Postpartum Preeclampsia | Treatment, Symptoms And Causes

You’ve very likely heard of preeclampsia, a condition that occurs in the second half of pregnancy.

You might be surprised to know this condition can also occur after you give birth.

Postpartum preeclampsia is rare, affecting around 600 women per year.

It’s a very serious condition that needs immediate treatment to prevent complications and death.

Read on to find out more about the causes, symptoms, and treatment of postpartum preeclampsia.

What is postpartum preeclampsia?

As the name suggests, postpartum preeclampsia occurs after your baby is born. Like preeclampsia that occurs in the second half of pregnancy, the condition has the same main signs: high blood pressure (hypertension) and excessive protein in your urine.

You can develop postpartum preeclampsia within 48 hours of giving birth; some women develop the condition up to six weeks later.

You can read more about preeclampsia during pregnancy in Preeclampsia | Symptoms, Signs, And Causes.

What causes postpartum preeclampsia?

Much like preeclampsia, the exact causes of postpartum preeclampsia are unknown.

There are certain risk factors for postpartum preeclampsia that increase a woman’s chances of developing it.

They are:

• High blood pressure that occurred in a previous pregnancy
• Any condition related to uncontrolled hypertension before the pregnancy
• Family history of preeclampsia or postpartum preeclampsia
• Maternal age (<20 years or >40 years)
• Being overweight or obese
• Having multiple babies, such as twins or triplets
• Type 1 or type 2 diabetes.

If you have any of these risk factors, your doctor will be more vigilant for signs or symptoms of hypertension after your baby is born.

During pregnancy, routine pregnancy screening will look at your family history and include high blood pressure monitoring.

Postpartum preeclampsia symptoms

The main sign of postpartum preeclampsia is a raised blood pressure of 140/90mm Hg, or more, after birth.

That is why your health care provider or midwife will monitor your blood pressure within 48 hours of birth and continue to check it regularly for up to 6 weeks after your baby is born.

Other signs or symptoms that indicate serious complications related to postpartum preeclampsia are:

• Headaches that occur after birth, which are unusual and can be severe
• Visual disturbances (blurry vision or light sensitivity)
• Swollen hands, feet, and face
• Sharp pain in the area below your ribs, usually on the right side (epigastric pain)
• Decreased urination and protein in your urine
• Sudden weight gain (within the first 2 weeks).

If you have any of these symptoms of postpartum preeclampsia after giving birth, seek immediate medical attention.

How is postpartum preeclampsia diagnosed?

It is important to get fast and effective treatment for postpartum preeclampsia. If left untreated, postpartum preeclampsia can lead to serious complications, including stroke and seizures.

Your doctor may order blood tests to check for elevated liver enzymes, red blood cells, and low platelet count. Regular urine tests will check for protein in the urine.

Postpartum preeclampsia treatment

There are 4 types of medication used to treat postpartum preeclampsia:

1. Antihypertensive drugs, to lower your blood pressure and strive to bring it back within the normal range
2. Anti convulsive drugs, such as magnesium sulfate, to prevent seizures in women with severe signs and symptoms. Magnesium sulfate is typically taken for 24 hours during which time your blood pressure and urine output will be monitored closely
3. Diuretics, to get your kidneys functioning optimally. Kidney function can be affected by raised blood pressure causing decreased urination
4. Blood thinners, to prevent the formation of blood clots that could lead to stroke.

How long does postpartum preeclampsia last?

Most women who develop postpartum preeclampsia do so within 48 hours of childbirth. However, the condition can develop up to six weeks after childbirth.

With early discharge from hospital quite common in many countries, it’s important your doctor knows if you have any risk factors for postpartum preeclampsia, so you can be monitored before going home. This means if you are at risk for developing the condition, it can be picked up quickly and treated.

If you develop symptoms after going home, you should go straight to the hospital.

Once you have been seen in the emergency room, your doctor will prescribe medications to get your blood pressure under control right away, and treat any other symptoms of postpartum preeclampsia.

This could take several days or up to six weeks to resolve and can lengthen your recovery from childbirth.

How serious is postpartum preeclampsia?

Postpartum preeclampsia is an extremely serious condition that can lead to brain damage, stroke, HELLP syndrome, and death if not treated.

Studies suggest 0.3–28% of women experience hypertension after giving birth. With proper management, however, they can be treated effectively and recover fully.

If you experience any of the symptoms described in this article, seek medical care right away at your local emergency room, to rule out postpartum preeclampsia.

Does postpartum preeclampsia go away?

Postpartum preeclampsia doesn’t go away on its own without treatment. As discussed above, if left untreated it can lead to stroke, seizures, organ damage, and death.

Fortunately, with prompt and effective diagnosis, postpartum preeclampsia can be treated and you will make a full recovery.

This is why it’s so important to share your medical and obstetric history with your health care providers in future pregnancies. Your health during this pregnancy will inform your doctor about your risk factors and maternity care needs for your next pregnancy.

Two of the common causes of hypertension after birth are:

• Gestational hypertension (high blood pressure during pregnancy)
• Preeclampsia (sudden onset of high blood pressure during the second trimester).

Research shows the risk of having preeclampsia again is around 20%. However, experts believe the range is between 5% and 80%, depending on additional risk factors and how severe it was the first time.

In developed countries such as the US, UK, and Australia, the maternal death rate due to postpartum preeclampsia is between 0% and 1.8%.

Postpartum preeclampsia and breastfeeding

It’s still possible to breastfeed even if you develop postpartum preeclampsia.

Your milk supply could be affected by the medications used to manage your condition but this can be managed with the help of a lactation consultant.

Studies have found that not breastfeeding increases a woman’s risk of hypertension.

Because women who have high blood pressure during pregnancy are at greater risk of hypertension and cardiovascular disease later in life, breastfeeding could be particularly important in helping to reduce this risk.

Check out Breastfeeding And High Blood Pressure – Does Breastfeeding Help? for more information.

Another study found lactation to be associated with lower blood pressure after birth among overweight women who developed hypertension during pregnancy.

The same protective effect was not found in women who developed preeclampsia during pregnancy.

Overall, breastfeeding reduces the risk of increased blood pressure in women, both in the postpartum period and in later life.

Postpartum preeclampsia diet

To date, there is no evidence to show dietary changes will have an effect on the risk of developing preeclampsia during pregnancy or after birth.

However, a nutritious diet during and after pregnancy is essential for the health of you and your baby. It also optimizes breastfeeding, which helps reduce blood pressure, as discussed above.

A balanced diet is recommended. It should have the right amounts of lean proteins, healthy fats, whole grains, and calcium-rich foods, with plenty of fresh fruit and vegetables.

Commercially prepared and pre-packaged food should be avoided due to the high amounts of salt and sugar.

Postpartum preeclampsia prevention

Unfortunately, there’s no way to prevent preeclampsia or postpartum preeclampsia from happening. The best and most important thing you can do is reduce your risk of hypertension during pregnancy.

This means keeping your weight in the healthy range for your age and build, before you fall pregnant and also during pregnancy.

Exercise is an important part of improving your overall health and should be incorporated into your daily routine, even after you conceive.

Other tips to maintain a healthy blood pressure are:

• Be mindful of your salt intake, especially the hidden salt in processed food
• Stay well hydrated, and drink plenty of water throughout the day
• Make sure you eat enough protein in your diet (lean and organic sources are best)
• Sleep on your left side to reduce pressure on major blood vessels.

Postpartum preeclampsia is a rare condition but it can be serious if left untreated.

Postpartum recovery is already overwhelming, due to the hormonal shifts and the massive changes in your sleep patterns.

Make sure you have a supportive team, including your partner and family members, so that you can focus on getting adequate nourishment and rest.

Notify your healthcare provider of any symptoms of higher blood pressure, such as persistent or new headache or visual disturbances.