Preeclampsia is a complication of pregnancy in which a woman’s blood pressure becomes elevated and protein is found in her urine. The cause is unknown, though there are well-documented risk factors.
- History of high blood pressure before pregnancy
- Age over 40 or under 18
- First pregnancy
- Multiple pregnancy (twins or more)
- Black race
- Other chronic conditions, such as lupus
Preeclampsia is a dangerous condition. Not only are women at risk for long-term health complications, including high blood pressure later in life, preeclampsia is a known risk factor for stillbirth. It is also a contributing factor in many preterm deliveries. Untreated, preeclampsia may become eclampsia, which can be fatal to both mother and baby.
Severe preeclampsia may also become HELLP Syndrome, which stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. If not “cured” by delivery, HELLP Syndrome can cause hemorrhage (severe bleeding), pulmonary edema (fluid in the lungs), kidney failure, liver failure, or death for a woman. HELLP Syndrome may also cause placental abruption.
It is possible to have high blood pressure in pregnancy and not have preeclampsia. Some women have chronic hypertension prior to getting pregnant. Some women also develop mildly elevated blood pressure during pregnancy without ever getting the other symptoms of preeclampsia (this is called Pregnancy Induced Hypertension). However, in both of these cases, a woman is at greater risk for developing preeclampsia and should be monitored very closely.
Symptoms of preeclampsia that may occur include:
- High blood pressure
- Protein in the urine
- Headache, often severe
- Swelling, especially of the hands, feet, or face
- Epigastric pain, or pain in the high center or high right side of the belly
- Visual changes, such as spots in front of the eyes or flashing lights
- Sudden weight gain
- Nausea and vomiting
- Decreased urine output
- Abnormal liver enzymes
- Low platelets
If you have any of the symptoms of preeclampsia, you should be evaluated by a doctor or midwife. Your blood pressure will be checked, and several lab tests will be done. You will have to give a urine sample and some blood will be drawn.
Many women do not feel sick at first with preeclampsia. That is one of the reasons it is so important to get regular prenatal care. Your blood pressure will be checked at each visit, as well as your urine for protein. Detecting preeclampsia early may mean the difference between life and death for you or your baby.
The only cure for preeclampsia is delivery. If you are already at full term, your doctor will most likely recommend an induction of labor. If you are earlier than 37 weeks, your doctor will have to determine how severe your preeclampsia is to choose the best treatment plan.
It is possible to lower the risk of eclampsia (seizure) by giving magnesium sulfate through an IV. This is only a temporary fix, however, and usually only used to keep a woman protected from eclamptic seizure long enough to give steroid injections to mature the fetus’s lungs in preparation for delivery. Steroids are generally given between 24 and 34 weeks gestational age.
Preeclampsia and Pregnancy Loss
Preeclampsia is associated with stillbirth, but is also a common indication for inducing labor prematurely (before 37 weeks). Prematurity continues to be one of the leading causes of death in infants.
Cunningham, F., Gant, N., et al. Williams Obstetrics, 21st Edition. 2001.
National Institutes of Health “HELLP Syndrome” U.S. National Library of Medicine. Accessed: 13 May 2012.
National Institutes of Health “Preeclampsia” U.S. National Library of Medicine. Accessed: 13 May 2012.