Preeclampsia: What You Need to Know About this Serious Pregnancy Complication

You’ve made it through the first trimester, mama, and hopefully the morning sickness is easing and you’re getting more comfortable with your ever-increasing bump. As you make your way into your second trimester, your pregnancy care provider may share information with you about a serious pregnancy condition called preeclampsia.

Preeclampsia can develop as early as 20 weeks of pregnancy to as late as six weeks after giving birth. It’s rare—developing in about 4% of all pregnancies in the U.S, but it’s the second most common cause of maternal death worldwide.

Left untreated, preeclampsia can lead to eclampsia, a deadly condition in which a pregnant person can experience seizures and stroke.

Also, if you experience preeclampsia in pregnancy, you’re at greater risk for another pregnancy complication, HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Talk with your pregnancy care provider and learn all that you can about preeclampsia because it can also occur without symptoms.

Risk

The exact cause of preeclampsia is unknown. However, there are health-related causes that can make the condition more likely for someone to develop preeclampsia. This may include the following risk factors:

High Risk Factors

• Preeclampsia in a previous pregnancy
• Pregnant with multiple babies (such as twins)
• History of high blood pressure, diabetes, kidney disease, auto-immune disorder (such as  lupus)

Moderate Risk Factors

• First time being pregnant or more than 10 years since last pregnancy
• Body mass index of more than 30
• Family history of preeclampsia (mother or sister)
• African American/Black ancestry due to racism and inequalities in access to adequate prenatal care that increase poor outcomes
• Lower income due to inequities that increase the risk of illness
• Age 35 or older
• Undergoing in vitro fertilization

Screening

The United States Preventive Services Task Force (USPSTF) recommends that all pregnant people be screened for preeclampsia with blood pressure measurements at each prenatal visit throughout pregnancy. Ask what your blood pressure numbers are so that you can compare your reading to what’s considered normal at 120/80. If your blood pressure measures higher than the normal range, ask your pregnancy provider to check it again in your other arm.

Signs and Symptoms

Preeclampsia is diagnosed when you have high blood pressure and at least one of these additional symptoms:

• Vision changes such as blurriness, flashing lights, or sensitivity to light
• Headache that doesn’t go away, even after taking medication
• Difficulty breathing like you’re gasping for air
• Nausea, vomiting, or dizziness
• Swelling in your face, hands, legs, and/or feet
• Pain in your upper right stomach or your shoulder
• Sudden weight gain within 1-2 days

Prevention

Your pregnancy care provider may recommend the use of low-dose aspirin after 12 weeks of gestation if you are at higher risk for preeclampsia. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine consider this treatment safe. Lifestyle changes that can help are to stop smoking and exercise regularly. Make shared decisions with your provider if your weight, blood pressure, or blood sugar are concerns.

Preeclampsia can lead to serious complications. It’s important to be familiar with the symptoms and your risk factors so you are empowered to act if you believe you are experiencing preeclampsia.

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AUTHOR

Shawana S. Moore, DNP, APRN, WHNP-BC, PNAP, FAAN