Most people with preeclampsia have healthy babies. However, left untreated, it can cause serious problems to the mother and the baby.
Preeclampsia occurs in 8% of pregnancies around the world, and cases in the United States have risen by about 25% since the 1980s.
Symptoms of Preeclampsia
Signs of preeclampsia include high blood pressure, also called hypertension, and proteinuria, where elevated levels of protein are detected in your urine. The amount of protein will be about 300 milligrams (mg) over a 24-hour urine collection in cases of preeclampsia.
Many people do not have symptoms. Even if they do, it’s difficult to recognize them as signs of preeclampsia. The condition is usually suspected because of blood pressure and urine testing during a routine appointment with your obstetrician.
Other symptoms of preeclampsia may develop, including:
A headache that won’t go away Shortness of breath Blurred vision, seeing spots, or other vision changes Pain in the upper abdomen or shoulder Nausea and vomiting Sudden weight gain Swelling in the hands or face Lightheadedness
When preeclampsia progresses to more severe forms, additional signs and symptoms may include:
Low platelet count Abnormal kidney or liver function Abdominal pain Severe headache Blood pressures of 140/90 mmHg and higher Vision changes Fluid in the lungs Seizures
Causes
It’s not clear what causes preeclampsia. Changes in the placenta is a leading theory since the placenta creates proteins and a number of other substances that enter the pregnant person’s bloodstream. Proteins and other substances generated by the placenta are believed to play a vital role in the progression of pregnancy and even labor.
Swelling in the hands or faceSudden weight gain over a day or twoHeadache that won’t go away or gets worseTrouble urinatingNausea and vomitingVision changesDizzinessStomach pain below your ribs, usually on the rightRight shoulder painTrouble breathing
Factors that may increase the risk of preeclampsia include:
Autoimmune disordersBlood vessel problemsYour dietYour genes
You’re more likely to develop preeclampsia during pregnancy if the following factors apply to you:
First pregnancy Past history of preeclampsia Multiple pregnancy (twins or more) Family history of preeclampsia Obesity Being older than 35 years old History of diabetes, high blood pressure, or kidney disease History of thyroid disease
Diagnosis
Your doctor will perform a physical exam to evaluate for high blood pressure. Expect to also provide urine and blood samples for testing.
Your test and exam may show the following if you have preeclampsia:
High blood pressure High levels of protein in your urine Low platelet count (thrombocytopenia) Poor liver function Tenderness in the upper abdomen Poor kidney function Pulmonary edema
Those who had low blood pressure at the start of their pregnancy, followed by a significant rise in blood pressure, may need to be monitored more closely for the development of preeclampsia.
Treatment
Preeclampsia often resolves after the baby is born and the placenta is delivered. However, it may persist or even begin after delivery.
Most often, at 37 weeks, your baby is developed enough to be healthy outside of the womb. Your provider may want your baby to be delivered early so the preeclampsia does not get worse.
If your baby is not fully developed and you have mild preeclampsia, the disease can sometimes be managed at home until your baby has matured.
Fetal monitoring will be done, and you may be given corticosteroids to help your baby’s lungs reach maturity in case a hasty delivery is required.
The baby may have to be delivered if there are signs and symptoms of preeclampsia with severe features, including:
The bottom number of your blood pressure is 110 mmHg or greater or the top number is 160 mmHg or greater on two occasions at least four hours apart OR your blood pressure remains elevated and medications need to be startedAbnormal liver function test resultsSevere headachesPain in the stomachSeizures or changes in mental functionFluid buildup in the pregnant person’s lungsHELLP syndrome, which refers to a group of symptoms including hemolysis (destruction of red blood cells), elevated liver enzymes, and low platelet countsLow platelet count or bleedingAbnormal or worsening kidney function tests
If you develop severe preeclampsia, you may also be given magnesium sulfate to prevent seizures and medications to help control your blood pressure.
Coping
Coping with preeclampsia can be difficult. Make sure you have a strong support system in place to help you and your baby stay safe. Talk to your doctor if you need help. If you have a difficult time managing your condition at home, your doctor may have you admitted to the hospital for better care.
People who develop preeclampsia during pregnancy are at higher risk of developing cardiovascular diseases later in life. Talk to your doctor about your risks and steps you can take to protect your health after delivery.
Summary
Some people may develop high blood pressure after 20 weeks of pregnancy. Knowing whether you have risk factors for preeclampsia can help you and your doctor prepare for it and identify it promptly if it does occur. If diagnosed in a timely manner, you and your baby can be kept safe.
A Word From Verywell
Preeclampsia can be a scary complication of pregnancy, but your doctor can help you come up with a plan to manage it if it does occur. If you are at high risk of developing preeclampsia or if you have already been diagnosed, discuss next steps with your doctor. Seek out a good support system or tell your doctor if you need more help.
