pregnancy can be a challenging time. Unless you’re one of the lucky few, it brings swelling, aches and pains, nausea, and other unpleasant symptoms. While most soon-to-be mothers would agree that the changes in their bodies are worth it, some pregnancy symptoms can indicate problems like preeclampsia, which involves high blood pressure, swelling of the hands and feet, and protein in the urine. It’s dangerous because when it’s untreated, it can lead to HELLP syndrome and eclampsia, which are life-threatening.

Preeclampsia affects between 5-8% of pregnancies and usually develops between 20 weeks gestation and six weeks after delivery.

Signs of Preeclampsia

Preeclampsia can be scary because its symptoms often aren’t noticed. In fact, if you have preeclampsia, the first time you may have any indicator something’s wrong will be at your regular prenatal appointments when your doctor screens your blood pressure and urine. Because preeclampsia can mimic regular pregnancy symptoms, regular prenatal visits with your doctor are critical.

Signs (changes in measured blood pressure or physical findings) and symptoms of preeclampsia can include:

• High blood pressure (hypertension). High blood pressure is one of the first signs you’re developing preeclampsia. If your blood pressure is 140/90 or higher, it may be time to become concerned. Even if you’re not developing preeclampsia, high blood pressure can indicate another problem may be happening. If you have high blood pressure, your doctor may recommend medications and ask you to monitor your blood pressure at home between visits.
• Lower back pain related to impaired liver function.
• Changes in vision, usually in the form of flashing lights or inability to tolerate bright light.
• Sudden weight gain of more than 4 pounds in a week.
• Protein in the urine (proteinuria). Preeclampsia can change the way your kidneys function, which causes proteins to spill into your urine. Your doctor may test your urine at your prenatal visits. If you’re showing signs of preeclampsia, you may also be asked to collect your urine for 12 or 24 hours. This will give your doctor more accurate results for how much protein is in your urine and can help him or her diagnose preeclampsia.
• Shortness of breath.
• Increased reflexes, which your doctor may evaluate.
• Swelling (edema). While some swelling is normal during pregnancy, large amounts of swelling in your face, around your eyes, or in your hands can be a sign of preeclampsia.
• Nausea or vomiting. Some women experience nausea and vomiting throughout their pregnancy. However, for most women, morning sickness will go away after the first trimester. If nausea and vomiting come back after mid-pregnancy, it can be a sign you’re developing preeclampsia.
• Severe headaches that don’t go away with over-the-counter pain medication.
• Abdominal pain, especially in the upper right part of your abdomen or in your stomach.

Who’s at risk?

While it’s impossible to tell which expecting mothers will develop preeclampsia, you may be at risk if the following factors are present:

• A multiple pregnancy (twins or more)
• History of preeclampsia
• A mother or sister who had preeclampsia
• History of obesity
• High blood pressure before pregnancy
• History of lupus, diabetes, kidney disease, or rheumatoid arthritis
• Having in vitro fertilization
• Being younger than 20 or older than 35

Complications of preeclampsia

Preeclampsia can affect both mother and baby. These complications might include:

• Preterm birth. The only way to cure preeclampsia is to deliver your baby, but sometimes delivery can be postponed to give your baby more time to mature. Your doctor will monitor your pregnancy and preeclampsia symptoms to determine the best time for your baby to be delivered in order to preserve your health and the health of your baby.
• Organ damage to your kidneys, liver, lungs, heart, or eyes.
• Fetal growth restriction. Because preeclampsia affects the amount of blood carried to your placenta, your baby may have a low birth weight.
• HELLP syndrome. HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome is a severe form of preeclampsia that can be life-threatening for you and your baby. HELLP syndrome damages several organ systems at once.
• Eclampsia. Uncontrolled preeclampsia can turn into eclampsia. It includes all of the same symptoms of preeclampsia, but you’ll also experience seizures. Eclampsia can be dangerous for both mother and baby. If you’re experiencing eclampsia, your doctor will deliver your baby no matter how far along you are.
• Cardiovascular disease in the future. Your risk of cardiovascular disease increases if you have preeclampsia more than once or if you’ve had a preterm delivery.
• Placental abruption happens when the placenta separates from the wall of your uterus before your baby is delivered. It causes bleeding and can be life-threatening for you and your baby.

Treatment options for preeclampsia

Your doctor will treat your preeclampsia based on how severe your symptoms are, how far along you are, and how well your baby is doing. When monitoring your preeclampsia, your doctor may recommend regular blood pressure and urine testing, blood tests, ultrasounds, and non-stress tests. He may also recommend:

• Treatment with betamethasone, a steroid that will help mature your baby prior to delivery if you’re still early (< 37 weeks) in your pregnancy
• Delivery of your baby if your symptoms are severe or if you’re at 37 weeks or more.
• Modified bed rest at home or in the hospital if you’re not yet at 37 weeks, and if your and your baby’s conditions are stable.

Preeclampsia generally worsens as pregnancy goes on, so your doctor’s recommendations may change, depending on your health and the health of your baby.

Seek care right away

To catch the signs of preeclampsia, you should see your doctor for regular prenatal visits. Call your doctor and go straight to the emergency room if you experience severe pain in your abdomen, shortness of breath, severe headaches, or changes in your vision. If you’re concerned about your symptoms, be sure to ask your doctor if what you’re experiencing is normal.