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High Blood Pressure in Pregnancy (Preeclampsia)

What is preeclampsia?

Preeclampsia is a special condition of high blood pressure in pregnancy. About 6 to 8% of pregnant women have preeclampsia, and it happens after the 20th week of pregnancy. Blood pressure goes up, and there is more than the usual amount of protein in your urine. Preeclampsia sometimes affects the functioning of many parts of the body.

Preeclampsia can be mild or severe. If you have severe preeclampsia, it might affect your blood cells, kidneys, liver, brain, and other organs. It can cause serious problems for you and the baby. Sometimes, but very rarely, it causes death for the mother or baby.

This condition has other names, such as toxemia, gestational hypertensive disease, and pregnancy-induced hypertension (PIH). If the high blood pressure causes seizures, the disease is called eclampsia.

What is the cause?

The cause of preeclampsia is not known. There are probably several different ways it can happen. However, doctors think that it has something to do with the placenta in most cases. You have a higher risk of preeclampsia if:

  • It is your first pregnancy.
  • You are less than 25 years old.
  • You are over 35 years old.
  • You had problems with high blood pressure before you were pregnant.
  • You have kidney disease or diabetes.
  • You are pregnant with more than 1 baby.
  • You have had preeclampsia in a previous pregnancy.
  • Your mother or a sister has had preeclampsia.

What are the symptoms?

If you have mild preeclampsia, you may not have any symptoms and may feel perfectly well. You should go to all prenatal checkups so your healthcare provider will be able to spot the condition quickly. Your provider will measure your blood pressure and check for protein in the urine.

A common symptom of mild preeclampsia is more than normal puffiness or swelling of the hands, feet, or face (also called edema).

Other symptoms that may be a sign of more severe preeclampsia include:

  • Sudden weight gain (3 to 5 pounds within 5 to 7 days)
  • Changes or problems with your vision
  • Severe headaches
  • Dizziness
  • Intense stomach pain
  • Nausea and vomiting
  • Urinating very little or infrequently
  • Shortness of breath
  • Bruising more easily
  • Getting tired more easily
  • Seizures

If you have any of these symptoms during the second half of pregnancy, call your healthcare provider right away. Seizures can be life-threatening. If you have a seizure, someone will need to call 911 so you can go to the hospital as quickly as possible by ambulance.

How is it diagnosed?

Your healthcare provider will measure your blood pressure and test your urine at each prenatal checkup. Blood tests can confirm the diagnosis and check for how it is affecting your body.

How is it treated?

Treatment depends on how close you are to your due date. Delivery of the placenta and baby, when possible, is the best treatment. If your due date is near and your baby has developed enough, your healthcare provider may decide to start your labor early and deliver the baby before the due date. Or, instead of starting labor, you may have surgery (a C-section) to deliver the baby.

If your baby has not developed enough and the preeclampsia is not too severe, your healthcare provider may consider waiting to deliver the baby. In this situation, many women need to stay in the hospital with very close monitoring. In some very special situations, your provider may allow you to be at home while you wait for the best time for delivery. If this happens, you may need to:

  • Rest in bed, lying on your left side as much as possible to take the weight of the baby off your major blood vessels
  • Check your blood pressure at home with a home blood pressure monitoring device that is easy to use
  • See your healthcare provider for additional, frequent checkups, which may include more frequent ultrasound scans and other tests of the baby's health
  • Take medicines to reduce the complications of preeclampsia
  • Have frequent blood and urine tests

Once your healthcare provider decides to deliver the baby, a medicine called magnesium sulfate will probably be given to you to prevent the seizures that are a very serious complication of preeclampsia.

How long will the effects last?

For most women all of the symptoms of preeclampsia go away within 7 days after delivery. There are a few women who will keep having related problems for several weeks.

How can I help prevent high blood pressure and preeclampsia during pregnancy?

Currently, there is no sure way to prevent preeclampsia. Many factors may contribute to the development of high blood pressure during pregnancy. Some can be controlled and some cannot. Follow your healthcare provider's instructions for diet and exercise. Practice the following good health habits:

  • Eat healthy.
  • Use little or no added salt in your meals.
  • Don't eat a lot of fried foods and junk food.
  • Get enough rest.
  • Exercise according to your provider's recommendations.
  • Put your feet up several times during the day.
  • Avoid drinking alcohol and beverages containing caffeine.
  • Don’t gain too much weight.

If you have a high risk for preeclampsia, your provider may recommend that you take low doses of aspirin or calcium every day.

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