Preeclampsia and High Blood Pressure
What is preeclampsia?
Preeclampsia is new-onset high blood pressure that happens during pregnancy. It usually starts after the 20th week of pregnancy. You may have preeclampsia if you have a systolic pressure of 140 mm Hg or higher and/or a diastolic pressure of 90 mm Hg or higher on two recordings at least four hours apart. Other signs of preeclampsia include high levels of protein in the urine or other signs of organ damage.
What are the signs or symptoms?
Some women don’t notice any symptoms. When they do happen, symptoms may include:
- Headaches with unknown cause that don’t go away with medication
- Vision changes
- Upper abdominal pain
- Nausea and/or vomiting
- Shortness of breath
- Rapid swelling (edema), especially of the feet
In some cases, preeclampsia can become severe and lead to serious problems. Severe symptoms may include:
- Very high blood pressure (160/110 or higher)
- Severe headaches
- Organ dysfunction
- Fluid in the lungs
If you have these symptoms, call your health care professional right away.
What increases the risk of preeclampsia?
Some factors that make preeclampsia more likely include:
- Being pregnant for the first time
- Having preeclampsia in a past pregnancy
- Chronic high blood pressure, chronic kidney disease or both
- Blood clotting problems
- Being pregnant with more than one baby at a time
- Getting pregnant through in-vitro fertilization
- Family history of preeclampsia
- Being obese
- Having diabetes
- Being younger than 18 or older than 35
How is it diagnosed?
Regular prenatal care can help catch the early stages of preeclampsia. High blood pressure is a key sign that preeclampsia may be developing. Doctors may test the mother’s urine, blood and physical health. Ultrasound and fetal monitoring of the baby may be needed.
Other signs of preeclampsia are:
- Protein in urine (proteinuria)
and/or any of these newly developed symptoms
- Low blood platelets
- Kidney or liver problems
- Fluid in the lungs and difficulty breathing
- Signs of brain trouble, such as headaches or vision problems
How is preeclampsia treated?
Preeclampsia treatment depends on a few factors. These include the overall health of the mother and the condition’s progress.
Medications including beta-blockers (such as labetalol) or calcium channel blockers (nifedipine) are often used to lower blood pressure. The health care professional will prescribe the best medication for the mother.
To prevent the risk of severe health issues for the mother, the baby may need to be born early. If the mother has severe symptoms and is at least 34 weeks pregnant, experts recommend delivering the baby as soon as it is safe. If the pregnancy is less than 34 weeks, medication might be given to help the baby grow and be better prepared for an early delivery. If the mother’s condition is not severe, delivery at 37 weeks is recommended. Preeclampsia signs and symptoms may continue after delivery but usually disappear within six weeks.
Most women deliver healthy babies and fully recover. However, in some cases, preeclampsia can be life-threatening to the mother and baby. There can also be long-term heart and brain health effects for the mother and child after preeclampsia.
How can women reduce their risk?
Currently, there is no test being used regularly in the U.S. to predict preeclampsia. The mother and baby are monitored at their regular prenatal visits.
There is no proven way to prevent gestational hypertension or preeclampsia. But, women at risk of developing preeclampsia can lower their risk by taking low-dose aspirin during pregnancy. Women should ask their health care professional if aspirin is appropriate.
For a healthy pregnancy, women should:
- Get early and regular medical care.
- Check their blood pressure at home if told to.
- Eat a heart-healthy diet.
- Get regular physical activity.
Women with preeclampsia are more likely to develop high blood pressure, neurologic problems and diabetes later in life. It also increases the risk of heart disease and stroke, research shows. This is especially true if preeclampsia happens in more than one pregnancy. Tell your health care professionals if you have a history of preeclampsia.
Is eclampsia the same thing as preeclampsia?
No, eclampsia is a severe complication of preeclampsia that causes seizures. It can be dangerous for the mother and baby and needs to be treated right away. Warning signs and symptoms are not always present, but most women have one of the following before developing eclampsia:
- Severe and persistent headaches
- Blurred vision
- Sensitivity to bright lights
- Confused or unusual behavior
If you have any of these signs or symptoms, call your health care professional right away.
