Your Questions About Preeclampsia, Answered
Up to 8% of pregnancies around the world are affected by a blood pressure condition known as preeclampsia, according to the American College of Obstetricians and Gynecologists. Left unmanaged, preeclampsia can put both the pregnant person and their baby at risk of serious health issues.
While a preeclampsia diagnosis can be scary, the condition is well known and well studied, and your doctor will have a plan for you if you develop it. “This isn't like Pandora's box, or a mysterious black box of 'What is this?'” says Ilina Pluym, M.D., a board-certified ob-gyn at UCLA Health, in California. “We know how to manage it once we get the diagnosis, so you can trust your doctor and their ability to keep you and your baby safe.”
Here’s what every pregnant person should know about preeclampsia.
What Is Preeclampsia?
Preeclampsia occurs when a pregnant person develops new onset elevated blood pressure readings (top number at or over 140 and/or bottom number at or over 90) that persist. Other clinical signs of preeclampsia could include reduced platelet count or problems with the liver, kidneys, brain, or fluid in the lungs, occurring after 20 weeks of pregnancy or in the postpartum period. It may be diagnosed by blood pressure readings and/or symptoms or results of lab tests.
What Are the Signs of Preeclampsia?
Symptoms of preeclampsia include the following:
- Persistent headache
- Swelling of the face or hands
- Vision changes, such as blurry vision, seeing spots, or changes in eyesight
- Pain in the right upper or central upper abdominal area
- Protein in the urine
Be sure to call your healthcare provider if you start to experience any of these symptoms during pregnancy. However, be aware that not everyone who develops the condition notices the symptoms of preeclampsia, which is why those routine prenatal blood pressure readings and urine tests are so important. Also, many of the symptoms of preeclampsia are nonspecific, which means that it’s possible to have some of these symptoms but not have preeclampsia.
What Are the Risks?
Without proper monitoring and treatment, preeclampsia can pose serious health risks to both you and your baby.
“By affecting your blood pressure, it can affect your heart, your kidneys, your liver, your lungs, your brain, and the baby,” Pluym says.
Preeclampsia can affect the blood supply to your placenta, which can be harmful and, in rare cases, even fatal for the fetus. “Fetal risks include abruption, growth restriction, preterm birth, and fetal demise,” says Chenchen Sun, M.D., a board-certified ob-gyn at Tufts Medical Center, in Boston.
Early diagnosis is essential to help manage and treat preeclampsia to keep both you and your baby safe and healthy.
How Is Preeclampsia Treated?
Preeclampsia treatment options depend on the severity of the condition as well as how far along you are in your pregnancy. The goals are to limit health complications for the pregnant person and deliver the healthiest baby possible.
When Preeclampsia Is Caught Early
If preeclampsia is diagnosed early in pregnancy, you (and the baby) will likely be monitored closely, with more frequent checkups. You may be asked to invest in a blood pressure cuff to regularly check your blood pressure at home.
“Depending on the severity, more frequent visits with your doctor and weekly monitoring of your baby may be recommended,” Sun says. “For more severe cases, hospital admission or oral medication may be needed.”
It’s also important to know that preeclampsia can progress rapidly to a dangerous stage, adds Sun. “If you’re being monitored at home, take your blood pressure daily, and look out for any symptoms that may be a sign of progression of preeclampsia, such as headache, visual changes, and pain underneath your right breast, which could also be a sign of liver compromise.”
Seek emergency care if you experience any signs of progression of preeclampsia, which may require hospitalization or even emergency delivery.
When Preeclampsia Is Caught Late
If a pregnant person is diagnosed with preeclampsia when close to full term (39 weeks), experts say the best treatment option is to deliver the baby.
Preeclampsia is the cause of approximately 15% of premature deliveries, or those before week 37 of pregnancy. And preterm babies are at an increased risk of health complications like low birth weight as well as issues with breathing, feeding, hearing, seeing, and staying warm.
It’s important to note that most cases of preeclampsia don’t occur until at or near full term. “The majority of women, if they get it, won't get it until the very tail end of pregnancy, when they're going to be close to delivery anyways, and [delivering the baby] is the treatment,” Pluym says.
“The only ‘cure’ is delivery,” Sun adds.
Life After Preeclampsia
Preeclampsia typically disappears after delivery. However, in very rare cases, it may not show up at all until after delivery, which is known as postpartum preeclampsia. Whenever it is diagnosed, your healthcare provider will monitor you for several weeks after delivery to ensure there are no issues. For your part, pay attention to how you feel after birth, and if you experience any unusual symptoms at all, follow up with your doctor.
If you’ve ever been diagnosed with preeclampsia, you may be at risk of developing it again in subsequent pregnancies, so be sure to tell (or remind) your doctor. “Anybody who's had a history of preeclampsia is going to be on low-dose aspirin in a future pregnancy,” Pluym says. “But if you had very severe preterm preeclampsia, you will probably be at least co-managed by a high-risk [pregnancy] specialist to see if there's anything further that needs to be done.”
What’s more, a history of preeclampsia may provide a glimpse into your future health situation. “Women who have been diagnosed with preeclampsia are at risk for long-term cardiovascular complications,” Pluym says. “It's always important to mention to your primary care physician if you had preeclampsia in one of your previous pregnancies, to help them be more aware to screen you for cardiovascular health later in life.”
The more you know about what preeclampsia is and how it works, the better your ability to navigate the condition during pregnancy—and the better positioned you are to successfully manage your lifelong health after delivering your baby.
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