May 13, 2014 in Features, Health

Signs of preeclampsia should raise red flags

Dr. Alisa Hideg
 

Pregnancy causes many changes in women’s bodies. These changes are usually entirely normal, but some can cause life-threatening complications. One of these potentially dangerous conditions is a blood pressure problem called preeclampsia, which happens in 5 to 8 percent of all pregnancies.

Preeclampsia can become eclampsia, also called toxemia, with seizures, excessive bleeding, fluid in the lungs, kidney failure and liver failure. Preventing eclampsia requires being aware of and treating preeclampsia. May is Preeclampsia Awareness Month. If everyone knows the signs and symptoms of this life-threatening condition, it could save the life of a woman and/or her baby.

A pregnant woman is diagnosed with preeclampsia if she has a new onset of high blood pressure after the 20th week of pregnancy. Initially, many women with preeclampsia have few symptoms. Swelling in the feet is common during late pregnancy, but in preeclampsia it may come on quickly, be severe and develop into swelling of the hands and face. Persistent headache, blurry vision, light sensitivity, abdominal pain and nausea are also possible symptoms of preeclampsia. Blood pressure may go up before these symptoms start or not until after they begin, so any pregnant woman with these symptoms should report them immediately to her health care provider and get her blood pressure checked.

It is not yet known why some women develop preeclampsia, but a woman who has had it in one pregnancy is more likely to have it in later pregnancies. Obesity, diabetes, being younger than 20 or older than 40, history of autoimmune disease, chronically high blood pressure and other conditions also increase the risk. Low-dose aspirin after the first trimester in subsequent pregnancies and exercise have been evaluated for reducing the risk of preeclampsia, but you should always discuss what is best for you with your health care provider before taking any action. The most important thing a pregnant woman can do is to start prenatal care as soon as she knows she is pregnant and continue during the entire pregnancy.

Preeclampsia can only be cured by delivering the baby. If it is too early in pregnancy (before 37 weeks), there are risks for the baby from early delivery. Medications to prevent eclampsia or to help the baby’s lungs mature faster may be recommended to further your baby’s development. These include blood pressure medication, corticosteroids, and anti-convulsive medications. When preeclampsia is too advanced or the baby is not doing well, immediate delivery becomes necessary no matter how far along the pregnancy is. In such cases, labor is induced. Sometimes, a cesarean section may be recommended.

Regardless of how and when the baby is delivered, the mother’s blood pressure usually returns to normal within a few days to a few weeks. Medication after delivery becomes necessary if blood pressure remains too high.

If you have had a pregnancy with preeclampsia, make sure all your health care providers know about it. Preeclampsia increases your lifelong risk of cardiovascular disease including stroke, hypertension and heart attack.

Learning as much as possible about a condition can be helpful and even comforting for some people, but for others it is a source of even more worry. At the very least, make sure you talk to your health care provider and fully understand what your limitations are, what recommendations you should follow and what monitoring is needed. You can get support at the Preeclampsia Foundation’s community forum at www.preeclampsia.org/get-support.

If you are pregnant and have symptoms of preeclampsia or if you notice them in someone who is pregnant, speak up immediately. Doing so could save two lives.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section.


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