What Is Preeclampsia and How Could It Affect a Pregnancy?

Preeclampsia is a serious complication of pregnancy, affecting 5% to 8% of pregnancies in the U.S. It is characterized by new onset high blood pressure and organ damage in the second half of pregnancy or in the postpartum period (the six weeks after delivery). Although the majority of women have good outcomes, preeclampsia can be associated with devastating complications for both the mother and her baby, including preterm delivery, stroke, seizures and even death. There can also be long-term consequences from preeclampsia, including an increased risk for cardiovascular disease (such as high blood pressure or heart attack) for both the mother and her child later in life.

For all these reasons, Meredith Rochon, MD, Chief, Division of Maternal Fetal Medicine, Lehigh Valley Health Network (LVHN), is surprised and concerned when the occasional patient tells her they’ve never heard of preeclampsia.

“Patients need to know about it, which is what makes Preeclampsia Awareness Month so important,” Dr. Rochon says.

An initiative of the Preeclampsia Foundation, Preeclampsia Awareness Month occurs every May. But for pregnant women, their babies and those who care about them, preeclampsia demands attention year-round.

There are many issues that can increase a woman’s risk for preeclampsia, but the actual cause of the condition is not completely understood. Some common risk factors include first pregnancy, multiple gestations such as twins, extremes of age (older or younger), obesity, chronic medical conditions such as hypertension or diabetes, and a history of preeclampsia in a prior pregnancy.

Symptoms of preeclampsia include:

• Headaches
• Changes in vision, such as blurriness, seeing spots or sensitivity to light
• Abdominal pain
• Nausea or vomiting
• Chest pain
• Trouble breathing

Often preeclampsia offers no noticeable symptoms. Instead, it may show up unexpectedly during a routine blood pressure check or urine test. Systolic and diastolic blood pressure measures of at least 140 mm Hg and/or 90 mm Hg registered on two separate occasions and the presence of protein in urine on a urine test are needed to make the diagnosis.

Unusually quick weight gain or the sudden appearance of swelling in the legs, hands or face may also be associated with preeclampsia.

Preeclampsia can progress quickly. A mother and her baby can go from healthy to desperately ill in just days.

There is no medicine that can treat preeclampsia. The only true treatment is delivery. Whether your doctor recommends immediate delivery or delayed delivery depends on how far along you are in your pregnancy. In some cases, delivery can be safely delayed by several weeks, although this requires careful monitoring, often in the hospital.

“Fortunately, most cases develop close to the due date, but a small percentage will develop preterm, meaning at less than 37 weeks,” Dr. Rochon says. “The ones we really worry about are those at less than 34 weeks, six weeks short of a full-term pregnancy. That’s much more challenging to manage.”

While delivering a baby early might be the best thing to do for the mom, it’s not so good for the baby.

“Gestational age makes all the difference. We make very different decisions at 24 weeks than we do at 34 weeks, for example, because risks for the fetus are very different.”

As there’s no real treatment for preeclampsia, Dr. Rochon recommends that women do all they can to reduce their risk, even before getting pregnant.

“One thing a woman can do is to really prepare for pregnancy,” Dr. Rochon says. “If there’s anything you can do to modify a risk factor, do it. For example, if you have a chronic medical condition such as diabetes or hypertension, get it under control. If you are obese, weight loss can decrease your risk. And have all your medications adjusted to medications that are safe to take during pregnancy.” In women with risk factors, low-dose aspirin has been shown to decrease the risk for developing preeclampsia.

Additionally, Dr. Rochon recommends women start prenatal care early and follow all their doctor’s instructions and recommendations.

“Starting prenatal care early might not prevent preeclampsia, but it will help your doctor detect it sooner, which can improve outcomes for both the mom and the baby. And go to all your prenatal visits, even if you feel fine, since preeclampsia can be diagnosed even if you don’t have symptoms,” Dr. Rochon says.

Also pay attention to all the informational materials you receive during your pregnancy, and take advantage of every opportunity to educate yourself.

“LVPG Obstetrics and Gynecology offers webinars for patients once a trimester, as well as postpartum, and the information they provide is really valuable. They go over all the things you need to know about that trimester, including preeclampsia,” Dr. Rochon says.

The good news is that most women with preeclampsia will fully recover and deliver healthy babies, but if you have any doubts at any time about your health or your baby’s, don’t hesitate to let your doctor know.

“Pay attention to your body. If you feel that something is off, make sure your concerns are heard. Advocate for yourself,” Dr. Rochon says. “There are a lot of symptoms women can have that can get dismissed as just typical symptoms of pregnancy, but get them checked out, because although those symptoms might be simply pregnancy related, they may also indicate that there’s a problem.”

While any pregnant woman might develop preeclampsia, there are many factors that elevate the risk above the norm. The following list, while long, isn’t comprehensive.

• First pregnancy
• Previous pregnancy with preeclampsia
• Family history of preeclampsia
• Pregnancy comprised of more than one baby
• History of chronic high blood pressure, diabetes, kidney disease or organ transplant
• Maternal age over 40 or under 18
• Obesity
• Gestational diabetes
• Lupus or other autoimmune disorder
• Any type of vascular disease
• Obstructive sleep apnea
• Sickle cell disease
• Use of assisted reproductive technology, including In-vitro fertilization (IVF)
• Black or African American ethnicity
• Failure of the baby to grow well in the current pregnancy or a prior pregnancy

Note, too, that the more risk factors present in any one woman, the higher her risk.