I don’t know at what point I developed preeclampsia, but I can’t help but look back at how swollen I was and wonder why it didn’t occur to me sooner. I’d heard of preeclampsia, but I had no idea what pregnant women with preeclampsia really went through.
Not understanding how much higher risk I would be if I had preeclampsia, I insisted my OB not worry when she told me at one of my third-trimester appointments that my blood pressure was high.
I was moving that day, and there were literally movers at my house packing up while I visited the doctor. Of course, my blood pressure was high.
My OB reluctantly accepted my explanation, but insisted I buy a blood pressure monitor and keep track of my blood pressure throughout the weekend.
It was erratic–sometimes borderline high, sometimes extremely low. So first thing Monday morning, I was picking up a kit to collect urine samples for 24 hours to look for protein in my urine.
The following few weeks were a whirlwind. They were filled with tons of doctors appointments, attempting to unpack a home and prepare for a baby while on modified bedrest, a somewhat stressful “nonstress test.” It finally ended with a labor induction at 37 weeks of pregnancy that caught me completely off guard.
But it shouldn’t have caught me off guard. If I’d known anything about preeclampsia, I probably would’ve been much better prepared. Here, I hope to prepare you for your journey, should you find yourself in this same place.
What is Preeclampsia?
Preeclampsia is a condition that affects late pregnancy and should always be taken seriously.
According to the Mayo Clinic, it is generally characterized by high blood pressure and symptoms of liver or kidney dysfunction.
Harvard Health says it “usually begins after the 20th week,” though many cases are diagnosed much later.
A mother who develops preeclampsia should expect to be monitored carefully and should follow all of her doctor’s instructions, including keeping an eye out for symptoms that suggest the condition is worsening.
Usually, staying on modified or full bed rest is par for the course with preeclampsia.
Why Knowing the Signs of Preeclampsia is Important
It’s essential that we know the signs of preeclampsia because it’s a serious condition that we want to watch out for.
In her recent book High Risk, Maternal Fetal Medicine Specialist Dr. Chavi Eve Karkowsky explains, “Preeclampsia can be mild; but historically, it is also one of the reasons that women get sick and even die in pregnancy.”
This sounds terrifying, I know, but that’s why it’s so important to know what to look out for and to follow the instructions of your medical care providers.
The risks of preeclampsia are greatly mitigated by close monitoring and good healthcare.
Signs and Symptoms
If you’re being carefully monitored by your healthcare provider, the first sign of preeclampsia will likely be a high blood pressure reading during a routine appointment.
But more symptoms appear later and signify that the condition is becoming more serious.
- Severe headaches
- Vision changes–temporary loss of vision, blurred vision, or sensitivity to light
- Abdominal pain in the upper right quadrant of your stomach
- Onset of nausea or vomiting
- Decreased urine output
- Shortness of breath
- Edema (swelling)
There are other symptoms of preeclampsia that are important for monitoring, but they’re only available via lab work through your healthcare provider.
How to Get a Preeclampsia Diagnosis
If you have a high blood pressure reading (140/90 or above, with either number being high) during pregnancy, your doctor will likely want to monitor you for preeclampsia.
According to the National Institute of Health, official preeclampsia diagnosis requires a high blood pressure reading (for many practitioners, 2 high blood pressure readings, at least 4 hours apart, and one of the following:
- High levels of protein in urine after collecting all urine specimens for 24 hours (most common method of diagnosis)
- Blood tests showing kidney or liver dysfunction
- Fluid in the lungs
- Visual impairment
While many doctors rely on high blood pressure as an indication of preeclampsia, I learned something during my own journey that I want to make sure you know in case you need to advocate for yourself accordingly.
Erratic blood pressure can be a symptom of preeclampsia, including low blood pressure readings.
My OB was initially confused by my low blood pressure–I fit the preeclampsia diagnosis because I had two high readings + extremely high urine protein levels. But more often than not, my blood pressure was too low, not too high.
When I visited my Maternal Fetal Medicine specialist (MFM), however, she told me that having erratic blood pressure is very common in preeclampsia.
She actually called me case “textbook,” even though it didn’t fit what my OB told me, or the information I was able to find online.
I asked Dr. Karkowsky, renowned MFM and author of High Risk, about erratic blood pressure in preeclampsia, and she painted a picture that really highlights the complexity of this particular disease.
“Preeclampsia can be thought of, in part, as a spasmodic disease of blood vessels, so it’s not unheard of for blood pressures to revert to their norm, but alternate with extremely high blood pressures.
And of course, women often feel completely fine until they’re quite sick, so it is a very confusing disease if you catch someone; I often say that with preeclampsia, I don’t need just the photograph, I need the whole movie to know what’s going on.”Dr. Chavi Eve Karkowsi, Maternal Fetal Medicine Specialist
Preeclampsia Treatment + Why It’s Important
Treating preeclampsia is a matter of regular, attentive, good medical care, not actually of a cure. As Dr. Karkowski reminds us in High Risk, “The only cure for preeclampsia is delivery.”
The exact preeclampsia causes are unknown, though there are various risk factors. But according to the Mayo Clinic (and every doctor I’ve ever discussed the subject with), “Experts believe that preeclampsia begins in the placenta.”
In order to cure preeclampsia, it’s essential to remove the placenta from the body, which of course means also removing the baby (either through delivery, usually induced, or by c-section.) In severe cases where the mother and/or baby’s lives are at risk, most doctors will deliver immediately.
The more common approach is for doctors to treat the symptoms of preeclampsia while carefully monitoring the patient and prescribing bedrest. If symptoms get too strong, you may be admitted to the hospital for ongoing monitoring until delivery.
Potential treatments of symptoms include:
- Blood pressure medications
- Corticosteroids to help support mom’s organ function and baby’s lung development
- Medication to prevent seizures
- Bed rest or modified bed rest
Preeclampsia After Delivery: What You Need to Know
Because preeclampsia is a serious condition that has the potential to lead to fetal or maternal mortality, it’s essential to continue monitoring yourself even after delivery.
According to the Preeclampsia Foundation, the most common symptom to remain after delivery is high blood pressure.
For this reason, it’s important to continue to monitor your blood pressure in the hospital, at home, and at all postnatal doctor’s appointments. Talk to your doctor about a specific plan for monitoring blood pressure.
Some doctors may recommend avoiding certain pain medications that can cause elevated blood pressure. What’s most important is that you and your doctor have a candid conversation about how you should self-monitor based on your own specific case.
There is also a condition that can develop called postpartum preeclampsia, in which a woman develops preeclampsia after the birth of her child, despite not having a diagnosed case during pregnancy.
Keep an eye out for all symptoms of preeclampsia during the 6 weeks following the birth of your baby, and contact your doctor immediately if you notice any of those changes.
Did you know to expect after your preeclampsia diagnosis? Tell us about your experience in the comments!
Frequently Asked Questions About Preeclampsia
While the symptoms of preeclampsia can be treated, the only cure for preeclampsia is delivery.
Experts are unsure what causes preeclampsia, but they generally agree that it originates in the placenta. Potential causes may include genetic factors, immunological issues, or insufficient blood flow to the uterus.
While there is no guaranteed way to prevent preeclampsia, many studies suggest you can lower your risk by taking baby aspirin and/or calcium supplements, but you should never take medicine while pregnant without consulting your doctor and evaluating your specific case.
Anyone can develop preeclampsia during pregnancy, but major risk factors include: a history of preeclampsia; chronic hypertension; advanced maternal age; obesity; pregnancy with multiples; history of high blood pressure, migraines, diabetes, kidney disease, blood clots, or lupus; race. Black women have the greatest risk of developing preeclampsia.
Katy Huie Harrison, PhD, is an author, mom, recurrent miscarriage survivor, & owner of Undefining Motherhood. She lives in Atlanta with her husband (affectionately known on the internet as “Husband,”) son (Jack), and dog (Charlotte). She believes our society puts too many expectations on women that make womanhood and motherhood restrictive. Her goal is to shift the paradigm about what it means to be a woman and mother, giving all women a greater sense of agency over their own lives. You can find Katy and her work featured in places like CNN’s Headline News, Romper, Scary Mommy, Demeter Press’s Motherhood and Social Exclusion, & more.