Pregnancy often comes with unpleasant side effects, such as morning sickness and indigestion, but sometimes there are more significant concerns. Preeclampsia is a high blood pressure problem that can happen during pregnancy or up to six weeks after delivery. Older terms for preeclampsia include toxemia or pregnancy-induced hypertension (PIH).
There are two types of preeclampsia:
- In preeclampsia without severe features, blood pressure is typically between 140-159 and 80-109 mmHG. Women have no symptoms and blood test results are normal.
- In preeclampsia with severe features, blood pressure is typically over 160/110 mmHg. Women tend to have severe headache or visual problems and blood test abnormalities, such as elevated liver enzymes and low platelets.
“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 Elizabeth Silverman, MD, an OB-GYN at Scripps Clinic La Jolla. “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.“
Preeclampsia affects 8 to 10% of pregnancies. It is uncommon for preeclampsia to cause pregnancy complications before 34 weeks, although it may start as early as 20 weeks of pregnancy or up to six weeks after giving birth.
The cause of preeclampsia is unknown, but you may have a higher risk of preeclampsia if you:
- Have had preeclampsia in a previous pregnancy
- Have not been pregnant before
- Are over 40 years old or under 18 years old
- Had high blood pressure prior to becoming pregnant
- Are obese and/or have diabetes
- Are pregnant with twins or triplets
- Have kidney problems or lupus
High blood pressure that develops during pregnancy and abnormally high protein levels in your urine are the main symptoms of preeclampsia, but you may have other signs including:
- Swelling in your hands or face
- Rapid weight gain within one to two days
- Severe headaches
- Pain in the upper right side of your abdomen
- Severe shortness of breath
- Changes in vision
- Continuous nausea or vomiting
If not recognized and treated, preeclampsia can progress to eclampsia, in which the mother suffers seizures.
Because pregnant women have no way of knowing if they have the two most common symptoms of preeclampsia (high blood pressure and protein in their urine), it’s especially important to keep all of your prenatal appointments, including blood pressure monitoring.
Your obstetrician can identify warning signs that would otherwise go unnoticed. In addition to blood and urine tests to diagnose preeclampsia, your doctor may order an ultrasound or other tests to check the baby’s health and development.
Women diagnosed with preeclampsia without severe features who are less than 37 weeks pregnant may be managed with rest, lifestyle modifications and increased monitoring of the baby’s well-being (such as monitoring fetal heart rate, checking amniotic fluid levels and following growth by ultrasound). More serious cases may require medication or hospital care to control blood pressure and prevent complications.
“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.”
In some cases, preeclampsia symptoms may last for several weeks after the baby is born.
There is no way to completely prevent PIH or preeclampsia, but you can take steps to lower your risk. Be sure to attend all prenatal visits with your obstetrician 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.
“If you have risk factors, talk to your doctor about changes you can make before and during your pregnancy to lower your chances of developing preeclampsia,” says Dr. Silverman. “These may include losing weight, quitting smoking and controlling high blood pressure.”