Women's health

Preeclampsia occurs in about five to eight percent of all pregnancies in the U.S. It is a serious medical condition that can happen in the last half of pregnancy. It can affect all organs of the woman’s body. A woman with preeclampsia has protein in her urine — a sign of stress on her kidneys — as well as high blood pressure (hypertension). Gestational hypertension is high blood pressure without protein in the urine. Gestational hypertension can develop into preeclampsia.

Preeclampsia brings health risks for both mother and baby. It can only be cured by delivery of the baby. If you have preeclampsia, you need special care for the rest of your pregnancy and in the days that follow delivery.

Risks from preeclampsia depend on whether it is mild or severe. Most cases of preeclampsia are mild. They usually go away in the first few weeks after delivery and cause no permanent problems for mother or baby. Nevertheless, even a mild case of preeclampsia is serious, as it can quickly become severe. Severe preeclampsia can cause significant — even life-threatening — complications for both you and your baby. Some of these are listed below.

Risks to you

• Your kidneys, brain, and other organs could be damaged.
• You could have seizures, a complication called eclampsia.
• You could develop HELLP syndrome and serious bleeding and liver problems. HELLP is an abbreviation in which the H stands for hemolysis (red blood cell damage), EL stands for elevated liver enzymes (a sign of liver inflammation), and LP stands for low platelets in the blood (a factor in bleeding problems).

Risks to baby

• Your baby may not grow well inside your uterus. This is because preeclampsia can limit the blood supply to the placenta, the organ that nourishes the fetus during development.
• The placenta can pull away from the uterine wall before the baby is born (placental abruption).
• If your baby needs to be delivered early because of preeclampsia, he could have complications from prematurity, such as breathing and feeding problems.

Many women with preeclampsia have no symptoms and don’t feel sick at all. However, some women notice headaches, changes in vision, nausea, dizziness, or upper abdomen pain. Some also experience a sudden weight gain (more than 5 pounds in a week). Swelling, especially in the face and hands, is fairly common with preeclampsia — but is also common in all pregnant women.

See a doctor if you notice any of these symptoms of preeclampsia:

• Severe or persistent (ongoing) headache
• Vision changes such as temporary vision loss, blurry vision, or sensitivity to light
• Nausea or vomiting
• Dizziness
• Pain in your upper abdomen (upper stomach area)
• Sudden weight gain — more than five pounds in a week
• Rapid increase in swelling, especially in the face and hands
• Trouble breathing

Also, like any other pregnant woman, you should get medical help right away if you notice:

• Decreased fetal movement (baby seems to be moving less than usual)
• Vaginal bleeding, which could be a sign of a serious problem with the placenta
• Ruptured membranes (your water breaks)
• Uterine contractions

Scientists don’t know what causes preeclampsia. However, they have learned that some women are more likely than others to develop this condition. For example, your chance of having preeclampsia is higher if you:

• Are pregnant for the first time, or pregnant for the first time with a new partner
• Have had preeclampsia in a previous pregnancy
• Had chronic high blood pressure, diabetes, or kidney disease before pregnancy
• Are older than 40 or younger than 18 years
• Are pregnant with twins, triplets, or other multiples
• Are obese
• Are African American
• Have an immune disorder, such as lupus

Preeclampsia is usually discovered through regular prenatal checkups, which include blood pressure readings and urine tests. If you’re more than 20 weeks along in your pregnancy and have protein in your urine and high blood pressure, your doctor or midwife may diagnose preeclampsia. Keep in mind that blood pressure has normal ups and downs, so a diagnosis requires more than one high reading.

Preeclampsia can only be cured by the baby’s birth. In some cases, a doctor or midwife may recommend an early delivery. This decision depends on whether the risks from preeclampsia (for you or your baby) outweigh the risks of an early birth for your baby.

Many women with preeclampsia can continue their pregnancies until labor begins on its own. However, if you have preeclampsia, you need special care for the rest of your pregnancy. This care aims to keep preeclampsia from getting worse, to monitor you and your baby carefully for problems, and plan for a safe delivery. It may include the following:

• More frequent prenatal visits. Your doctor or midwife may ask to see you two to eight times a month. Your urine will be tested to see if your kidneys are working well. You’ll be asked about symptoms such as headaches and abdominal pain, which could mean that the brain and liver are being affected.
• Extra testing. You may have extra tests to gauge your baby’s health. These may include a pregnancy ultrasound, a nonstress test, or biophysical profile. To monitor your health, you may have extra blood and urine tests as well as more frequent blood pressure and weight checks.
• Partial bed rest. Your doctor or midwife may ask you to limit your activity, avoid stress, and rest often throughout the day.
• Medications. You may need to take medication to lower your blood pressure or prevent seizures. (Magnesium sulfate is often used during labor to prevent or stop seizures.) You may need to take corticosteroids to help your baby’s lungs mature.
• Hospitalization. Your doctor or midwife may want to admit you to the hospital. This allows the medical team to monitor you and your baby more closely.