What Is Preeclampsia in Pregnancy?

Preeclampsia can be dangerous for both the mother and baby if not treated. Pregnant women with preeclampsia may experience problems, such as kidney, liver, and brain damage, blood clotting issues, seizures (eclampsia) and stroke.

Potential risks for the baby include premature birth, low birth weight and restricted fetal growth.

There are two types of preeclampsia: mild preeclampsia and preeclampsia with severe features.

Severe preeclampsia is when blood pressure is 160/110 mmHg or higher and there are elevated levels of protein in the urine and other symptoms. Women may experience severe headaches, vision issues, and abnormal blood test results like high liver enzymes and low platelets. Your doctor may prescribe medications for treatment. In extreme cases, delivering the baby may be the only option, regardless of the stage of pregnancy.

“Pregnancies complicated by preeclampsia with severe features are particularly concerning because the ability of the placenta to provide adequate nutrition and oxygen to the fetus can be impaired,” says Dr. Silverman.

“As a result, the baby may have fetal growth restriction or low amniotic fluid. If these pregnancies need to be delivered prematurely, there are increased risks of learning disabilities and other problems,“ she says.

Mild preeclampsia is marked by high blood pressure (around 140/90 mmHG) and protein in the urine. Your doctor will regularly check your blood pressure and order laboratory tests. It may be necessary to delivery your baby early if you are at least 37 weeks pregnant and your condition is stable.

Preeclampsia affects up to 8% of pregnancies worldwide. In the United States, it affects 4% of pregnancies, according to the Centers for Disease Control and Prevention. It typically begins after 34 weeks of pregnancy. However, it can also start as early as 20 weeks or up to six weeks after delivery.

Doctors classify the risk of getting preeclampsia as high or moderate.

High risk factors include:

• Preeclampsia in a previous pregnancy
• Being pregnant with multiple babies
• Chronic high blood pressure
• Kidney disease
• Diabetes
• Autoimmune conditions such as lupus

Moderate risk factors include:

• First-time mom
• Being pregnant more than 10 years after previous pregnancy
• Obesity
• Family history of preeclampsia
• Maternal age 35 or older
• Became pregnant using vitro fertilization

Black women have a higher risk of getting preeclampsia and other pregnancy-related complications compared to White women. Growing awareness of this issue has led to increased efforts to address them.

Aside from high blood pressure and protein in urine, there are other signs of preeclampsia to watch out for, including:

• Swelling in your hands or face
• Rapid weight gain within one to two days
• Severe headaches
• Pain in the upper stomach area
• Severe shortness of breath
• Changes in vision
• Continuous nausea or vomiting

Doctors diagnose preeclampsia by checking blood pressure, urine for protein and blood for liver and platelet issues.

Doctors use ultrasounds to check the baby's growth and amniotic fluid levels. These tests help them see how serious preeclampsia is and decide on the best treatment.

Women diagnosed with preeclampsia without severe features and who are less than 37 weeks pregnant can be treated with rest, lifestyle modifications and extra monitoring of the baby’s health, including:

• Monitoring fetal heart rate
• Checking amniotic fluid levels
• Following growth by ultrasound

Preeclampsia usually goes away after giving birth, but severe cases may require medication, or a hospital stay to control blood pressure.

“The only real cure for preeclampsia is to give birth,” says Dr. Silverman. “If the pregnancy is far enough along or if signs and symptoms of preeclampsia with severe features develop, then your doctor may recommend induction of labor or delivery by cesarean section in certain cases.”

Sometimes, symptoms of preeclampsia can continue for weeks after the baby is born and may need medication for treatment.

There is no way to completely prevent preeclampsia, but steps can be taken to lower your risk.

Make sure to attend all prenatal visits and follow through on any tests. If you have risk factors for preeclampsia, you may need more frequent prenatal appointments. Make any lifestyle changes that your doctor recommends, such as changing your diet or getting additional rest.

Purchase a blood pressure monitor and get instructions on how to use it properly. Monitor your blood pressure at home carefully and write down your results. If you see a significant increase in your blood pressure, let your doctor know before your next visit. You may be asked to bring your monitor to a prenatal visit to check to see if it is giving accurate readings.