Let’s be frank, pregnancy is a lot harder than people realize. After all the work that goes into getting pregnant in the first place, particularly for those of us that struggle with fertility issues, dealing with a pregnancy complication can be terrifying and extremely overwhelming.
At Binto, we believe knowledge is power, and the more you know about what you are getting yourself into, the better prepared you will be to handle any bumps in the road. Today, we are talking about preeclampsia, a pregnancy complication that can have devastating consequences for you and your baby if left untreated.
What is preeclampsia?
Preeclampsia is a hypertensive disorder, meaning it involves abnormally high blood pressure levels. According to the International Society for the Study of Hypertension in Pregnancy (ISSHP), hypertensive disorders affect 10% of pregnancies. More specifically, preeclampsia is characterized by new sudden spikes in blood pressure after 20 weeks of pregnancy, and complicates an estimated 5% of all pregnancies.
Pregnancies with preeclampsia are high risk for both the mother and the baby. For mom, women experiencing preeclampsia suffer an increased risk of long term hypertension, heart problems, heart attack, and even stroke. For your baby, preeclampsia can increase the risk of intrauterine growth restriction, preterm birth, fetal distress and even fetal death.
What causes preeclampsia?
Normally, early in your pregnancy, new blood vessels develop to efficiently send blood to the placenta. When you have preeclampsia, these blood vessels don’t seem to develop properly. Instead, they are narrower than they should be and react differently to hormone signaling, which limits the amount of blood that can flow through them.
Researchers have not yet identified one single cause for this condition. Factors contributing to the development of preeclampsia may include insufficient blood flow to the uterus, damage to blood vessels, problems with your immune system, or certain genetic factors.
What are the risk factors for preeclampsia?
While researchers have not yet identified the specific cause of this condition, they have identified risk factors. You may be at a higher risk for preeclampsia if:
- You have a history of preeclampsia, either personally or in your family
- You already have chronic high blood pressure
- This is your first pregnancy
- The paternity of your baby has changed between pregnancies - each pregnancy with a different partner or sperm donor increases the risk of preeclampsia more than the second or third with the same paternity
- You are very young, i.e. teens, or you are over the age of 35
- You are a Black woman - Black women suffer from preeclampsia at higher rates than women of other racial backgrounds
- You have a high BMI
- You are carrying twins, triplets, or other multiples
- Your last pregnancy was less than two years ago, or more than 10 years ago
- You have a history of migraines, diabetes, kidney disease, or lupus
- Your baby was conceived via IVF
Further guidelines from the National Institute for Health and Care Excellence divide these risk factors into high and moderate categories:
You may be at high risk of preeclampsia if you have a history of hypertensive disease in previous pregnancies, or suffer from chronic kidney disease, autoimmune diseases, diabetes, or chronic hypertension.
Women are at moderate risk if they are over 40, have a high BMI, have a family history of preeclampsia, are pregnant with multiple fetuses, or it has been more than 10 years since their last pregnancy
What are the symptoms of preeclampsia?
Red flag #1: A sudden spike in your blood pressure
As a hypertensive disorder, changes in blood pressure are a good indication that something might be up with your pregnancy. These changes can be sudden or develop slowly over time, which is why monitoring your blood pressure is such an important part of prenatal care. A blood pressure reading of 140/90 mm of mercury (mm Hg) or greater documented on two occasions at least four hours apart is abnormal and could be a sign of preeclampsia.
Other signs of preeclampsia involve your organ function, specifically your kidneys and liver. Keep an eye out for excess protein in your urine or other signs of kidney issues, severe headaches, changes in vision like temporary blindness, blurred vision or light sensitivity, and upper abdominal pain under your ribs, usually on the right side.
If you experience nausea or vomiting, less urine output, shortness of breath or fluid in your lungs, or sudden weight gain and swelling especially in your face and hands, these could also be signs of preeclampsia. These also occur in normal pregnancies, so they are not always the most reliable sign.
When to see a doctor:
A critical piece of the screening process for preeclampsia is high quality prenatal care. Make sure you are going to your prenatal checkups so your doctor can monitor your blood pressure over the course of your pregnancy.
Many of the aches and pains associated with preeclampsia can also just be part of being pregnant, and it can be difficult to figure out when you might be facing a serious issue, especially if this is your first pregnancy. If you have symptoms that concern you, reach out to your doctor.
Contact your doctor or go to the ER immediately if you have a sudden intense headache, blurred vision or other visual issues, severe pain in your abdomen or severe shortness of breath.
How to treat preeclampsia?
A key piece of managing your risk for preeclampsia is prevention. If you know you might be at risk for preeclampsia and you are trying to get pregnant, you will need to keep your body in tip top shape. As a general rule, it’s a good idea to eat a varied diet, exercise regularly, and ensure that any chronic health conditions are well-managed.
Regular Prenatal Care
Once you are pregnant, we cannot overemphasize the importance of regular prenatal care. You and your doctor can work together to detect and manage a preeclampsia diagnosis, prevent complications and make the best decisions for you and your baby.
Prescriptions From Your Doctor
If you meet certain risk factors, like a history of preeclampsia or a multiple pregnancy, your doctor may recommend a daily low-dose aspirin once you reach 12 weeks of pregnancy. Research indicates that taking low-dose aspirin can be effective in reducing the incidence of preeclampsia in high risk pregnancies, but it is more effective if you start before you reach 16 weeks.
Research also indicates that women who are calcium deficient can benefit from calcium supplements to prevent preeclampsia. In fact, the WHO even issued a recommendation that pregnant women are provided with calcium supplements for this very purpose. That being said, women in the United States typically get adequate calcium from their diets so this is unlikely to help women form developed countries. What’s important is that you take a great prenatal vitamin to give your body what it needs to support your baby’s growth. If you are concerned about your vitamin levels, check in with your doctor.
Left untreated, preeclampsia can lead to serious and even fatal complications for you and your baby. Your risk increases with the severity of your condition and how early in your pregnancy the condition is diagnosed. The most effective treatment is to deliver your baby, most often through a C-section.
If you are diagnosed too early to deliver, you and your doctor face a more challenging task. You may need to be put on bed rest until your baby is ready to be delivered. Your doctor may even recommend hospitalization for more up to the minute monitoring of your baby’s well-being.
After your baby is born, it may still take a while for your body to recover. You could suffer from damage to your kidneys, liver, lungs, heart, or eyes, and even brain, depending on how severe your preeclampsia is. It is possible you might also have an increased risk of future cardiovascular problems. To take care of your body post-delivery, it’s important to eat a variety of fruits and vegetables, maintain a healthy weight, exercise regularly and quit smoking.
What is eclampsia?
Put simply, if your preeclampsia is not properly controlled in consultation with your doctor, you and your baby are at serious risk of death. Eclampsia is preeclampsia with the added symptom of seizures. It is difficult to predict what cases of preeclampsia will escalate to eclampsia, and there are often no symptoms or warning signs to indicate the progression. If you are experiencing eclampsia, your baby will have to be delivered immediately, no matter how far along the pregnancy is.
We know this sounds really scary, which is why it is so important to communicate with your doctor and attend regular prenatal checkups so your health provider can monitor you for risk factors and intervene appropriately. Part of your preeclampsia treatment may also include anticonvulsant medications to prevent these seizures, if you have a severe case.
We are here to help!
All this to say, preeclampsia must be handled very carefully to protect you and your baby, but you are not alone in your journey. Beyonce, Laura Bush, and Mariah Carey all suffered from preeclampsia while pregnant with their respective sets of twins and still delivered healthy babies. Take Kim Kardashian as another example. She has spoken publicly about her struggles with preeclampsia, among other pregnancy complications, during her first two pregnancies. After delivering her first two babies safely, Kim and her husband, Kanye West, turned to a surrogate to carry their last two children.
The all important reminder is that every woman’s body and pregnancy experience are different, so it’s important to stay in tune with your body, including any preexisting medical conditions that might have an impact on your pregnancy. Keep checking in with yourself and your doctor as your pregnancy continues to make sure everything stays on track.
If you have questions or concerns, know that we are always here to help. You can chat with one of our healthcare providers any time through the chat portal on our website, or by scheduling a telehealth appointment here. We’ve got your back!