Preeclampsia is the most common serious medical problem women face in pregnancy.
It most commonly occurs after the 20th week of pregnancy.
The exact number of those who develop preeclampsia is unknown.
Experts estimate that preeclampsia affects 5-10% of all pregnancies globally.
What is preeclampsia?
Preeclampsia used to be known as toxemia. It’s a condition that develops only in pregnant women.
It usually occurs in the second half of pregnancy, or even several days after birth. It affects both mothers and their unborn babies.
The condition can develop very rapidly. The first sign that preeclampsia is developing is high blood pressure in women who haven’t previously experienced high blood pressure.
Often, the early signs of this condition are things you might not notice yourself, but your doctor should pick them up during your prenatal appointments.
Early symptoms for mild preeclampsia include:
- High blood pressure (140/90 mm hg or higher)
- Protein in the urine (proteinuria)
High blood pressure can affect a woman during pregnancy but might not be a cause for concern.
The presence of protein in the urine, however, is an extra sign that indicates preeclampsia is developing.
Signs of preeclampsia
As the condition progresses, further signs and symptoms can develop.
Contact your doctor or healthcare provider immediately if you experience any of the following:
- Sudden swelling (edema) to face or feet, and weight gain over 1-2 days
- Pain in the abdomen, especially in the upper right side
- Severe headaches
- Excessive vomiting and nausea
- Blurry vision, flashing lights, or floaters
- Changes to reflexes
- Reduced or no urine output
Your doctor might recommend tests to determine the cause of these symptoms, and also a nonstress test to check on your baby’s wellbeing.
What causes preeclampsia?
For decades, scientists have searched for the cause of preeclampsia. It’s believed to occur when there are blood vessel problems in the placenta.
As the placenta develops, blood vessels form to act as part of the ‘exchange’ between mother and baby.
Oxygen, nourishment, and waste are all moved through these vessels.
In women with preeclampsia, the blood vessels don’t develop properly.
They’re usually narrower, and they respond differently to hormone signals. This leads to reduced blood flow to the placenta, preventing it from functioning properly.
When there’s an insufficient blood supply, the vessels are damaged, causing a rise in blood pressure.
There are several reasons why these blood vessels don’t develop normally:
- Lack of blood flow to the uterus
- Genetic factors (family history of preeclampsia, in both parents)
- Limited exposure to sperm of the same partner before conception
- Damage to blood vessels
- Immune system problems
Preeclampsia risk factors
There are a number of factors that increase your risk of preeclampsia happening during pregnancy.
The risk factors for preeclampsia include:
- First pregnancy
- Family history (your mother or sister had it)
- Long interval between pregnancies (at least 10 years)
- Previous pregnancy with preeclampsia (there is a 20% chance of developing it again)
- Your age (teens and women over 40 years of age are more likely to develop preeclampsia)
- Preexisting medical conditions, such as kidney disease, hypertension, migraines, and diabetes
- Being obese before pregnancy (a body mass index of 30 or more)
- Pregnancy with twins.
Being at risk for preeclampsia can be stressful and worrying. It could mean many weeks of feeling concerned about your baby’s wellbeing.
Having it appear late in pregnancy can be a shock. You are likely to have your baby sooner, and without waiting for labor to begin on its own.
All these factors can have a huge impact on your emotions. You might need to seek the support of your partner, family, and friends to cope with this complication.
Preeclampsia with severe features
Today, severe preeclampsia complications are rare, because care providers can identify women at risk for preeclampsia and recognize the signs early on.
If the condition is not treated, it can result in severe life-threatening complications, such as:
- Convulsions/seizures (eclampsia)
- Stroke (cerebral hemorrhage)
- Fluid in the lungs due to heart failure (pulmonary edema)
- Kidney disease or failure
- Elevated liver enzymes and liver damage, and blood clotting disorder (HELLP syndrome)
Preeclampsia and eclampsia
In rare situations, preeclampsia can lead to seizures, a condition called eclampsia. Eclampsia can be life-threatening for both a mother and her baby.
Before seizures occur, these signs and symptoms of preeclampsia might be present:
- Severe or persistent headache
- Vision changes, including blurred vision, seeing spots, or sensitivity to light
- Mental confusion
- Intense upper abdominal pain
Can a baby survive preeclampsia?
Preeclampsia is one of the leading causes of premature birth.
Your baby receives nourishment and oxygen from you via the placenta. If your pregnancy is complicated by preeclampsia, it can prevent enough blood from reaching the placenta and your baby.
This is called placental insufficiency and means your baby won’t receive optimal nourishment and oxygen, affecting his growth and development (growth restriction).
The condition also increases the risk of placental abruption, which means the placenta suddenly separates from the uterus. This is a medical emergency. Your baby needs to be born urgently if placental abruption occurs.
Premature birth brings complications and risks as well.
You can find out more in Premature Babies – What To Expect Week By Week.
Currently, the most effective treatment for preeclampsia is to give birth to your baby.
If you’re not close to early full term (37 weeks), your healthcare provider or doctor might recommend extra prenatal care and management of your symptoms in the hospital. This will give your baby extra time to develop.
This management might include:
- Frequent monitoring of your baby
- Medication, to lower your blood pressure
- Blood and urine tests, to check for liver enzymes and low platelet count
- Corticosteroids, to promote the development of your baby’s lungs, as well as to improve your liver function and blood clotting function
- Drugs to prevent seizures (magnesium sulfate)
- Minimal intravenous fluid; a fluid overload will cause complications.
If preeclampsia occurs early in the second half of pregnancy and is severe, treating it becomes a balancing act.
Although prolonging pregnancy is ideal for the baby, it can mean a greater risk for the mother.
If you have severe preeclampsia, your doctor might recommend you stay in the hospital, so you and your baby can be carefully monitored, to prevent serious complications.
Some symptoms of preeclampsia can be temporarily relieved by treatments, but the condition is progressive, and it won’t just go away.
If you’re close enough to early full term, or if the condition progresses rapidly and treatment isn’t an option, you’ll need to give birth to your baby, regardless of gestational age.
Can you prevent preeclampsia?
Currently, there is no way to prevent preeclampsia from developing. It can be caught early, however, in order to minimize its impact.
If you are at a higher risk of preeclampsia, your doctor or health care provider will recommend you attend regular prenatal care appointments, where you will be assessed for warning signs.
This involves having your blood pressure checked regularly, and your urine tested for protein. Small amounts of protein in urine can be normal, but anything more than a trace should be investigated.
If preeclampsia does develop, regular prenatal care will at least make sure it is diagnosed as early as possible in pregnancy.
Some care providers recommend women who are identified as high risk take low-dose aspirin early on in their pregnancy.
Preeclampsia early screening
In the past, there was no way to screen for preeclampsia. Now, however, you can be screened at the first-trimester scan, to determine whether you’re at high risk of developing the condition.
The screening will detect about 90% of women who will develop preeclampsia.
Check with your healthcare provider about having this screening, especially if you’re in the high-risk group.
As part of the screening:
- Blood is collected between 11-13+6 weeks of pregnancy. to measure pregnancy-associated placenta protein-A (PAPP-A) and placental growth factor (PIGF) in maternal blood.
- An ultrasound scan measures the placental blood flow.
These results are combined with maternal blood pressure and information about family history, to provide a result.
Your doctor may prescribe low-dose aspirin or other medication to reduce your risk of developing the condition.
Can you survive preeclampsia?
Advanced medical screening, diagnosis, and care means preeclampsia and eclampsia rarely result in maternal death.
Being able to recognize the symptoms early has reduced the chances of preeclampsia being life-threatening. Mild preeclampsia is often managed, to ensure your baby has extra time to develop.
If there is no treatment, however, preeclampsia can lead to the death of both the woman and her baby.
If preeclampsia is left unchecked, other organs in the body are affected and this can also lead to HELLP Syndrome.
Read HELLP Syndrome During Pregnancy for more information.
Does bed rest help preeclampsia?
Although bed rest has been recommended in women with preeclampsia, little evidence supports its benefit.
In fact, prolonged rest during pregnancy increases the risk of blood clots developing in the body (thromboembolism or DVT); this is due to lack of mobility.
Women with conditions related to high blood pressure might be put on bed rest to lower stress and blood pressure.
In this situation, you would be carefully monitored by your doctor, in order to minimize harm.
Does stress cause preeclampsia?
There’s no evidence to show chronic stress directly causes preeclampsia.
However, ongoing, long-term stress can elevate your blood pressure, and this can increase the risk of preeclampsia being worse if you develop it.
Ideally, if you are prone to stress or have a stressful event occur, look for ways to lower your blood pressure naturally.
Read Stress During Pregnancy | How Does Stress Affect Pregnancy? for some great tips.
Can drinking lots of water prevent preeclampsia?
If you’re at risk of developing preeclampsia, you can take steps to keep your blood pressure at a normal level.
Drinking plenty of fluids is one of those ways. There has been some research that shows dehydration is linked to high blood pressure disorders.
During pregnancy, your need for fluid increases even more, as your blood volume goes up by 50%.
Find out more in Electrolytes During Pregnancy – 9 Important Reasons To Have Them.
Preeclampsia after birth
Although rare, preeclampsia can occur after birth. Statistics differ but it’s estimated between 4% and 6% of women with preeclampsia are diagnosed with the disorder during the postpartum period.
If preeclampsia develops after birth, it’s usually within 48 hours. It can also develop up to 6 weeks or more after birth.
The symptoms of postpartum preeclampsia are the same as those occurring during pregnancy, such as severe headaches, swelling, blurred vision, and high blood pressure.
In postpartum preeclampsia, the risk of complications can be more serious. They can also develop much more rapidly and require immediate treatment.
Can you have another baby if you had preeclampsia?
If you developed preeclampsia in a previous pregnancy, the chances of it happening again in the future are about 20%.
Research has shown certain factors will make your risk higher, such as having early-onset preeclampsia and having it in a severe form.
Although it’s impossible to eliminate the risk factors linked to recurrent preeclampsia, you can work with your healthcare provider to reduce the risk.
An Australian study has shown Metformin, a drug used to treat diabetes, could prevent or treat preeclampsia.
Other research indicates low-dose aspirin might be effective in preventing preeclampsia in women with a history of the condition.