Occurring in about 1 in every 12 pregnancies in the United States, preeclampsia is a serious blood pressure disorder that can occur during pregnancy or shortly thereafter. Untreated, it can lead to preterm birth, loss of pregnancy, maternal or newborn death.
While the exact cause is not fully understood, preeclampsia is thought to stem from abnormal development of the placenta. More common in first pregnancies and multiples (e.g., twins, triplets, etc.), the risk for preeclampsia is higher in pregnant individuals with:
- obesity
- pre-existing hypertension
- diabetes
- kidney disease
- autoimmune disease (e.g., lupus or antiphospholipid syndrome)
- personal or family history of preeclampsia
- history of complications in a previous pregnancy (e.g., baby with low birthweight)
Individuals who had fertility treatment (IVF), are Black, or are aged 35 or older are also at increased risk for the disorder.
One of the challenges of diagnosing preeclampsia is that some symptoms overlap with normal pregnancy discomforts. These include:
- sudden weight gain
- swelling of the hands or face
- severe persistent headache
- shortness of breath
- severe pain in the upper abdomen or shoulder
- vision changes, including seeing spots and blurry vision
However, preeclampsia often begins without noticeable symptoms, which makes attending regular prenatal visits all the more critical.
Warning signs that can be revealed through a prenatal visit include:
- High blood pressure: A reading of 140/90 mmHg or higher on two occasions at least four hours apart after 20 weeks of pregnancy.
- Protein in urine (proteinuria): This indicates kidney dysfunction and is often detected during routine prenatal care.
- Decreased urine output: A sign of impaired kidney function.
Women at higher risk may benefit from more frequent check-ups or home blood pressure monitoring during the second and third trimesters.
In rare cases, preeclampsia may occur postpartum, usually within 48 hours after delivery but sometimes up to six weeks later.
Treatment for preeclampsia is based on how far along you are in your pregnancy and the severity of the condition at the time of diagnosis. If fetal development is restricted by abnormal blood flow, your doctor may recommend early delivery. In less severe cases, delivery may be induced after 37 weeks, which is considered full-term. While delivery of the baby and the placenta frequently resolves preeclampsia, your doctor will monitor you for several weeks to ensure symptoms go away.
If you experience any symptoms associated with preeclampsia or feel unwell during pregnancy, contact your healthcare provider immediately. REMEMBER: When caught early, preeclampsia can be treated and managed to keep you and your baby safe and healthy.
Themarge Small, MD, FACOG, is an obstetrics & gynecology specialist at SVMC.