Preeclampsia

What is preeclampsia?

Preeclampsia, formerly called toxemia, is a high blood pressure disorder that may occur before, during, or shortly after delivery. Preeclampsia can cause problems with the kidneys and other organs. Preeclampsia can be diagnosed after 20 weeks of pregnancy.

What is a maternal-fetal medicine physician?

A maternal-fetal medicine physician, or MFM, specializes in caring for women with high-risk pregnancies. Some pregnancies may be considered high-risk as a result of a medical condition present before pregnancy. Other high-risk pregnancies occur as a result of a complication or medical condition that develops during pregnancy, like preeclampsia. Further, an MFM also takes care of healthy moms with babies with abnormalities or special conditions.

What causes preeclampsia?

The exact cause is unknown, but preeclampsia develops as a result of a placenta that doesn’t function properly.

Who is at a higher risk for developing preeclampsia?

It is not always clear why some women develop preeclampsia. However, the following known factors increase the risk of preeclampsia in women who:

• Are pregnant for the first time
• Had high blood pressure before getting pregnant
• Had preeclampsia in a previous pregnancy
• Have a family history of preeclampsia
• Have a history of chronic hypertension, kidney disease, or both
• Are 40-years-old or older
• Are carrying more than one baby
• Have diabetes
• Have a genetic or acquired reason for forming more blood clots
• Have lupus
• Are obese
• Had in vitro fertilization

What are the symptoms of preeclampsia?

If preeclampsia is a concern, your provider may check to see if you have high blood pressure, proteinuria (an abnormal amount of protein in the urine), low-platelet count, abnormal kidney function, abnormal liver function, and/or fluid in your lungs. Symptoms you may experience on your own may include:

• Changes in vision
• Severe headache
• Swelling of face or hands
• Pain in the upper abdomen
• Nausea and vomiting (in the second half of pregnancy)
• Sudden weight gain
• Difficulty breathing

What is the difference between chronic hypertension, gestational hypertension, preeclampsia, and eclampsia?

Chronic hypertension is when you have high blood pressure before getting pregnant or before 20 weeks gestation. Gestational hypertension, also called pregnancy-induced hypertension (PIH), is when high blood pressure develops after 20 weeks gestation and goes away after delivery. Chronic hypertension and gestational hypertension can lead to preeclampsia. Preeclampsia is when you have high blood pressure and other features like increased proteinuria (protein in the urine), severe headaches, neurologic symptoms, or evidence of kidney or liver abnormalities after 20 weeks gestation. Eclampsia are seizures in pregnancy that are often associated with another sign of preeclampsia.

What is HELLP syndrome?

The cause of HELLP syndrome is unknown, but women who have preeclampsia or eclampsia are at a higher risk for developing HELLP syndrome which is a severe form of preeclampsia. HELLP stands for:

• H: Hemolysis (destruction of red blood cells)
• EL: Elevated liver enzymes (evidence liver damage)
• LP: Low platelet count (platelets help clot the blood)

HELLP syndrome is diagnosed when red blood cells are damaged, resulting in elevated liver enzymes and liver failure, which can lead to internal bleeding that won’t clot due to low platelets. Complications from HELLP syndrome may be life threatening to the mother and/or baby.

How common is preeclampsia?

Preeclampsia affects approximately 1 in 20 pregnancies.

How is preeclampsia detected?

The first warning signs are often symptoms such as severe headache, blurry vision, severe upper abdominal pain, or excessive swelling over a short period of time. The diagnosis of preeclampsia is made by an obstetric care provider by evaluating a mom’s symptoms, blood pressures, laboratory tests (such as liver, kidney, and blood count tests), and checking a mom’s urine for excessive protein. Excessive protein in the urine is not required to make the diagnosis of preeclampsia if a woman has high blood pressure and other signs and symptoms.

How is preeclampsia treated?

While high blood pressures can be treated with blood pressure medicines, the only known treatment to fix preeclampsia is often delivery of the baby. Yet, preeclampsia can still occur after delivery. The timing of this delivery depends on the severity of the disease. To help prevent eclamptic seizures in those with more severe forms of preeclampsia, providers may give magnesium during and after delivery.

What is postpartum preeclampsia?

Postpartum preeclampsia is when preeclampsia signs and symptoms develop after the baby is delivered. In most cases, it occurs within 48 hours of childbirth but it can happen as far out as 6 weeks after birth.

If a problem with the placenta is the cause of preeclampsia, then why can postpartum preeclampsia occur?

It is currently unknown what is the specific cause of postpartum preeclampsia. One thought is that the abnormal proteins or signals that came from affected preeclampsia organs such as the placenta may still be in mom’s blood causing preeclampsia.

What are the effects of preeclampsia on the mother?

Women who have had preeclampsia are at in increased risk of developing cardiovascular disease and kidney disease, including heart attack, stroke, and high blood pressure, later in life.

What are the effects of preeclampsia on the baby?

Babies born to women with preeclampsia are also at an increased risk of cardiovascular and kidney disease later in life. Babies born prematurely as a result of preeclampsia may have additional complications.

What can you do to reduce your risk of preeclampsia?

It’s important to know that it’s not your fault for getting preeclampsia. However, there are ways you can lower your risk. The first step to preventing preeclampsia is to understand your risk factors and try to address them before you get pregnant or early in pregnancy. The only known preventative medicine now is daily aspirin starting after 12 weeks of gestation. While not 100 percent preventative, it does decrease the risks of developing preeclampsia.