Learn about the diagnosis, treatment of this pregnancy complication of high blood pressure with related damage to the kidneys or other organs.
Preeclampsia is a complication of pregnancy. With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range.
Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and baby.
Early delivery of the baby is often recommended. The timing of delivery depends on how severe the preeclampsia is and how many weeks pregnant you are. Before delivery, preeclampsia treatment includes careful monitoring and medications to lower blood pressure and manage complications.
Preeclampsia may develop after delivery of a baby, a condition known as postpartum preeclampsia.
The defining feature of preeclampsia is high blood pressure, proteinuria, or other signs of damage to the kidneys or other organs. You may have no noticeable symptoms. The first signs of preeclampsia are often detected during routine prenatal visits with a health care provider.
Along with high blood pressure, preeclampsia signs and symptoms may include:
Weight gain and swelling (edema) are typical during healthy pregnancies. However, sudden weight gain or a sudden appearance of edema — particularly in your face and hands — may be a sign of preeclampsia.
Make sure you attend your prenatal visits so that your health care provider can monitor your blood pressure. Contact your provider immediately or go to an emergency room if you have severe headaches, blurred vision or other visual disturbances, severe belly pain, or severe shortness of breath.
Because headaches, nausea, and aches and pains are common pregnancy complaints, it's difficult to know when new symptoms are simply part of being pregnant and when they may indicate a serious problem — especially if it's your first pregnancy. If you're concerned about your symptoms, contact your doctor.
The exact cause of preeclampsia likely involves several factors. Experts believe it begins in the placenta — the organ that nourishes the fetus throughout pregnancy. Early in a pregnancy, new blood vessels develop and evolve to supply oxygen and nutrients to the placenta.
In women with preeclampsia, these blood vessels don't seem to develop or work properly. Problems with how well blood circulates in the placenta may lead to the irregular regulation of blood pressure in the mother.
Preeclampsia is one high blood pressure (hypertension) disorder that can occur during pregnancy. Other disorders can happen, too:
Conditions that are linked to a higher risk of preeclampsia include:
Conditions that are associated with a moderate risk of developing preeclampsia include:
Several studies have shown a greater risk of preeclampsia among Black women compared with other women. There's also some evidence of an increased risk among indigenous women in North America.
A growing body of evidence suggests that these differences in risk may not necessarily be based on biology. A greater risk may be related to inequities in access to prenatal care and health care in general, as well as social inequities and chronic stressors that affect health and well-being.
Lower income also is associated with a greater risk of preeclampsia likely because of access to health care and social factors affecting health.
For the purposes of making decisions about prevention strategies, a Black woman or a woman with a low income has a moderately increased risk of developing preeclampsia.
Complications of preeclampsia may include:
HELLP syndrome. HELLP stands for hemolysis (the destruction of red blood cells), elevated liver enzymes and low platelet count. This severe form of preeclampsia affects several organ systems. HELLP syndrome is life-threatening to the mother and baby, and it may cause lifelong health problems for the mother.
Signs and symptoms include nausea and vomiting, headache, upper right belly pain, and a general feeling of illness or being unwell. Sometimes, it develops suddenly, even before high blood pressure is detected. It also may develop without any symptoms.
Eclampsia. Eclampsia is the onset of seizures or coma with signs or symptoms of preeclampsia. It is very difficult to predict whether a patient with preeclampsia will develop eclampsia. Eclampsia can happen without any previously observed signs or symptoms of preeclampsia.
Signs and symptoms that may appear before seizures include severe headaches, vision problems, mental confusion or altered behaviors. But, there are often no symptoms or warning signs. Eclampsia may occur before, during or after delivery.
The best clinical evidence for prevention of preeclampsia is the use of low-dose aspirin. Your primary care provider may recommend taking an 81-milligram aspirin tablet daily after 12 weeks of pregnancy if you have one high-risk factor for preeclampsia or more than one moderate-risk factor.
It's important that you talk with your provider before taking any medications, vitamins or supplements to make sure it's safe for you.
Before you become pregnant, especially if you've had preeclampsia before, it's a good idea to be as healthy as you can be. Talk to your provider about managing any conditions that increase the risk of preeclampsia.
A diagnosis of preeclampsia happens if you have high blood pressure after 20 weeks of pregnancy and at least one of the following findings:
A blood pressure reading has two numbers. The first number is the systolic pressure, a measure of blood pressure when the heart is contracting. The second number is the diastolic pressure, 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.
A number of factors can affect your blood pressure. If you have a high blood pressure reading during an appointment, your health care provider will likely take a second reading four hours later to confirm a diagnosis of high blood pressure.
If you have high blood pressure, your health care provider will order additional tests to check for other signs of preeclampsia:
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 health care provider will depend on the severity of preeclampsia, the gestational age of your baby, and the overall health of 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 the health of your baby. You'll likely be asked to check your blood pressure daily at home.
Severe preeclampsia requires that you be in the hospital to 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:
If you have preeclampsia that isn't severe, your health care provider may recommend preterm delivery after 37 weeks. If you have severe preeclampsia, your health care provider will likely recommend delivery before 37 weeks, depending on the severity of complications and the health and readiness of the baby.
The method of delivery — vaginal or cesarean — depends on the severity of disease, gestational age of the baby and other considerations you would discuss with your health care provider.
You need to be closely monitored for high blood pressure and other signs of preeclampsia after delivery. Before you go home, you'll be instructed when to seek medical care if you have signs of postpartum preeclampsia, such as severe headaches, vision changes, severe belly pain, nausea and vomiting.
Discovering that you have a potentially serious pregnancy complication can be frightening.
If you're diagnosed with preeclampsia late in your pregnancy, you may be surprised to learn that immediate delivery may be recommended. If you're diagnosed earlier in your pregnancy, you may be concerned about monitoring signs and symptoms at home and keeping more frequent appointments with your primary care provider.
It may help to learn more about your condition. In addition to talking to your provider, do some research. Make sure you understand when to call your provider and how to monitor signs and symptoms.
Preeclampsia is often diagnosed during a regularly scheduled prenatal appointment. If your primary care provider recommends certain tests for a preeclampsia diagnosis, you may also be discussing some of the following questions:
After a diagnosis of preeclampsia and at follow-up appointments, you might ask the following questions: