Preeclampsia: Everything You Need To Know
Preeclampsia: A Silent and Serious Pregnancy Threat
Let’s talk about preeclampsia—my ever-persistent adversary. Whether you expect it or not, it finds a way to show up. If you've ever spent time in a labor and delivery unit, you know someone is almost always grappling with it. Preeclampsia doesn’t play by the rules—it can be subtle, explosive, or somewhere in between. One thing's for sure: its surprises are rarely welcome.
In what feels like the blink of an eye (yes, a slight nod to And Just Like That, which, to be honest, I have mixed feelings about), preeclampsia can become your reality.
What Is Preeclampsia?
Preeclampsia is a serious pregnancy complication that typically emerges after 20 weeks of gestation. It’s primarily marked by high blood pressure and often—though not always—the presence of protein in the urine. If untreated, this condition can escalate to seizures, strokes, or even maternal or fetal death.
While it can technically arise any time after mid-pregnancy, preeclampsia is most frequently diagnosed in the third trimester.
Recognizing early warning signs—such as persistent headaches, vision changes, or upper abdominal pain—can be lifesaving. If you notice anything unusual, don't wait—speak to your doctor immediately.
This post aims to arm you with a clearer understanding of what preeclampsia is, how it presents, who’s at risk, and what treatment looks like.
Understanding Preeclampsia
Preeclampsia is classified under hypertensive disorders of pregnancy—a major global cause of maternal and fetal death. In the U.S., it affects around 5–8% of pregnancies. Worldwide, that figure climbs to more than 2 million cases annually.
The hallmark of preeclampsia is elevated blood pressure, sometimes accompanied by proteinuria, liver or kidney dysfunction, and other systemic issues.
One of the most alarming aspects is its speed—it can progress from mild to life-threatening within hours.
Eclampsia—the onset of seizures caused by severe preeclampsia—can happen before, during, or after delivery. It affects about 1 in 5 women diagnosed with preeclampsia. Strikingly, 20–38% of these women don’t exhibit the classic symptoms (like high blood pressure or protein in the urine) before having a seizure.
Preeclampsia is also one of the leading reasons for medically induced preterm births. Its impact on infants can extend beyond birth, contributing to growth issues, elevated childhood blood pressure, and even increased risk of heart disease later in life.
Preeclampsia on the Rise—Especially in the U.S.
Despite global reductions in preeclampsia rates, the United States is an outlier. According to the American College of Obstetricians and Gynecologists (ACOG), preeclampsia cases increased by 26% between 2000 and 2010. African-American women are disproportionately affected.
There are several theories. One points to rising obesity rates, as obesity is a known risk factor. Others suggest that how pregnancies are managed in the U.S. could be contributing.
Regardless of the cause, awareness is essential. Knowing the risk factors and warning signs can save lives.
Preeclampsia vs. Eclampsia
When preeclampsia leads to seizures, it's classified as eclampsia—a rare but critical complication. Eclamptic seizures can rapidly elevate blood pressure to dangerous levels, potentially causing brain hemorrhage or death if not treated immediately.
Common Symptoms of Preeclampsia
Sometimes, preeclampsia develops with no noticeable symptoms. Regular prenatal care, including blood pressure monitoring, is crucial for early detection.
Possible signs include:
Severe or persistent headaches
Vision disturbances (blurriness, light sensitivity, vision loss)
Shortness of breath (from fluid in the lungs)
Nausea or vomiting
Decreased urine output
Upper abdominal pain (often on the right side)
Swelling, especially in hands and face
Liver or kidney dysfunction
Low platelet count (thrombocytopenia)
What Causes Preeclampsia?
The exact cause remains unclear. It’s believed to originate in the placenta, which connects mother and baby. In preeclampsia, placental blood vessels don’t develop properly—they're narrower and limit blood flow.
Possible contributing factors include:
Blood vessel damage
Poor placental blood supply
Immune system dysfunction
Genetic predisposition
Obesity and poor diet
Other Pregnancy-Related Hypertensive Disorders
Gestational hypertension: High blood pressure after 20 weeks with no proteinuria, typically resolves after birth.
Chronic hypertension: High blood pressure predating pregnancy or occurring before 20 weeks.
Chronic hypertension with superimposed preeclampsia: Existing high blood pressure worsens during pregnancy and includes other preeclampsia indicators.
Risk Factors for Preeclampsia
You're at greater risk if you:
Are over age 35
Are obese (BMI over 30)
Have preexisting hypertension or diabetes
Have kidney disease or autoimmune conditions (like lupus or APS)
Are African American
Are pregnant with multiples
Conceived via IVF
Have had preeclampsia before
Have a short (<2 years) or long (>10 years) gap between pregnancies
Smoke or have sleep apnea
Serious Complications
Preeclampsia can result in:
HELLP Syndrome: A dangerous condition affecting the liver and blood.
Hemolysis (destruction of red blood cells)
Elevated liver enzymes
Low platelet count
Symptoms of HELLP include headaches, fatigue, chest/abdominal pain, and unusual bleeding.
Other complications:
Eclampsia
Placental abruption
Stroke
Pulmonary edema
Liver rupture or bleeding
Reversible vision loss
Maternal death
Diagnosing Preeclampsia
Preeclampsia is diagnosed by:
Blood pressure: 140/90 mmHg or higher on two separate readings (4+ hours apart), or 160/110 mmHg once, indicating severe hypertension.
Proteinuria: 300 mg+ in a 24-hour urine test, or a protein/creatinine ratio of 0.3+, or dipstick of 2+ (less reliable).
In the absence of protein in the urine, other criteria like low platelet count, impaired kidney/liver function, fluid in lungs, or persistent headaches may confirm the diagnosis.
Treatment Options
The only definitive treatment is delivery. For pregnancies at or beyond 37 weeks, delivery is typically recommended.
If preeclampsia is mild and you're earlier in the pregnancy, you may be monitored closely—possibly in the hospital. Blood pressure medications and anticonvulsants may be prescribed to reduce the risk of seizures.
In severe cases, early delivery might be the safest option. Most symptoms resolve within 1 to 6 weeks postpartum.
Can Preeclampsia Be Prevented?
While it can’t be entirely prevented, steps to lower your risk include:
Attending all prenatal appointments
Managing chronic conditions like diabetes or hypertension
Avoiding smoking and alcohol
Maintaining a healthy weight
Exercising regularly
Following a balanced diet
Taking low-dose aspirin (81 mg) after 12 weeks if at high risk—only under doctor’s supervision
Postpartum Preeclampsia
Though most cases occur during pregnancy, some women develop postpartum preeclampsia, usually within four weeks of delivery. The symptoms mirror prenatal preeclampsia and can include headaches, vision changes, and high blood pressure.
Prompt treatment may involve hospital readmission and medication to prevent further complications.
Final Thoughts
Preeclampsia is unpredictable, often presenting in surprising ways. That’s why vigilance and awareness are essential. If you’ve had it before, your OB-GYN will plan carefully for future pregnancies. And if you’re pregnant now and just don’t feel quite right, don’t hesitate to speak up.
As the old GI Joe motto goes, “Knowing is half the battle.”
If you’ve had experience with preeclampsia—or know someone who has—I’d love to hear your story. Let’s support one another by sharing and spreading this important knowledge.
0 Comments