In my practice as an obstetrician-gynecologist at Temple Health, I’m often asked how to ensure a healthy pregnancy. One of my key pieces of advice: Keep up with prenatal appointments. They’re a chance to learn more about how your baby is developing and to address concerns and questions as they arise. They also give your provider the best chance of detecting — and treating — any problems that develop.
A case in point: preeclampsia, which is high blood pressure during pregnancy. Preeclampsia affects up to 15% of all pregnancies. Preeclampsia doesn’t always cause symptoms, but it can be detected during routine prenatal checkups, and early detection can help prevent serious, even life-threatening, complications.
What is preeclampsia?
The causes of preeclampsia are still being studied, but it seems to start in the placenta, which nourishes the baby during pregnancy. Problems with the blood vessels that supply the placenta may cause the pregnant person’s blood pressure to rise.
Preeclampsia sometimes leads to other complications, such as kidney, liver, and other organ damage; stroke; or eclampsia, which can result in seizures or coma. People who have preeclampsia may also be at increased risk for heart disease and other health problems after the baby is born.
Preeclampsia also can prevent the fetus from receiving enough oxygen-rich blood and nutrients, increasing the risk of slow infant growth, preterm birth, and other problems.
It’s important to talk with your pregnancy care provider about your risk for preeclampsia. Although any pregnant person can get preeclampsia, you may be at high risk if, for instance, you:
- Had it in a previous pregnancy
- Had high blood pressure before you became pregnant
- Have diabetes, kidney disease, or an autoimmune disease, like lupus
- Are pregnant with twins or more
Factors that may moderately raise your risk for preeclampsia include:
- Being pregnant for the first time or 10 years after your last pregnancy
- Having a body mass index over 30
- Having a family history of preeclampsia
- Using in vitro fertilization to get pregnant
- Being 35 or older
Preeclampsia is also more common among Black people and people with lower incomes, possibly due to inequities that increase the risk of illness.
Recognizing preeclampsia
Preeclampsia typically starts with a sudden spike in a pregnant person’s blood pressure, usually after the 20th week of pregnancy.
If a pregnant patient’s blood pressure is high, I typically test for additional indicators of preeclampsia, such as:
- Elevated protein in the urine. A high level of protein (proteinuria) can be a sign that preeclampsia is affecting kidney function, causing protein to spill into the urine.
- Higher-than-normal liver enzymes. We may test for elevated liver enzymes, a potential sign of a preeclampsia-related problem with the liver.
- Low platelets. A lower than normal number of platelets can be seen in patients with preeclampsia.
You can have preeclampsia and not know it. But when signs and symptoms of preeclampsia do occur, they may include:
- Severe headache that isn’t relieved by over-the-counter medicine
- Vision changes, such as blurry vision, light sensitivity, or seeing spots
- Shortness of breath
- Abdominal pain, usually under the ribs, on the right side
- Nausea or vomiting in the second half of pregnancy
- Swelling of the hands and face which, unlike normal pregnancy weight gain, comes on suddenly
If you’re pregnant and experiencing any of these warning signs, let your provider know right away. Preeclampsia can quickly become an emergency.
Treating preeclampsia
If you have preeclampsia, your provider will develop a plan for treating the condition and monitoring your health and the health of your baby.
Your provider may recommend inducing labor and delivering the baby earlier than full-term. If that happens, we’ll schedule a day for you to come to the hospital. We’ll then give you a medication that makes labor start.
Decisions about when to deliver the baby depend on how severe the preeclampsia is and how far along the pregnancy is.
Scheduling an early delivery usually resolves preeclampsia. But if the baby is less than 37 weeks and your preeclampsia is mild, we may consider other treatment options that allow the baby more time to develop. These other options may include:
- Reduction in strenuous activities, which may help lower blood pressure and boost blood flow to the placenta.
- Close monitoring of the pregnant person and their fetus. We want to make sure preeclampsia isn’t progressing to eclampsia. Monitoring includes frequent blood pressure and urine tests for the patient and ultrasound and heart rate monitoring for the fetus.
- Giving medications, such as magnesium sulfate, to help prevent seizures.
Some patients may develop preeclampsia or its more severe form, eclampsia, after their babies are born. For this reason, we tend to keep a close eye on people who’ve had high blood pressure or preeclampsia for at least 72 hours after delivery.
Remember, preeclampsia can become severe quickly. It’s important to ask your prenatal care provider about it, especially if you’re at higher risk. My patients sometimes tell me that it can be hard to know if they’re dealing with normal pregnancy discomforts or the signs and symptoms of preeclampsia or other pregnancy problems. I encourage everyone to reach out to their provider with any concerns or questions they have.
And you should seek immediate medical help if you think you have any of the warning signs.
When you need high-risk pregnancy care
The specialists at Temple Health are experts at diagnosing and treating a variety of conditions that can increase the risk of health problems during pregnancy. Request an appointment online or call 800-TEMPLE-MED (800-836-7536).
Helpful Resources
Looking for more information?