Important Facts about Preeclampsia
All women need to know their blood pressure numbers, and it’s especially important to know before attempting to conceive and become pregnant. Women with high blood pressure before pregnancy, especially if the condition is unchecked and untreated, face increased risk of developing preeclampsia while pregnant. Preeclampsia can adversely affect both mother and baby with severe health consequences and even death.
Yet many women don’t realize they have hypertension; thus, their condition remains untreated, leading to serious health obstacles for themselves and their babies should they wish to conceive:
- Mayo Clinic researchers found women with a history of severe preeclampsia have more markers linked to brain cell damage and inflammation compared to women who had uncomplicated pregnancies. The findings were presented at the Alzheimer’s Association International Conference in San Diego in late 2022.
- The January 2022 Journal of the American Heart Association (JAHA) stated incidence of new-onset hypertensive disorders of pregnancy doubled from 2007 to 2019, with persistent rural-urban differences, highlighting an increasing need for targeted interventions to improve women and baby’s health in the U.S.
- Additionally, studies released by Hopkins Medicine in December 2021 found alarming rates of hypertension among pregnant women, particularly Black American women, over their subsequent counterparts who were born outside the U.S. and emigrated here prior to experiencing pregnancy.
- Finally, a 2019 study estimated the prevalence of hypertension and diabetes in non-pregnant women of reproductive age in the U.S., the proportion who were unaware of their condition or whose condition wasn’t controlled and differences in the prevalence of these conditions by selected characteristics.
The study’s subsequent results were alarming, with an estimated prevalence of hypertension at 9.3% overall. Among those women with hypertension, 16.9% were unaware of their hypertension status and 40.7% had uncontrolled hypertension. Among women with diabetes, almost 30% had undiagnosed diabetes, and among those with diagnosed diabetes, the condition was not controlled in 51.5% cases.
About 8%, or 8 in 100 women, have some kind of high blood pressure during pregnancy. Some women diagnosed with preeclampsia can develop seizures, a serious medical emergency known as eclampsia. Left untreated, preeclampsia can lead to serious, even fatal, complications for mother and baby. Even after pregnancy, preeclampsia can cause long-term damage to a woman’s kidneys, heart and brain.
May is designated Preeclampsia Awareness Month. Your local Capital Women’s Care women’s health professionals share valuable information about preeclampsia and its proven risk factors, plus its symptoms, treatments and recovery recommendations. What’s more, important guidelines are outlined to help reduce your preeclampsia risk so you can achieve a healthy pregnancy and birth.
What Is Preeclampsia?
Preeclampsia is a condition due to untreated high blood pressure during pregnancy. Signs of preeclampsia in women include organ dysfunction, usually involving the kidneys and liver. There’s no exact known cause for the condition.
- having proteins in the urine.
- experiencing severe headaches.
- having vision issues, including blurred vision, seeing spots or eyesight changes.
- experiencing upper stomach area pain.
- nausea or vomiting.
- swelling of face or hands.
- sudden weight gain.
- and/or trouble breathing.
It’s important to treat even mild forms of preeclampsia, as it can be a serious medical condition.
Without treatment, preeclampsia can cause serious health problems in pregnant women, including kidney, liver and brain damage.
In rare cases, it can lead to life-threatening conditions called eclampsia and HELLP syndrome. Eclampsia causes seizures and can lead to coma. HELLP syndrome results from serious blood and liver problems.
Other health issues caused by high blood pressure in pregnant women include gestational diabetes, heart attack, kidney failure, placental abruption, postpartum hemorrhage, pulmonary edema, stroke and even pregnancy-related death.
Fetuses are also susceptible to health concerns if their mothers have untreated high blood pressure during pregnancy. Babies are at risk for premature birth, fetal growth restriction (where babies don’t get enough nutrients and oxygen from the umbilical cord attached to the placenta), low birthweight, plus fetal or neonatal death.
High Blood Pressure During Pregnancy
A blood pressure reading involves 2 numbers. The first number represents systolic pressure measurement, a measure of blood pressure when the heart is contracting. The second number represents diastolic pressure measurement, a measure of blood pressure when the heart is relaxed.
In pregnancy, high blood pressure is diagnosed if the systolic pressure is 140 millimeters of mercury (mm Hg) or higher or if the diastolic pressure is 90 mm Hg or higher.
There are 2 forms of hypertension that can affect pregnancy:
- Chronic hypertension is high blood pressure that is present prior to becoming pregnant or develops before 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia in the second or third trimester of pregnancy. This form of hypertension doesn’t diminish after birth. About 1 in 4 women with chronic hypertension (25%) has preeclampsia during pregnancy.
- Gestational hypertension is high blood pressure that only occurs in pregnant women. It begins after 20 weeks of pregnancy and usually goes away once baby is born. It usually causes a small rise in blood pressure, but some women develop severe hypertension and may be at risk for more serious complications later in pregnancy, like preeclampsia. Additionally, women diagnosed with gestational diabetes face greater risk of hypertension later in life.
Preeclampsia Risk Factors
Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia during a previous pregnancy is 7 times more likely to develop preeclampsia in a later pregnancy.
Other factors that can increase a woman’s preeclampsia risk include:
- chronic high blood pressure and/or kidney disease before pregnancy.
- high blood pressure or preeclampsia in an earlier pregnancy.
- overweightness or obesity indicate greater likelihood to have preeclampsia in more than 1 pregnancy.
- having a history of thrombophilia.
- age, with women older than 40 years having higher risk.
- multiple gestation (being pregnant with more than 1 fetus.)
- being of African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.
- and/or having family history of preeclampsia.
Preeclampsia is also more common among women who have histories of certain health conditions, including migraines, diabetes, rheumatoid arthritis, lupus, scleroderma, urinary tract infections, gum disease, polycystic ovary syndrome, multiple sclerosis, gestational diabetes and sickle cell disease.
What’s more, preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination or in vitro fertilization.
If you’re pregnant or are thinking about pregnancy, talk with your Capital Women’s Care provider about your personal preeclampsia risk.
Reducing Preeclampsia Risk
Fortunately, there are many factors within your control to reduce your personal risk for developing preeclampsia during pregnancy:
- Monitor and know your blood pressure before you become pregnant. Get annual physicals and well woman checks plus establish a personal preconception health plan with your Capital Women’s Care practitioner ideally 3 months before planning to conceive. If you have chronic hypertension, talk with your practitioner regarding safe medications to take during pregnancy.
- Follow health recommendations set forth in your personal preconception health plan. Focus on meeting specific health goals, including achieving a healthy weight, regular physical activity and healthy diet and nutrition and manage any preexisting health conditions as recommended to reduce hypertension risk once you become pregnant. Use birth control while focusing on your personal preconception health goals and see your practitioner as directed.
- Get early and regular prenatal care. Go to every appointment with your doctor or health care professional.
- Talk to your doctor about any medications you take, and ask which ones are safe. Don’t stop or start taking any type of medicine, including over-the-counter medicines, without first talking with your doctor.
- Keep track of your blood pressure at home with a home blood pressure monitor. Contact your doctor if your blood pressure is higher than usual or if you have symptoms of preeclampsia. Talk to your doctor or insurance company about getting a home monitor.
- Continue to choose healthy foods and keep a healthy weight throughout your pregnancy.
- Monitor your overall health after giving birth. If you had high blood pressure during pregnancy, you face higher risk for stroke and other problems after delivery. Tell your doctor or call 9-1-1 right away if you experience symptoms of preeclampsia after delivery. You might need emergency medical care.
Preeclampsia is diagnosed when a woman has high blood pressure after 20 weeks of pregnancy and at least 1 of the following:
- protein in the urine (proteinuria), indicating an impaired kidney.
- other signs of kidney problems.
- a low blood platelet count
- elevated liver enzymes indicating impaired liver functioning.
- fluid within the lungs (known as pulmonary edema.)
- new headaches that don’t resolve with pain medication.
- or new vision disturbances.
If you have high blood pressure, your health care provider will order additional tests to check for other signs of preeclampsia:
- Blood tests. A blood sample analyzed in a lab can show how well the liver and kidneys are working. Blood tests can also measure the amount of blood platelets, the cells that help blood clot.
- Urine analysis. Your health care provider will ask you for a 24-hour urine sample or a single urine sample to determine how well the kidneys are working.
- Fetal ultrasound. Your provider will likely recommend close monitoring of your baby’s growth, typically through ultrasound. The images of your baby created during the ultrasound exam allow for estimates of the baby’s weight and amount of amniotic fluid within the uterus.
- Nonstress test or biophysical profile. A nonstress test is a simple procedure that checks how your baby’s heart rate reacts when your baby moves. A biophysical profile uses an ultrasound to measure your baby’s breathing, muscle tone, movement and volume of amniotic fluid in your uterus.
The primary treatment for preeclampsia is either to deliver the baby or manage the condition until the best time to deliver the baby. This decision with your Capital Women’s Care practitioner will depend on the severity of preeclampsia, gestational age of your baby and overall health of both you and your baby.
If preeclampsia isn’t severe, you may have frequent provider visits to monitor your blood pressure, any changes in signs or symptoms and your baby’s health. You’ll likely be asked to check your blood pressure daily at home.
Severe preeclampsia diagnosis would require you to be in the hospital to closely monitor your blood pressure and possible complications. Your health care provider will frequently monitor the growth and well-being of your baby.
Medications to treat severe preeclampsia usually include:
- antihypertensive drugs to lower blood pressure.
- anticonvulsant medication, like magnesium sulfate, to prevent seizures.
- and/or corticosteroids to promote development of your baby’s lungs before delivery.
If you have preeclampsia that isn’t severe, your provider may recommend preterm delivery after 37 weeks, whether through induced labor or caesarean. If you have severe preeclampsia, your provider will likely recommend delivery before 37 weeks, depending on the severity of complications and your baby’s health and readiness.
Method of delivery, whether vaginal or cesarean, depends on preeclampsia severity, gestational age of your baby and other considerations you would discuss with your Capital Women’s Care practitioner.
You need to be closely monitored for high blood pressure and other signs of preeclampsia after your baby’s delivery. Before you go home, you’ll be instructed when to seek medical care if you have signs of postpartum preeclampsia, including severe headaches, vision changes, severe belly pain, nausea and vomiting.
It’s important to contact your Capital Women’s Care practitioner immediately if you have any health issues after your baby’s delivery.
Your local Capital Women’s Care team of empathetic, compassionate doctors, assistants and support staff is here to answer your questions and concerns relating to high blood pressure, preeclampsia and any women’s health issue. Our premier women’s health practices prioritize quality, comprehensive treatment and care so you achieve and enjoy a quality long life.