Causes, Incidence & Risk Factors
Preeclampsia is a pregnancy condition in which high blood pressure and protein in the urine develop after the 20th week (late 2nd or 3rd trimester) of pregnancy.
The exact cause of preeclampsia is not known. Possible causes include:
- Autoimmune disorders
- Blood vessel problems
Preeclampsia occurs in a small percentage of pregnancies. Risk factors include:
- First pregnancy
- Multiple pregnancy (twins or more)
- Older than age 35
- Past history of diabetes, high blood pressure or kidney disease
Often, women who are diagnosed with preeclampsia do not feel sick. Symptoms of preeclampsia can include:
- Swelling of the hands and face/eyes
- Weight gain
- More than 2 pounds per week
- Sudden weight gain over one - two days
Note: Some swelling of the feet and ankles is considered normal with pregnancy.
Symptoms of more severe preeclampsia:
- Headaches that are dull or throbbing and will not go away
- Abdominal pain, mostly felt on the right side, underneath the ribs. Pain may also be felt in the right shoulder, and can be confused with heartburn, gallbladder pain, a stomach virus or the baby kicking
- Decreased urine output, not urinating very often
- Nausea and vomiting
- Vision changes -- temporary loss of vision, sensations of flashing lights, auras, light sensitivity, spots and blurry vision
Signs and tests
The doctor will perform a physical exam and order laboratory tests. Signs of preclampsia include:
- High blood pressure, usually higher than 140/90 mm/Hg
- Protein in the urine
- Blood and urine tests will be done. Abnormal results include:
- Protein in the urine (proteinuria)
- Higher-than-normal liver enzymes
- Platelet count less than 100,000 (thrombocytopenia)
Your doctor will also order tests to see how well your blood clots, and to monitor the health of the baby and to determine whether your baby needs to be delivered immediately.
The only way to cure preeclampsia is to deliver the baby. St. Vincent’s staff is trained to deliver babies due to preeclampsia in the Family Birthing Center. St. Vincent’s Special Care Nursery can care for babies born after 30 weeks gestation.
If your baby is developed enough (usually 37 weeks or later), your doctor may want your baby to be delivered so the preeclampsia does not get worse. You may receive different treatments to help trigger labor, or you may need a c-section.
If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has a good chance of surviving after delivery. The doctor will probably recommend the following:
- Getting bed rest at home, lying on your left side most or all of the time
- Drinking extra glasses of water a day and eating less salt
- Following-up with your doctor more often to make sure you and your baby are doing well
- Taking medicines to lower your blood pressure (in some cases)
You and your doctor will continue to discuss the safest time to deliver your baby, considering:
- How close you are to your due date. The further along you are in the pregnancy before you deliver, the better it is for your baby.
- The severity of the preeclampsia. Preeclampsia has many severe complications that can harm the mother.
- How well the baby is doing in the womb.
- The baby must be delivered if you have signs of severe preeclampsia, which include:
- Tests (ultrasound, biophysical profile) that show your baby is not growing well or is not getting enough blood and oxygen
- The bottom number of the mother's blood pressure is confirmed to be over 110 mmHg or is greater than 100 mmHg consistently over a 24-hour period
- Abnormal liver function tests
- Severe headaches
- Pain in the belly area (abdomen)
- Eclampsia - seizures in a pregnant woman that are not related to a preexisting brain condition
- Fluid in the mother's lungs
- Low platelet count
- Decline in kidney function
For more information on preeclampsia, please consult your physician.
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