What is preeclampsia?

Every May is Preeclampsia Awareness Month. What is preeclampsia, and how do you know if you’re at risk?

Preeclampsia is a condition unique to pregnancy. Every May is Preeclampsia Awareness Month. What is preeclampsia and how can we prevent and treat it?

What is preeclampsia?

Preeclampsia is a disorder which affects between 5% to 8% of pregnancies in the United States. It is becoming more common; there has been a 25% increase in this condition over the last two decades. Signs and symptoms of preeclampsia usually occur after the 20th week of pregnancy up until your due date, and it can also occur after delivery up until six weeks postpartum.

The diagnosis of preeclampsia is made by your obstetric provider. It can occur in a spectrum, from just an elevation in blood pressure, up to maternal seizures called eclampsia.

The American College of Obstetricians and Gynecologists (ACOG) recently updated its criteria for diagnosis. Preeclampsia is diagnosed by a finding of an elevation of blood pressure after the 20th week of pregnancy with or without protein present in the urine. When measuring your blood pressure, a systolic blood pressure (top number) of 140 mmHg or higher or a diastolic blood pressure (bottom number) of 90 mmHg or higher is abnormal, and you should to contact your obstetric provider.

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Signs of preeclampsia

While a majority of patients with preeclampsia will have healthy babies and fully recover, a few will experience severe complications. Because the condition can progress rapidly, early recognition of preeclampsia signs and symptoms could save your life and the life of your baby.

Symptoms of preeclampsia can include:

  • Headaches
  • Upper abdominal pain
  • Shortness of breath
  • Chest pain
  • Visual disturbances such as flashes of light or very blurred vision

If you experience any of these symptoms you should contact your obstetrician or midwife.

Who is at risk for preeclampsia?

If you have any of the risk factors below, talk with your obstetrician, midwife or nurse practitioner about prevention strategies for preeclampsia.

Patients who have preexisting conditions listed below:

  • Diabetes
  • Kidney disease
  • Hypertension
  • Lupus
  • Thrombophilia (inherited clotting disorders)
  • Pregnancy conceived with assisted reproductive technology (IVF)
  • Obstructive sleep apnea

Other risk factors can include:

  • First pregnancy
  • Multiple gestation (twins, triplets, quadruplets)
  • History of preeclampsia
  • Maternal age over 35
  • Obesity (a body mass index over 30)
  • Persons of color

A simple low-dose aspirin (81 milligrams) taken daily during pregnancy before your 16th week up until delivery has been shown to decrease risk for developing preeclampsia by 30%.

How do we treat preeclampsia?

The ultimate cure for preeclampsia is delivery of the baby. The mother’s blood pressure, kidney and liver function and overall well-being will improve after delivery. Many times the diagnosis is made early in pregnancy. In this case, your doctor may prescribe blood pressure medication or a stay in the hospital with frequent laboratory tests and ultrasounds to monitor you and the baby. It becomes a balance of keeping mother and baby as safe as possible.

After delivery with a preeclampsia diagnosis you may require a longer stay in the hospital to monitor and control your blood pressure. When you are discharged it is important to rest, take your blood pressure and continue your medications. Follow-up three to five days after discharge is very important, either by telemedicine or in person, to ensure your blood pressure is improving. Your medications may need to be adjusted as well.

Postpartum preeclampsia care

Preeclampsia also can develop postpartum in patients who did not have elevated blood pressure in pregnancy. Warning signs for post-birth preeclampsia can include:

  • Headache
  • Chest pain
  • Shortness of breath
  • Extreme swelling in the hands and feet

If you experience these, contact your health care provider.

If you had preeclampsia, you are three to four times more likely to have high blood pressure, heart disease and stroke after delivery or even later in life. After your postpartum period, you will need to let your primary care provider (PCP) know about your preeclampsia diagnosis. Your PCP will continue to monitor your blood pressure and assess your risk for heart disease and stroke. Hopefully this will lead to a healthier you!

Lyndsey D. Neese, M.D., MMM, FACOG, is an OB/GYN with Norton Women’s Care and serves as medical directory of quality for women’s services at Norton Healthcare.

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