Preeclampsia is a medical condition in which high blood pressure (hypertension) develops during pregnancy, accompanied by a rise in the amount of protein in the urine. It can develop gradually, but it also can strike suddenly, anytime after the 20th week of pregnancy but more often in the last month.
The reason for the name has to do with a very serious condition called eclampsia. This is when someone with pre-eclampsia (which may not even have been diagnosed yet) has a seizure, which is called an eclamptic seizure. This dramatic and powerful event can be life-threatening for both the mother and the baby. Pre-eclampsia thus comes before, or precedes, eclampsia.
A related condition is Pregnancy-Induced Hypertension (PIH), which is when the blood pressure is elevated but there are no other findings consistent with pre-eclampsia. Patients with this condition have a very high chance of developing pre-eclampsia, so this is also a high-risk situation.
The only way to cure preeclampsia is to deliver the baby. If your baby is too small or has not developed enough, you and your doctor may have to wait until the baby matures before delivering, but the waiting period can allow the condition to worsen. Thus, the management of preeclampsia requires a skilled practitioner.
Symptoms of Preeclampsia
If your blood pressure was normal before you got pregnant, there are specific symptoms your healthcare provider will watch for, such as:
- High blood pressure: also known as hypertension, readings of 140/90 mm Hg or greater
- Proteinuria: protein found in urine (the protein is called albumin, and we all have a lot of this in our blood stream)
- Headaches: severe headaches are more worrisome
- Changes in vision: blurred vision, double vision, photophobia (sensitivity to light)
- Nausea or vomiting
- Sudden weight gain (more than two pounds per week)
- Upper abdominal pain (under the ribs on the right side)
- Swelling (sudden increase or development of swelling in the legs, hands, or face)
Causes of Preeclampsia
The cause of preeclampsia is unknown. It used to be known as toxemia because experts believed that preeclampsia was caused by toxins in a pregnant woman’s bloodstream. That theory has been discarded, however. Many experts now believe it is a type of auto-immune disease in which the placenta is producing too much of certain compounds which then lead to the elevation of blood pressure and other findings of pre-eclampsia.
Your Chance of Developing Preeclampsia
Preeclampsia affects 3 to 5 percent of pregnancies. Your chance of developing preeclampsia while you’re pregnant depends on a number of variables:
- Family history of preeclampsia
- Prior pregnancy with pre-eclampsia
- Whether this is your first pregnancy
- Age — the risks are higher if you are a teenager or over the age of 40
- Multiple fetuses
- Long period of time between pregnancies, or a new pregnancy with a different partner
- Gestational diabetes in a patient who was diabetic prior to pregnancy
- History of medical conditions such as chronic high blood pressure, kidney disease
- History of lupus or other autoimmune diseases
Risks of Preeclampsia
It’s important to remember that most women with preeclampsia deliver healthy babies. Unfortunately, if you’re suffering from severe preeclampsia or if you developed it early in your pregnancy, your doctor may need to induce labor or perform a Cesarean section and deliver your baby prematurely.
Patients with pre-eclampsia are at risk for developing other conditions. These include:
- Placental abruption: When the placenta detaches from the inner wall of the uterus causing bleeding and painful uterine contractions
- HELLP Syndrome: This stands for Hemolysis Elevated Liver enzymes and Low Platelet Count, and it can become life-threatening for mom and baby
- Eclampsia: preeclampsia plus seizures. Can develop if preeclampsia is not managed carefully.
The only cure for preeclampsia is the delivery of your baby. If you are near the end of your pregnancy, your doctor may encourage you to induce labor immediately. If you are not near the end of your pregnancy, your doctor will want to monitor you very closely until your baby reaches a safe gestational age and your cervix becomes ready. You will most likely give birth via c-section if you are suffering from preeclampsia and have to deliver prematurely.
Your doctor may give you medications to help manage preeclampsia while you’re pregnant. These medications include:
- Antihypertensives to lower blood pressure until delivery
- Corticosteroids to improve liver and platelet functioning and to help speed up the development of the baby’s lungs if the pregnancy is premature
- Anticonvulsive medications to prevent seizures
If you have PIH, your doctor may also recommend that you limit your activities and try to remain on bed rest to reduce high blood pressure and increase blood flow to your placenta. With PIH you can be managed at home (outpatient management), but once you are diagnosed with pre-eclampsia, most providers will admit you to the hospital for close observation or for delivery.