As many as one in ten women develop preeclampsia during pregnancy. Because doctors don’t fully understand what causes it, preventing it isn’t really an option. “Which,” says Dr. Katie Barker, an OB/GYN at Baystate Women's Health, “is why it’s incredibly important for moms-to-be to stay vigilant for the signs and symptoms of the condition and attend all prenatal visits no matter how great you’re feeling.”
What is preeclampsia?
Preeclampsia is a disease that only occurs during pregnancy. As Barker explains, “The disease is defined by the presence of two symptoms beginning after your 20th week of pregnancy. The first is an elevated blood pressure, and the second is the presence of protein in your urine, also called proteinuria.”
Preeclampsia typically occurs in the third trimester (28 weeks) but, as Barker notes, 10% of cases are postpartum.
How does preeclampsia affect mom and baby?
To begin with, preeclampsia puts stress on a mother’s heart and can impair liver and kidney function. In fact, the presence of protein in urine is a sign the kidneys aren’t working properly. In addition to kidney failure, Moms with preeclampsia are at risk of suffering a stroke, seizures, hemorrhaging at delivery, and death.
On the baby side of things, preeclampsia can restrict the amount of blood being carried to the placenta. “If the placenta doesn't get enough blood, the baby may not get even blood. And because blood is what supplies oxygen and nutrients to the baby, a lack of it can contribute to low birth weight and make it necessary to deliver a baby preterm.” Babies delivered early have a higher risk of developing long-term health issues, including learning disorders, cerebral palsy, epilepsy, deafness, and blindness. In some instances, preeclampsia causes the placenta to separate from the wall of the uterus before delivery. Tragically, this often leads to stillbirths.
How is preeclampsia treated?
While there’s no ‘cure’ for preeclampsia, Barker says the most effective treatment for it is to deliver the baby and the placenta. “Depending on when the diagnosis happens and how severe the condition is, we may monitor a patient hoping to safely extend the length of pregnancy. The goal is to get to 37 weeks when the baby has the best chance of a healthy survival. In the time leading up to the 37-week mark, a patient will be monitored very closely—often over several days at the hospital— and given medication to control blood pressure and prevent seizures.”
In cases of postpartum preeclampsia, which can occur with 48 hours of delivery or up to six weeks later, treatment includes the same blood pressure and anti-seizure medications.
Who is at risk of developing preeclampsia?
While preeclampsia can strike anyone, there are some factors that put women at higher risk of developing the disease. Among the most concerning are the following:
- Suffering from preeclampsia in a previous pregnancy
- Carrying multiple fetuses
- High blood pressure before pregnancy
- Kidney disease
- Autoimmune disease
- COVID-19 infection during pregnancy
Other risk factors of concern include:
Being over 40 years old
- A first pregnancy or a period of ten years between current and previous pregnancy
- Being overweight
- Mother or sister who had preeclampsia
- African American ethnicity
What are warning signs preeclampsia?
“Preeclampsia is only formally diagnosed when you have an elevated blood pressure and a blood test detects protein in your urine indicating an issue with kidney and liver function,” says Barker. “But there are symptoms a woman may experience that should absolutely drive her to contact her doctor to have both her blood pressure and blood checked.”
Some of the most common warning signs of preeclampsia during pregnancy and postpartum include:
A headache that won’t go away or respond to usual treatment
- Seeing spots, blurry vision, or other changes to vision
- Severe and sudden swelling of the hands or face
- Sudden weight gain
- Nausea and vomiting in second half of pregnancy
- Pain in right upper abdomen or shoulder
- Shortness of breath and feeling of a heavy chest
Barker urges any women experiencing ANY of these symptoms to, “Contact your doctor immediately. Do not put it off for any reason.” She continues, “Some of the scariest phone calls I get are from expectant moms saying, ‘I don’t know what’s wrong, but something isn’t right.’ If you have that feeling, TRUST your mother’s intuition and call your doctor.