Preeclampsia

What is preeclampsia?

Preeclampsia is a serious blood pressure condition that develops during pregnancy. People with preeclampsia often have high blood pressure (hypertension) and high levels of protein in their urine (proteinuria). Preeclampsia usually develops after the 20th week of pregnancy.

Preeclampsia can also affect other organs in your body and cause kidney and liver damage, brain injury and other serious side effects. It’s dangerous for both you and the developing fetus. Because of these risks, your healthcare provider will need to monitor your pregnancy closely and recommend treatment right away.

How common is preeclampsia?

Preeclampsia is a condition unique to pregnancy that complicates between 5% and 8% of all births in the United States. It’s also the cause of about 15% of premature deliveries (delivery before 37 weeks of pregnancy) in the U.S.

Is preeclampsia an emergency?

Yes, it can be. When you have preeclampsia, your blood pressure is (higher than 140/90 mmHg), and you may have high levels of protein in your pee (a sign of kidney damage). Preeclampsia puts stress on your heart and other organs and can cause serious complications. It can also affect the blood supply to the placenta, damage your liver and kidneys or cause fluid to build up in your lungs. Getting treatment is critical to avoid life-threatening complications.

What are the symptoms of preeclampsia?

Many people with preeclampsia don’t have signs or symptoms until a visit with their healthcare provider. For those that do, some of the first signs of preeclampsia are high blood pressure, protein in your pee and retaining water (this can cause weight gain and swelling).

Other signs of preeclampsia include:

• Headaches.
• Blurry vision or light sensitivity.
• Dark spots appearing in your vision.
• Upper right side abdominal pain.
• Swelling in your hands, ankles and face (edema).
• Shortness of breath.

You often don’t know you have preeclampsia until your healthcare provider checks your blood pressure and urine (pee) at a prenatal appointment. It’s also important to share all of your pregnancy symptoms with your healthcare provider.

Severe preeclampsia may also include signs like:

• Hypertensive emergency (blood pressure is 160/110 mmHg or higher).
• Decrease in kidney or liver function.
• Fluid in your lungs (pulmonary edema).
• Low blood platelet levels (thrombocytopenia).
• Not producing or producing very little pee.

If your preeclampsia is severe, your healthcare provider may admit you to the hospital for closer observation. In some instances, you’ll need to deliver your baby right away.

What causes preeclampsia?

No one is entirely sure. Some researchers believe preeclampsia may happen due to a problem with blood supply to the placenta.

Does stress cause preeclampsia?

While stress may impact blood pressure, stress isn’t a direct cause of preeclampsia. While some stress is unavoidable during pregnancy, avoiding high-stress situations or learning to manage your stress is a good idea.

Who is at risk for preeclampsia?

Healthcare providers aren’t entirely sure why some people develop preeclampsia, but they know some factors can increase your risk of developing it. They classify your risk as high or moderate.

Factors that may put you at high risk for preeclampsia are:

• History of high blood pressure, kidney disease or diabetes.
• Expecting twins, triplets or more.
• Autoimmune conditions like lupus.
• Preeclampsia in a past pregnancy.

Factors that put you at moderate risk of preeclampsia are:

• Being pregnant for the first time.
• Having obesity.
• Being older than 35.
• Family history of preeclampsia.
• Complications in prior pregnancies like low birth weight.

What week of pregnancy does preeclampsia start?

Preeclampsia typically occurs after 20 weeks of pregnancy. Most preeclampsia occurs in the third trimester (after 27 weeks). When it develops before 34 weeks of pregnancy, it’s called early-onset preeclampsia.

Preeclampsia can also come after delivery (postpartum preeclampsia), which usually occurs between the first few days to one week after delivery.

What are the complications of preeclampsia?

If left untreated, preeclampsia can be potentially fatal to both you and the fetus. It can cause severe kidney and liver damage and interfere with your brain function. Some of the most serious complications to the pregnant person are:

• Seizures.
• Eclampsia.
• Coma.
• Stroke.

Preeclampsia can cause HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). This happens when preeclampsia damages your liver and red blood cells and interferes with blood clotting.

The most common complications to the fetus are:

• Premature birth.
• Low birth weight.
• Placental abruption.

People with preeclampsia — particularly those who develop the condition early in pregnancy — are at a greater risk for the following conditions later in life:

• Kidney disease.
• Heart disease.
• Stroke.
• Developing preeclampsia in future pregnancies.

You can work with your primary care provider to take steps to reduce these risks.

How is preeclampsia diagnosed?

Healthcare providers often diagnose preeclampsia during a routine prenatal appointment. Routine prenatal appointments occur at regular intervals during pregnancy. It’s where your healthcare provider checks things like your pregnancy weight gain and blood pressure.

If your provider suspects preeclampsia, they may:

• Order additional blood tests to check kidney and liver functions.
• Suggest a 24-hour urine collection to watch for proteinuria.
• Perform an ultrasound and other fetal monitoring to look at the size of the fetus and assess the amniotic fluid volume.

Preeclampsia can be mild or severe. Mild preeclampsia is when you have high blood pressure plus high levels of protein in your pee.

Severe preeclampsia is when you have signs of mild preeclampsia plus:

• Signs of kidney or liver damage (seen in blood work).
• Low platelet count
• Fluid in your lungs.
• Headaches and dizziness.
• Visual impairment or seeing spots.

How is preeclampsia treated?

Your healthcare provider will advise you on the best way to treat preeclampsia. Treatment generally depends on how severe your preeclampsia is and how far along you are in pregnancy. Your healthcare provider will want you to remain pregnant as long as possible — as long as preeclampsia isn’t putting your life in danger.

If you’re close to full term (37 weeks pregnant), your provider will probably recommend an early delivery. You can still have a vaginal delivery, but sometimes, a C-section is safer. Your healthcare provider may give you medication to help the fetus’s lungs develop and manage your blood pressure until they can deliver your baby. Sometimes, it’s safer to deliver the baby early than to risk prolonging the pregnancy.

When preeclampsia develops earlier in pregnancy, your provider will monitor you closely for the rest of your pregnancy. They’ll want to prolong pregnancy as long as possible to allow for the fetus to grow and develop. You’ll have more frequent prenatal appointments, including ultrasounds, urine tests and blood draws. You may have to check your blood pressure at home. If the preeclampsia worsens or becomes more severe, your provider will recommend delivery.

If you have severe preeclampsia at diagnosis, you could remain in the hospital for monitoring until you deliver your baby.

During labor and delivery, your provider may give you magnesium sulfate to prevent eclampsia (seizures from preeclampsia).

Is there a cure for preeclampsia?

No. The only cure for preeclampsia is delivery. Your healthcare provider will still want to monitor you for several weeks after delivery to make sure your symptoms go away.

How can I reduce my risk of getting preeclampsia?

If you have a risk factor for preeclampsia, there are some steps you can take before and during pregnancy to lower the chance of developing preeclampsia. These steps can include:

• Losing weight if you have obesity (prior to pregnancy-related weight gain).
• Managing your blood pressure and blood sugar (if you had high blood pressure or diabetes before pregnancy).
• Maintaining a regular exercise routine.
• Getting enough sleep.
• Eating healthy foods that are low in salt and avoiding caffeine.

Can you prevent preeclampsia?

Taking a baby aspirin daily may decrease your risk of developing preeclampsia by about 15%. If you have risk factors for preeclampsia, your healthcare provider may recommend starting aspirin in early pregnancy (around 12 weeks in pregnancy). Don’t start taking aspirin unless your provider tells you.

Can you deliver naturally with preeclampsia?

Yes, you can still have a vaginal delivery if you have preeclampsia.

Can a baby survive preeclampsia?

Yes. Preeclampsia can cause preterm delivery (your baby being born early). Premature babies are at an increased risk for health complications like low birth weight and breathing issues.

Does preeclampsia go away after delivery?

Preeclampsia typically goes away within days to weeks following delivery. Sometimes, your blood pressure can remain high for a few weeks after delivery, requiring treatment with medication. Your healthcare provider will work with you after your pregnancy to manage your blood pressure.

When should I see my healthcare provider?

Preeclampsia can be a fatal condition during pregnancy. If you’re getting treatment for this condition, make sure to see your healthcare provider for all of your appointments and blood or urine tests. Contact your obstetrician if you have any concerns or questions about your symptoms.

Go to the nearest hospital if you’re pregnant and experience the following:

• Symptoms of a seizure, like twitching or convulsing.
• Shortness of breath.
• Sharp pain in your abdomen (specifically the right side).
• Blurry vision.
• Severe headache that won’t go away.
• Dark spots in your vision that don’t go away.

What questions should I ask my doctor?

If your healthcare provider gives you a preeclampsia diagnosis, it’s normal to have concerns. Some common questions to ask your healthcare provider are:

• Do I need to take medication?
• Do I need to restrict my activities?
• What changes should I make to what I eat?
• How often will you need to monitor my health during pregnancy?
• Will I need to deliver my baby early?
• How can I best manage preeclampsia?

What are the three early signs of preeclampsia?

In most cases, your provider will recognize signs of preeclampsia during a prenatal appointment.

The early signs of preeclampsia usually include:

• High blood pressure.
• Protein in your pee.
• Retaining water or swelling.

What’s the difference between preeclampsia and eclampsia?

Eclampsia is severe preeclampsia that causes seizures. It’s considered a complication of preeclampsia, but it can happen without signs of preeclampsia.

What is postpartum preeclampsia?

Postpartum preeclampsia is when you develop preeclampsia after your baby is born. It typically happens within two days of giving birth but can also develop several weeks later.

A note from Cleveland Clinic

Preeclampsia is a serious condition that most people aren’t aware they have. That’s why it’s so important to go to all your prenatal appointments and be open with your provider about symptoms you feel during pregnancy.

After diagnosis, your healthcare provider will watch your pregnancy closely. In severe cases, they may recommend delivery as soon as possible. Their goal is to keep both you and the fetus safe and healthy. Most people with preeclampsia go on to have healthy babies. Preeclampsia almost always goes away within a few weeks after your baby is born.