About preeclampsia

What is preeclampsia?

Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal.

Left untreated, preeclampsia can lead to serious — even fatal — complications for both you and your baby. If you have preeclampsia, the only cure is delivery of your baby.

If you're diagnosed with preeclampsia too early in your pregnancy to deliver your baby, you and your doctor face a challenging task. Your baby needs more time to mature, but you need to avoid putting yourself or your baby at risk of serious complications.

What are the symptoms for preeclampsia?

Preeclampsia sometimes develops without any symptoms. High blood pressure may develop slowly, or it may have a sudden onset. Monitoring your blood pressure is an important part of prenatal care because the first sign of preeclampsia is commonly a rise in blood pressure. Blood pressure that exceeds 140/90 millimeters of mercury (mm Hg) or greater — documented on two occasions, at least four hours apart — is abnormal.

Other signs and symptoms of preeclampsia may include:

  • Excess protein in your urine (proteinuria) or additional signs of kidney problems
  • Severe headaches
  • Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
  • Upper abdominal pain, usually under your ribs on the right side
  • Nausea or vomiting
  • Decreased urine output
  • Decreased levels of platelets in your blood (thrombocytopenia)
  • Impaired liver function
  • Shortness of breath, caused by fluid in your lungs

Sudden Weight gain and swelling (edema) — particularly in your face and hands — may occur with preeclampsia. But these also occur in many normal pregnancies, so they're not considered reliable signs of preeclampsia.

When to see a doctor

Make sure you attend your prenatal visits so that your care provider can monitor your blood pressure. Contact your doctor immediately or go to an emergency room if you have severe headaches, blurred vision or other visual disturbance, severe pain in your abdomen, or severe shortness of breath.

Because headaches, nausea, and aches and pains are common pregnancy complaints, it's difficult to know when new symptoms are simply part of being pregnant and when they may indicate a serious problem — especially if it's your first pregnancy. If you're concerned about your symptoms, contact your doctor.

What are the causes for preeclampsia?

The exact cause of preeclampsia involves several factors. Experts believe it begins in the placenta — the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta.

In women with preeclampsia, these blood vessels don't seem to develop or function properly. They're narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them.

Causes of this abnormal development may include:

  • Insufficient blood flow to the uterus
  • Damage to the blood vessels
  • A problem with the immune system
  • Certain genes

Other high blood pressure disorders during pregnancy

Preeclampsia is classified as one of four high blood pressure disorders that can occur during pregnancy. The other three are:

  • Gestational hypertension. Women with gestational hypertension have high blood pressure but no excess protein in their urine or other signs of organ damage. Some women with gestational hypertension eventually develop preeclampsia.
  • Chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy. But because high blood pressure usually doesn't have symptoms, it may be hard to determine when it began.
  • Chronic hypertension with superimposed preeclampsia. This condition occurs in women who have been diagnosed with chronic high blood pressure before pregnancy, but then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy.

What are the treatments for preeclampsia?

The only cure for preeclampsia is delivery. You're at increased risk of seizures, placental abruption, stroke and possibly severe bleeding until your blood pressure decreases. Of course, if it's too early in your pregnancy, delivery may not be the best thing for your baby.

If you're diagnosed with preeclampsia, your doctor will let you know how often you'll need to come in for prenatal visits — likely more frequently than what's typically recommended for pregnancy. You'll also need more frequent blood tests, ultrasounds and nonstress tests than would be expected in an uncomplicated pregnancy.

Medications

Possible treatment for preeclampsia may include:

  • Medications to lower blood pressure. These medications, called antihypertensives, are used to lower your blood pressure if it's dangerously high. Blood pressure in the 140/90 millimeters of mercury (mm Hg) range generally isn't treated.

    Although there are many different types of antihypertensive medications, a number of them aren't safe to use during pregnancy. Discuss with your doctor whether you need to use an antihypertensive medicine in your situation to control your blood pressure.

  • Corticosteroids. If you have severe preeclampsia or HELLP syndrome, corticosteroid medications can temporarily improve liver and platelet function to help prolong your pregnancy. Corticosteroids can also help your baby's lungs become more mature in as little as 48 hours — an important step in preparing a premature baby for life outside the womb.
  • Anticonvulsant medications. If your preeclampsia is severe, your doctor may prescribe an anticonvulsant medication, such as magnesium sulfate, to prevent a first seizure.

Bed rest

Bed rest used to be routinely recommended for women with preeclampsia. But research hasn't shown a benefit from this practice, and it can increase your risk of blood clots, as well as impact your economic and social lives. For most women, bed rest is no longer recommended.

Hospitalization

Severe preeclampsia may require that you be hospitalized. In the hospital, your doctor may perform regular nonstress tests or biophysical profiles to monitor your baby's well-being and measure the volume of amniotic fluid. A lack of amniotic fluid is a sign of poor blood supply to the baby.

Delivery

If you're diagnosed with preeclampsia near the end of your pregnancy, your doctor may recommend inducing labor right away. The readiness of your cervix — whether it's beginning to open (dilate), thin (efface) and soften (ripen) — also may be a factor in determining whether or when labor will be induced.

In severe cases, it may not be possible to consider your baby's gestational age or the readiness of your cervix. If it's not possible to wait, your doctor may induce labor or schedule a C-section right away. During delivery, you may be given magnesium sulfate intravenously to prevent seizures.

If you need pain-relieving medication after your delivery, ask your doctor what you should take. NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can increase your blood pressure.

What are the risk factors for preeclampsia?

Preeclampsia develops only as a complication of pregnancy. Risk factors include:

  • History of preeclampsia. A personal or family history of preeclampsia significantly raises your risk of preeclampsia.
  • Chronic hypertension. If you already have chronic hypertension, you have a higher risk of developing preeclampsia.
  • First pregnancy. The risk of developing preeclampsia is highest during your first pregnancy.
  • New paternity. Each pregnancy with a new partner increases the risk of preeclampsia more than does a second or third pregnancy with the same partner.
  • Age. The risk of preeclampsia is higher for very young pregnant women as well as pregnant women older than 40.
  • Obesity. The risk of preeclampsia is higher if you're obese.
  • Multiple pregnancy. Preeclampsia is more common in women who are carrying twins, triplets or other multiples.
  • Interval between pregnancies. Having babies less than two years or more than 10 years apart leads to a higher risk of preeclampsia.
  • History of certain conditions. Having certain conditions before you become pregnant — such as chronic high blood pressure, migraines, type 1 or type 2 diabetes, kidney disease, a tendency to develop blood clots, or lupus — increases your risk of preeclampsia.
  • In vitro fertilization. Your risk of preeclampsia is increased if your baby was conceived with in vitro fertilization.

Is there a cure/medications for preeclampsia?

There is no cure for preeclampsia. There are only medications that can help you get through it.

  • Preeclampsia is a condition that happens in pregnancy. It's characterized by high blood pressure and protein in your urine, which makes it difficult for your kidneys to work properly. If you have preeclampsia, you may also experience headaches and swelling in your hands and face.
  • In most cases of preeclampsia, the symptoms go away after delivery—but for some women, they become more severe and lead to preeclampsia eclampsia, which is when seizures occur as well as high blood pressure.
  • The good news is that preeclampsia is treatable with medication. There are three main categories of preeclampsia medications: antihypertensive medications, magnesium sulfate, and magnesium carbonate.
  • Antihypertensive medications help lower blood pressure. Magnesium sulfate is an anticonvulsant that prevents seizures associated with preeclampsia. And magnesium carbonate helps prevent kidney damage caused by preeclampsia. In order to avoid it, here is the list of medications:
  • The first and most common medication is magnesium sulfate, which is usually administered through an IV drip. This helps prevent seizures, which can be a symptom of preeclampsia.
  • Gestational hypertension and preeclampsia are often treated with labetalol (a beta-blocker), which is also given through an IV drip. Labetalol works by blocking the effects of adrenaline on your blood vessels, which can help lower your blood pressure and prevent complications for both you and your baby.
  • If you have severe preeclampsia, you may be given magnesium sulfate along with labetalol to lower your blood pressure more quickly than either drug would do alone.


Symptoms
Headaches,Dizziness or lightheadedness,Severe swelling in your face and hands (edema),Chest pain or shortness of breath,Feeling very thirsty or hungry despite having eaten recently
Conditions
High blood pressure (hypertension)
Drugs
Angiotensin-converting enzyme inhibitors (ACEIs),Angiotensin receptor blockers (ARBs),Aldosterone antagonists,Calcium-channel blockers (CCBs),Diuretics

Video related to preeclampsia