Preeclampsia is a condition that only occurs in pregnancy and happens in about 3 to 5 percent of pregnancies. It usually develops after the 20-week mark. The hallmark of pre- eclampsia is elevated blood pressure along with protein in your urine. The protein is detected by a quick pee-in-a-cup test at your provider's office, or possibly by a 24-hour urine collection.
The normal blood pressure of a pregnant woman should be around 120/80. The severity of preeclampsia depends on the specific blood pressure numbers (abnormal blood pressures need to be present twice, at least 4 hours apart, to confirm diagnosis) and whether or not other concerning factors are present (such as other symptoms or worrisome blood tests). Your provider will make this diagnosis.
There are many theories about what causes preeclampsia; unfortunately, we're still not exactly sure of the cause. However, scientists have discovered that there is a connection to proteins made and released into the woman's bloodstream by her placenta. There are a few factors that increase the risk of developing this condition:
- History of high blood pressure prior to pregnancy
- First pregnancies
- Women with a family history of preeclampsia
- Women who have had preeclampsia in the past
- Multiple pregnancies
- Women with a BMI over 30
- Women under the age of 20 or over the age of 40
- New sperm source (that is, a new partner or sperm donor)
In many cases, women find out they have preeclampsia at a regular prenatal appointment when their blood pressure is found to be high. There are some symptoms to look out for, including:
- Changes in your vision
- Dizziness or light-headedness
- Nausea and vomiting
- Sharp pain in your upper right belly
- Difficulty breathing (call 911 in this case)
- Decreased urine
If you have any of these symptoms, call your provider right away. Preeclampsia can cause damage to a woman's kidneys, liver, and other organs. It can also affect the placenta, which could cause harm to the baby. In extremely rare cases, preeclampsia can evolve into eclampsia, where a woman experiences seizures. In rare instances, women can also develop HELLP syndrome (see page 461).
The only cure for preeclampsia is giving birth. Some women may be given medication to control their blood pressure, but this won't cure the condition. Depending on how far along you are in your pregnancy, you may be given steroids to help your baby's lungs develop faster, so they're ready to be born sooner. You and your medical team may decide that it's safer for the baby to be born than to continue the pregnancy with preeclampsia.
Your baby may need to spend some time in the NICU if they are born early. In severe cases of preeclampsia, in order to prevent seizures, women are given a medication through an IV called magnesium sulfate before and during labor, as well as for the first day after. Magnesium sulfate can make you feel pretty crummy, unfortunately, but your nurses and provider will be keeping a very close eye on you to make sure you're safe.
One note: It is possible to have a totally normal pregnancy and develop postpartum preeclampsia, or extended episodes of high blood pressure after you give birth. It usually occurs within 48 hours of giving birth, though it can happen up to 6 weeks after. If you experience any of the symptoms listed above, call your provider immediately.