Medical City Healthcare - September 04, 2018

Preeclampsia is a serious medical condition that affects 4% of all pregnancies in the U.S., according to the CDC. That may not sound like a huge number until you realize it means 1 out of 25 pregnancies. And pregnancy complications related to high blood pressure are on the rise — up from 5.3% of delivery hospitalizations in 1993 to 9.1% in 2014.

Preeclampsia, or toxemia as it was formerly called, occurs when a pregnant woman experiences high blood pressure (hypertension) during the second half of her pregnancy, including during delivery and after giving birth. It's what 36-year-old superstar Beyoncé suffered from while she was pregnant with her twins, revealing in the September issue of Vogue that she was “swollen from toxemia” and had an emergency C-section because her health and her babies' health were in danger.

Preeclampsia symptoms.

Some symptoms of preeclampsia can be noticed by pregnant women, while others can only be detected through a medical exam or testing.

Noticeable preeclampsia symptoms can include:

  • Rapid swelling and puffiness, especially in the hands and face, that doesn't diminish
  • Headaches that won't go away or are accompanied by vision problems
  • Upper abdominal pain resembling bad heartburn that doesn't subside
  • New onset of high blood pressure (140/90 or higher) when taken twice at least 4 hours apart or blood pressure of 160/110 or higher in a woman with previously normal blood pressure*

*If you have an accurate, calibrated blood pressure monitor, know how to use it and monitor your blood pressure regularly.

Preeclampsia symptoms your OB-GYN will check at each prenatal visit:

  • Elevated blood pressure
  • Protein in the urine

Preeclampsia complications.

When preeclampsia occurs during pregnancy, it always resolves after delivery. Rarely, preeclampsia can occur after childbirth and is known as postpartum preeclampsia. The symptoms of postpartum preeclampsia are the same as those for preeclampsia. Postpartum preeclampsia is typically diagnosed within 48 hours after delivery but can occur up to 6 weeks later. That's why it's so important to plan for the fourth trimester of pregnancy, including scheduling postpartum check-ups with your OB-GYN.

Complications of preeclampsia can lead to:

  • Premature separation of the placenta
  • Stroke
  • Fluid in the lungs (pulmonary edema), causing difficulty breathing
  • Low blood platelet count
  • Abnormal kidney or liver function, resulting in sudden weight gain, edema or upper abdominal pain
  • And more rarely:
    • Seizures (eclampsia)
    • Abnormalities of the blood, or inability of the patient's blood to clot, which can lead to excessive bleeding.

Preeclampsia risk factors.

The exact causes of preeclampsia are still unknown. Risk factors include:

  • First pregnancies, especially young patients' first pregnancies and relatively older first pregnancies
  • Preeclampsia in a previous pregnancy can increase risk 20% to 40%
  • Pre-existing medical conditions, such as high blood pressure, diabetes, obesity, chronic kidney disease and lupus
  • Multiple births
  • Family history of preeclampsia.
  • African-American women and women who conceive via in-vitro fertilization are at slightly increased risk

How to prevent preeclampsia.

While there is no sure-fire way to prevent preeclampsia, there are things you can do to decrease your risks.

  • Schedule and keep all prenatal and postpartum doctor appointments
  • Manage chronic health conditions
  • Monitor your blood pressure regularly
  • Maintain a healthy weight, before and during pregnancy

Because preeclampsia is a common and dangerous condition, Medical City Healthcare's parent company, HCA Healthcare, pioneered the implementation of standardized protocols for the management of sudden and severe high blood pressure for pregnant women. These protocols are now used in hospitals worldwide to decrease the likelihood of complications from severe high blood pressure associated with the condition. In 2014, of 1.2 million deliveries within HCA hospitals nationwide, these protocols virtually eliminated severe high blood pressure as a cause of maternal death.

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Revised 5/14/2019