Preeclampsia is a condition unique to pregnancy that complicates up to 8 percent of all deliveries worldwide. It is characterized by high blood pressure (hypertension) and high levels of protein in the urine (proteinuria) in the mother. Preeclampsia typically occurs in first time mothers and in the later part of pregnancy (after 20 weeks gestation). It can also affect other organs in the body and can be dangerous for both the mother and her baby. Because of these risks, preeclampsia needs to be treated by a healthcare provider.
Risks of preeclampsia can include:
HELLP syndrome is a severe form of preeclampsia that develops in 4 to 12 percent of cases. The name stands for:
HELLP syndrome can be present without many of the typical signs of preeclampsia, including high blood pressure (hypertension) and proteinuria (protein in the urine), and in some cases the diagnosis can be missed or delayed.
Common symptoms of HELLP syndrome can include:
Diagnosis is usually made with blood tests. Delivery is generally necessary in order to treat HELLP syndrome and for the abnormalities to correct themselves. Complications associated with HELLP syndrome include rupture of the liver, massive bleeding, stroke and seizures.
Eclampsia is a life-threatening complication that develops in approximately 1 percent of women with preeclampsia and results in seizures or coma. Warning signs to watch for can include:
These patients often will have overactive reflexes. Treatment is based on preventing further seizure activity and generally involves use of magnesium sulfate given intravenously (directly into the vein) for at least 24 to 48 hours. High blood pressure must be treated aggressively in these patients. Generally, once the mother’s condition has been stabilized the baby is delivered. If the baby is extremely premature (less than 32 weeks), delivery may be delayed for 24 to 48 hours so that steroids may be given to the mother. These steroids help the baby’s lungs mature and prevent other complications related to premature birth. In some cases, eclampsia can occur following a seemingly normal delivery, even after the patient has gone home from the hospital.
Preeclampsia is thought to arise from a problem with the health of the placenta (the organ that develops in the uterus during pregnancy and is responsible for providing oxygen and nutrients to the baby). It is thought that the blood supply to the placenta is decreased in preeclampsia, and this can lead to problems with both the mother and baby.
A woman is more likely to develop preeclampsia if she:
Symptoms patients with preeclampsia may have include:
Preeclampsia is often diagnosed during routine prenatal appointments, when your healthcare provider checks your weight gain, blood pressure and urine protein. If preeclampsia is suspected, additional blood tests may be ordered. In some cases, blood pressure readings will be observed in the hospital and a 24-hour urine collection is performed to check for proteinuria (protein in the urine). An ultrasound and fetal monitoring may also be used to provide more information about the baby.
Your healthcare provider will advise you on the best way to treat preeclampsia. Preeclampsia can only be cured with delivery. If the patient is at term (37 weeks gestational age or greater), the baby will be delivered. If preeclampsia develops earlier in pregnancy, the patient can be monitored closely in the hospital in an effort to prolong the pregnancy and allow for the baby to grow and develop. If the preeclampsia worsens or becomes more severe, the baby will be delivered. Women with preeclampsia can have a vaginal delivery through induction of labor—which is more likely to be successful if the patient is closer to term—or planned cesarean section. During labor and following delivery, women with preeclampsia are often given magnesium intravenously (directly into the vein) to prevent development of eclampsia.
For patients with risk factors, there are some steps that can be taken prior to and during pregnancy to lower their chances of developing preeclampsia. These steps can include:
Preeclampsia typically goes away after the baby is delivered. Sometimes, 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. Patients with preeclampsia, particularly those who develop the condition early in pregnancy, are at greater risk for high blood pressure (hypertension) and heart disease later in life. Knowing this information, those patients can work with their primary care provider to take steps to reduce these risks.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 09/11/2018