Understanding Preeclampsia in Pregnancy
Preeclampsia—a condition associated with high blood pressure and kidney or liver damage—occurs in about three to seven percent of pregnancies. The causes of preeclampsia aren’t well understood, which means it’s important for all pregnant people to do their best to keep themselves and their babies healthy.
Basics of Preeclampsia
Occurring after 20 weeks of pregnancy, preeclampsia is more than just high blood pressure. To be diagnosed with the condition, patients must have hypertension in addition to signs that other organs are being affected. In addition to hypertension, symptoms of preeclampsia include:
- High levels of protein in urine
- Persistent headache or vision problems
- Sudden swelling of the hands and face
- Sudden weight gain
- Upper abdominal pain, nausea and vomiting
“Any pregnant person can develop preeclampsia very suddenly,” says Jennifer Johnson, CNM, a certified nurse midwife at Jefferson Health - Abington. “But there are certainly factors that put some people at a higher risk for it.”
Risk factors for preeclampsia include:
- Preeclampsia in a past pregnancy
- Immediate family history of preeclampsia
- Advanced maternal age
- Hypertensive disease
- First pregnancy, extended period of time between pregnancies or pregnancy with a new paternity
Historically, there has also been a high occurrence of preeclampsia in African-American people, BIPOC communities and those who have experienced systemic oppression.
Risks and Treatment Options
“There are risks to both you and baby if you develop preeclampsia,” says Jenine Boileau, MD, an OB/GYN at Jefferson Health - Abington. “For the parent, the biggest risk of preeclampsia is seizure or stroke. And for the baby, it can result in lack of oxygen or nutrients, low birth weight or, in some cases, death.”
If you are diagnosed with preeclampsia, treatment will depend on your specific symptoms and clinical picture. There are medications available to treat certain aspects of preeclampsia, which will be prescribed by your healthcare provider when appropriate.
“When there are signs of end organ damage, we’ll usually recommend delivery, if possible. End organ damage symptoms include headaches that don’t get better with over-the-counter pain medications, visual changes like white spots appearing in your vision or significant changes to blood work that indicate kidney or liver damage,” says Dr. Boileau. “If there isn’t end organ damage, we will monitor the preeclampsia until it’s safe to deliver—usually after 37 weeks.”
Once the baby is delivered, your blood vessels will start to normalize again. “Delivery is essentially a cure for preeclampsia,” says Dr. Boileau. “But it can increase your risk of developing preeclampsia again in future pregnancies or high blood pressure later in life.”
It’s important to take steps to prevent hypertension and preeclampsia if you’re pregnant or planning to become pregnant. “One of the main ways to avoid hypertensive complications in pregnancy is maintaining a healthy lifestyle and taking care of your body with good nutrition, hydration, adequate sleep and stress management,” says Johnson.
In addition, for women who are at risk for preeclampsia, taking baby aspirin daily during pregnancy, starting at week 12, has been shown to decrease the risk of hypertensive complications. “If someone has an underlying hypertensive disease before pregnancy, they can usually continue taking medications to keep their blood pressure under control,” says Johnson. “But it’s best to consult with your healthcare provider to make sure.”
As always, preventive care and open communication are essential to staying healthy. Talk to your provider if you have any concerns about high blood pressure during pregnancy. “Make sure you’re getting appropriate care throughout your pregnancy,” says Dr. Boileau. “We’ll check your blood pressure often—so we’re able to treat potential cases of preeclampsia before significant risks develop.”