If you’re pregnant and have signs of preeclampsia, you should partner with a provider who has expertise in this condition.
Even if you feel fine now, preeclampsia can suddenly and quickly get worse. And this can cause serious complications for you and your unborn baby.
Fortunately, University of Iowa Health Care is here to keep both of you as healthy as possible.
Our team includes obstetrics providers—particularly maternal-fetal medicine specialists—who routinely diagnose and manage preeclampsia. We have the experience it takes to distinguish preeclampsia from other pregnancy-related symptoms and conditions. And we’re skilled at determining whether it’s safer to deliver your baby early or continue monitoring your condition.
What is preeclampsia?
Preeclampsia is a medical condition that occurs during (or right after) pregnancy. It's most commonly associated with high blood pressure. But it can also cause liver failure, kidney failure, seizures, poor fetal growth, and even maternal-fetal death.
When your blood pressure to too high, it can lead to several problems. These include:
- Damage to your heart, lungs, or other organs
- Reduced blood flow to the placenta
- Intrauterine growth restriction (your unborn baby is smaller than it should be)
The sooner we identify preeclampsia, the sooner we can begin keeping a close eye on you. This is key to lowering your health risks.
Signs of preeclampsia
While preeclampsia can develop as early as 20 weeks of pregnancy, most people become symptomatic in the late second or third trimesters. Many don't have any symptoms early on. Your provider might discover it when they check your blood pressure and urine during a routine prenatal visit.
Signs of preeclampsia may include:
- Nausea and vomiting that begins in the second half of pregnancy
- Pain in the upper abdomen, usually on the right
- Shortness of breath
- Swelling in your face, hands, or legs
- Vision changes, including blurriness or light sensitivity
you should tell your obstetrician, midwife, or maternal-fetal medicine specialist right away if you develop any of these symptoms.
Uncontrolled preeclampsia can cause dangerous complications such as seizures, liver damage, heart attack, and stroke. However, by turning to experts like those from UI Health Care, you can usually avoid the most serious complications.
Preeclampsia care from UI Health Care
Once you develop preeclampsia, its effects do not necessarily go away after delivery. But in between your diagnosis and delivery, there are things we can do to help keep you safe.
The treatments you'll need depend on several factors. These include the severity of your symptoms and whether they started early or late in your pregnancy.
For many patients with mild preeclampsia, we recommend close observation. You'll have more frequent visits with your provider so we can keep better track of your blood pressure and proteinuria. We may also ask you to monitor your blood pressure at home.
Your preeclampsia may be considered mild if you meet the following criteria:
- Your blood pressure and the protein levels in your urine are only slightly elevated (and remain so)
- You don't have any noticeable symptoms
- Your results from other tests, including tests to check for liver damage, kidney damage, or blood clotting problems, are normal
If your blood pressure, symptoms, and labs indicate you have a severe form of the disease, we may admit you to the hospital. The length of your stay could be several days or weeks (or longer), depending on how far along you are.
With inpatient care, we have two goals. We want to monitor you and your baby around the clock. And we want to give your baby as much time in the womb as safely possible. This is because premature birth comes with its own risks.
During your stay, your management may also include:
- Medicine to help lower your blood pressure
- Medicine to help prevent seizures (a complication of severe preeclampsia)
- Steroids to help your baby's lungs and organs develop more quickly, in case you need to delivery early
- Frequent fetal heart rate monitoring
If your symptoms are severe or quickly getting worse, we may recommend you deliver your baby early. In some cases, prolonging your pregnancy—which could lead to serious preeclampsia complications—is riskier than premature birth.
If we think early delivery is the best option, we’ll have a thorough discussion with you before making any decisions. During that discussion, we’ll review the risks and benefits of delivering sooner rather than later. And we’ll determine whether you can deliver vaginally or if you should have a cesarean section (C-section).
There isn’t a one-size-fits-all rule for timing your delivery. However, we typically aim for the following:
- If your close to full term and your symptoms are mild, you probably won't deliver any sooner than 37 weeks.
- If your symptoms are severe, we often recommend delivery at 34 weeks gestation. At 34 weeks, most babies are far enough along in their development that they'll be fine with proper neonatal care.
Although it’s rare, we may recommend delivery earlier than 34 weeks if your preeclampsia is severe enough. In this situation, you can rest assured that we’re equipped to provide any medical treatments your baby needs to thrive.
Unmatched neonatal care
If your baby needs medical treatment because they were born prematurely or have other preeclampsia-related complications, they’re in good hands.
University of Iowa Stead Family Children’s Hospital is home to Iowa’s only Level 4 neonatal intensive care unit. This is the highest level of neonatal care any hospital can offer. It means we’re able to care for the tiniest or sickest babies, including those born as early as 22 weeks.
Our Level 4 designation also means your baby will never have to be transferred elsewhere for more advanced care. No matter what, you and your baby will stay together until they’re healthy enough to go home.
Lifelong care and support
Over the years, the medical community has gotten better at diagnosing and managing preeclampsia. However, there is still a lot to learn about this complex condition—including its immediate and long-term health effects.
We used to assume the risks of preeclampsia go away once a patient has given birth. But we’ve since learned that having preeclampsia increases your risk of certain health problems later in life.
For example, you may have a higher risk of developing conditions such as dementia and heart disease. In fact, preeclampsia is now considered as strong a risk factor for heart disease as obesity and smoking.
The importance of follow-up care
For these reasons, we recommend you:
- Attend your postpartum visits: It's important you schedule and attend your follow-up appointments with your maternal-fetal medicine specialist (or other pregnancy care provider).
- See your primary care provider (PCP) regularly: You should also let your PCP know about your history of preeclampsia. As your long-term health care partner, they'll need to keep an eye on your cardiovascular health and more.
Should you ever develop signs of a medical condition that requires advanced care, UI Health Care can help. We have experts in every specialty, including cardiology and nuerology, who can diagnose and treat future preeclampsia-related problems.
Leaders in preeclampsia research
part of the reason UI Health Care providers are so knowledgeable about this condition is because we're also researchers.
We continuously lead research projects that have contributed important findings to the scientific and medical communities. Some of our achievements and efforts include:
Predicting preeclampsia: We've discovered a special molecule (biomarker) that tells us whether you'll develop preeclampsia as early as the sixth week of pregnancy. We're working to create a test that providers can use to screen for this biomarker once you become pregnant. This would help ensure you receive the right monitoring and care right away.
Expanding medication options: We're investigating whether certain medications could lower your risk of developing preeclampsia if taken during pregnancy.
Studying the benefits of aspirin: We're evaluating whether patients with preeclampsia would benefit from taking aspirin after delivery, especially if symptoms linger. Taking low-dose aspirin during the postpartum period may improve blood flow through your blood vessels and lower your blood pressure.