Patient education: Preeclampsia (The Basics)

What is preeclampsia? — Preeclampsia is a dangerous condition that some people get when they are pregnant. It usually happens during the second half of pregnancy (after 20 weeks). It can also happen during labor or soon after the baby is born.

People with preeclampsia have high blood pressure. They might also have too much protein in their urine, or problems with organs like the liver, kidneys, brain, eyes, or placenta. (The placenta is the organ that brings the baby nutrients and oxygen and carries away waste.) Plus, the baby might not grow well and be smaller than normal.

What are the symptoms of preeclampsia? — Most people with preeclampsia do not feel any different than usual. Preeclampsia usually does not cause symptoms unless it is severe. Signs and symptoms of severe preeclampsia include:

●A bad headache

●Changes in vision, like blurry vision, flashes of light, or spots

●Belly pain, especially in the upper belly

If you have any of these symptoms, tell your doctor or nurse. You might not have preeclampsia, because these symptoms can also happen in normal pregnancies. But it's important that your doctor knows about them.

How might preeclampsia affect my baby? — Preeclampsia can:

●Slow the growth of the baby

●Decrease the amount of amniotic fluid around the baby (this is the liquid that surrounds and protects the baby in the uterus) (figure 1)

Is there a test for preeclampsia? — Yes. To test for preeclampsia, your doctor or nurse will:

●Take your blood pressure

●Check your urine for protein during pregnancy

They might also do blood tests to make sure your organs are working as they should.

When your doctor or nurse tells you your blood pressure, they will say 2 numbers. For instance, your doctor or nurse might say that your blood pressure is "140 over 90." To be diagnosed with preeclampsia, your top number must be 140 or higher, or your bottom number must be 90 or higher. Plus, you must have too much protein in your urine or certain problems with 1 or more of your organs.

It is possible to have high blood pressure (above 140/90) during pregnancy without having high protein in the urine or other problems. That is not preeclampsia. Still, if you develop high blood pressure, your doctor will watch you closely. You could develop preeclampsia or other problems related to high blood pressure.

How is preeclampsia treated? — For preeclampsia that develops during pregnancy, the only cure is to deliver the baby. Your doctor or nurse will talk with you about whether it is better for you to have your baby right away, or to wait. The best decision will depend on how severe your preeclampsia is and how many weeks pregnant you are. While delivering the baby will cure your preeclampsia, it's also important to give the baby as much time as possible to grow and develop.

If your preeclampsia is not severe:

●If you are less than 34 weeks pregnant, your doctor will probably suggest waiting.

●If you are between 34 and 37 weeks pregnant, your doctor will talk to you about your options and help you decide what to do.

●If you are more than 37 weeks pregnant, your doctor will probably suggest delivering your baby.

If the decision is to wait, the doctor will check you and your baby often for any problems. You might need to stay in the hospital until it is time to give birth.

When it is time to deliver your baby, you will probably get medicine to start contractions. This is called "inducing labor." Most people are able to have a vaginal birth. But in some cases the doctor will need to do a c-section. A c-section, or "cesarean birth," is surgery used to get the baby out of the uterus.

If your preeclampsia is severe, you will probably need to deliver your baby as soon as possible. You will also get medicine to lower your blood pressure, if it is very high. This is to keep you from having a stroke.

Rarely, people with preeclampsia have seizures. Your doctor or nurse might give you medicine during labor to prevent this.

What can I do to prevent preeclampsia? — You can't do anything to keep from getting preeclampsia. The most important thing you can do is to keep all the appointments you have with your doctor, nurse, or midwife. That way, they can find out as soon as possible if your blood pressure goes up, or if you have too much protein in your urine or any other problems.

If you are at high risk for preeclampsia, your doctor might tell you to take low-dose aspirin during your second and third trimesters of pregnancy (after 12 weeks). You are at high risk if you have had preeclampsia before and your baby was born early, if you are pregnant with twins, or if you have high blood pressure even when you are not pregnant. Your doctor can tell you if you are at high risk.

Do not take aspirin or other medicines unless your doctor or nurse tells you that it's safe.

Can preeclampsia cause other health problems? — If you had preeclampsia, you have a higher chance of getting high blood pressure and heart disease later in life. You should tell your primary care doctor or nurse that you had preeclampsia. They can talk to you about things that you can do to lower your chance of getting these health problems in the future. This might include not smoking, eating healthy foods, keeping a healthy weight, and being active.

When should I call the doctor? — Call your doctor or nurse right away if you have any symptoms of severe preeclampsia, like:

●A bad headache

●Changes in vision

●Belly pain

●New shortness of breath

You should also call if you are pregnant and:

●Have any bleeding from the vagina

●Notice your baby moving less than usual

●Think that you might be in labor

More on this topic

Patient education: Swelling (The Basics)
Patient education: High blood pressure and pregnancy (The Basics)
Patient education: HELLP syndrome (The Basics)
Patient education: High blood pressure in adults (The Basics)
Patient education: C-section (cesarean birth) (The Basics)

Patient education: Preeclampsia (Beyond the Basics)
Patient education: High blood pressure in adults (The Basics)
Patient education: High blood pressure treatment in adults (Beyond the Basics)
Patient education: Edema (swelling) (Beyond the Basics)