There is a general, almost universal, understanding that with pregnancy often comes uncomfortable swelling. This is to be expected. But while the occasional swollen feet or the ever-tightening wedding band can be a normal symptom of pregnancy, swelling can also be a sign of preeclampsia, which can be very dangerous.
Throughout your pregnancy, your health care provider should monitor you for any signs of preeclampsia, especially high blood pressure. But it is equally important that you stay attuned to your body as well to ensure that you can assess as soon as possible when something feels off. If left undiagnosed, your chances of experiencing short- and long-term complications from preeclampsia are higher, so the sooner your provider can help you manage the condition, the better.
To get all the details on preeclampsia, from what it is to risk factors to how it’s managed, we turned to the experts Anna Whelan, MDOB-GYN and maternal-fetal medicine physician, and associate with Physicians for Reproductive Health, and Frederick “Ricky” Friedman, Jr., MDprofessor and vice chair of academic affairs in the department of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai.
What is Preeclampsia?
Like gestational diabetes, preeclampsia is a condition unique to pregnancy that according to Dr. Friedman affects between 5–7% of pregnant women. According to American College of Obstetricians and Gynecologists (ACOG), preeclampsia usually develops after 20 weeks of pregnancy, usually in the third trimester, and may even appear after the baby is born. When it develops before 34 weeks of pregnancy it is called “early-onset preeclampsia.” As for what causes preeclampsia, said Dr. Whelan, “it is thought to be due to abnormal development of the placenta, however, the true cause is unknown. .”
In fact, the cause(s) of preeclampsia is a mystery that doctors and scientists have been trying to solve for decades. Funny explained by Dr. Friedman that researchers seem to consider everything—including bloodworms (a theory which since then is debunked). But until a true cause is confirmed, when it comes to diagnosing the condition, all doctors can do is keep risk factors in mind and closely monitor their patients.
Signs, Symptoms, and Risk Factors of Preeclampsia
So, what exactly are health care providers assessing when considering the condition? And what should you watch out for? said Dr. Friedman and Dr. Whelan that some of the signs and symptoms of preeclampsia include:
- A recurring, severe headache that doesn’t go away with Tylenol or caffeine
- Excessive swelling, especially in the fingers and face
- Chest pain
- Difficulty in breathing
- Blurred vision
- Elevated blood pressure
- Pain under your ribs on your right side
- Severe abdominal pain
- Excess protein in the urine (this requires a urine test to determine)
- Unusual weight gain
- Increased reflexes
While anyone can end up with preeclampsia, explained Dr. Friedman said there are several risk factors that, if known, would alert providers to monitor the patient just a little more closely because they have a higher chance of being diagnosed.
“The incidence increases in younger patients, such as teenagers, and patients over 35. Patients over 40 are at the highest risk. Underlying risk factors are any disorder of the blood vessels, such as chronic hypertension, kidney disease, lupus, and lupus-like disorders. Also, any situation where there is more placenta than usual, such as with twins or triplets.”
Another risk of preeclampsia is having a history of the condition. “Someone who has had preeclampsia once is more likely to have it a second time,” says Dr. Friedman, “And if it’s preeclampsia with severe features, especially pre-term preeclampsia, it’s more likely to have a subsequent pregnancy.”
Complications of Preeclampsia
If preeclampsia is misdiagnosed and not properly managed with appropriate interventions, then serious complications can develop that can be fatal for the expectant parent and/or the baby.
“Preeclampsia can lead to fetal growth problems and put the baby at increased risk for complications including preterm birth and stillbirth,” said Dr. Whelan, “These are the reasons why your doctor may recommend close monitoring with ultrasounds.”
These complications are scary enough, but preeclampsia poses serious risks to the health and well-being of the birthing parent. Dr. explained that. Friedman eclampsia is a severe seizure in a pregnant or early postpartum patient who has had preeclampsia. In layman’s terms, preeclampsia means “before a seizure,” and subsequent eclampsia is a dangerous complication of the condition.
In addition to severe seizures, other complications that Dr. Friedman and Dr. Whelan says that severe preeclampsia can include kidney and liver failure, stroke, temporary changes in mental status, temporary blindness, and even death.
Prevention and Management of Preeclampsia
Unfortunately, because doctors still don’t know what causes preeclampsia, there isn’t much pregnant women can do to prevent it. However, if a patient is at high risk of developing the condition, their health care provider may put them on baby aspirin.
“In someone at high risk for preeclampsia, baby aspirin has been shown in some patients to help prevent it, or at least delay its onset,” explains Dr. Friedman, “Many patients with a history of preeclampsia, chronic hypertension, or obesity. will be placed on this drug by their obstetrician.”
It is important to note, however, that even low-dose aspirin is not considered safe to take during pregnancy, so you should not take it unless your doctor specifically tells you to and is carefully monitoring you and your baby
Although there isn’t any proven way to prevent preeclampsia, take comfort in knowing that the condition doesn’t always end in complications. With proper care, it can be managed without any harm to the birth parent or baby.
“The management of a patient with preeclampsia depends on the gestational age at which it is diagnosed and how severe the changes in blood pressure and other findings are,” said Dr. Friedman. Some conservative methods of management that Dr. Whelan and Dr. Friedman typically includes:
- Blood pressure medications
- Intravenous magnesium sulfate (to help prevent seizures)
- Modified bed rest
- Frequent fetal well-being checks, such as non-stress tests
- Frequent sonograms to monitor the baby’s weight
Dr. explained further. Friedman says there is no “treatment” for the condition other than delivering the baby, and it’s not a decision taken lightly—especially since it can result in pre-term delivery. However, when a doctor decides that a patient’s preeclampsia has progressed to a point where induction and delivery are necessary, Dr. Friedman that this is because it is in the best interest of the parent and/or the health of the baby.
Preeclampsia is a very serious diagnosis, but you’ll have the best outcome as long as you stay aware of changes in your body, get prenatal care from a provider you trust, and speak up when something feels off. To learn more about preeclampsia, visit ACOG’s FAQ page here.
