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Pregnancy Complications

Hypertensive Disorders ~ PIH, Preeclampsia, Eclampsia, HELLP Syndrome

Preeclampsia Warning Signs

Preeclampsia is a complication of pregnancy characterized by high blood pressure, swelling (edema), and protein in your urine (proteinuria). It usually occurs in the second half of pregnancy and can be mild or severe.

During pregnancy, your blood volume increases. Normally the blood vessels in your body relax during this time to help accommodate the increased blood flow. When preeclampsia occurs, the blood vessels don't relax and blood pressure rises. Preeclampsia occurs in about 1 out of 10 pregnancies. Some women are at higher risk.

Increased Risk of Preeclampsia
  • Under 20 years old
  • Over 35 years old
  • Pregnant for the first time
  • Pregnant with twins or more
  • Chronic hypertension or diabetes
  • Family history of pre-eclampsia

Why Preeclampsia Is of Concern
The pregnant woman with pre-eclampsia can experience damage to her kidneys and liver. This damage usually repairs itself after the baby is delivered. Sometimes fluid can accumulate in the lungs of a pregnant woman with this disease. If pre-eclampsia is severe, blood clotting can be affected and there is a risk of internal bleeding.

Some women with preeclampsia will develop HELLP syndrome. HELLP stands for Hemolytic anemia (when red blood cells break down), Elevated Liver transaminases (a sign of liver damage), and Low Platelet count (this can mean difficulty with blood clotting). HELLP syndrome is a condition where the liver isn't functioning normally. It is a complication that occurs in a small group of women with preeclampsia or pregnancy complicated by hypertension. This condition can be mild or severe. When severe, it can be life threatening for both mother and baby.

Preeclampsia can decrease the flow of blood to the uterus. The placenta may not be able to supply enough nutrients and oxygen and the baby's growth may slow. Your provider may want to monitor your baby for signs of stress if you develop preeclampsia.

Signs of Preeclampsia
You could develop preeclampsia without experiencing any symptoms. This is one of the reason it is so important to keep all your prenatal visits. Your weight, blood pressure and urine are usually checked to screen for signs of pre-eclampsia. Some women do develop symptoms.

Warning Signs
  • Severe headache or blurred vision
  • Nausea or vomiting
  • Dizziness or double vision
  • Excessive swelling of the hands or feet
  • Decreased frequency of urination
  • Rapid pulse

If you experience symptoms, you should call your health care provider immediately. Preeclampsia is a serious problem, however, most women will deliver a healthy baby if it is detected early.

Treatment for Preeclampsia
The usual treatment for pre-eclampsia is delivery. If you are at less then thirty-seven weeks gestational age, your provider may delay delivery while carefully monitoring you and your baby. This conservative management is usually only possible if your blood pressure elevation is mild. Bedrest, medication, blood pressure monitoring or hospitalization may be necessary.

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Prevention of Preeclampsia
Preeclampsia is not always preventable for those at risk, however, steps can be taken to lower chances it will develop or to delay it. Being in good health before you become pregnant is probably the best thing you can do. Women who start their pregnancy at a normal body weight, are well nourished, don't smoke are less likely to develop preeclampsia. If you are at higher risk, be sure to follow all prenatal care advise and keep your medical appointments.

Diet and Preeclampsia
Is there a link between diet and pre-eclampsia? Some studies indicate that poorly nourished women develop pre-eclampsia more often. Studies of calcium supplementation for preventing preeclampsia have had mixed results with some recent studies showing no effect. A recent study showed that supplemental vitamin C and vitamin E may reduce preeclampsia in high risk women. The authors caution that it is too soon to recommend supplementation. Pregnant women should make sure their diet is adequate in food sources of these vitamins and take only the supplements prescribed by their prenatal care provider. The best advice appears to be to:

Diet Strategies To Prevent Preeclampsia
  • Maintain a normal weight before pregnancy.
  • Avoid excessive pregnancy weight gain.
  • Consume adequate sources of calcium.
  • Eat a well balanced, prenatal diet
  • Eat adequate fresh fruits and vegetables.
  • Take prescribed prenatal vitamins and calcium supplements.

It is not usually recommended to restrict salt intake during pregnancy. On-the-other-hand, avoiding excessive salt use is a good idea. Discuss salt and sodium recommendations with your physician if you are at higher risk for preeclampsia.

What About Future Pregnancies?
If you have pre-eclampsia with one pregnancy, you may be at higher risk for developing it again. This is particularly true if you developed severe pre-eclampsia, or if it occurred earlier in your pregnancy.

Women with preeclampsia are at higher risk for developing chronic hypertension in later years. Be sure and have your blood pressure checked regularly and inform you regular health care provider about your pregnancy complications.

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