What Expectant Parents Need to Know About Potentially Deadly Preeclampsia

When you’re pregnant, it’s all too easy to write off the discomfort and queasiness that frequently come with the territory. But doctors warn that some symptoms should never be dismissed because they could be the sign of a potentially deadly complication for mother and baby ― preeclampsia.

Preeclampsia can happen to any pregnant woman. A type of hypertensive disorder that affects blood flow to the placenta, preeclampsia often causes a rapid rise in blood pressure, which can lead to seizure, stroke, multiple organ failure and death of the mother and/or baby. Some women with preeclampsia also experience a placental abruption, in which the placenta separates partially or completely from the uterine wall, which is also a life-threatening emergency.

“Sometimes women don’t have any symptoms,” said Theresa Buckson, M.D., medical director of the Obstetrical Emergency Department at Baptist Health South Miami Hospital. “But many do have signs and they need to understand that the stakes are too high for them to ignore what is happening. We are talking life or death. If we can catch it early, we are better equipped to manage it and have great outcomes.”

Theresa Buckson, M.D., medical director of the Obstetrical Emergency Department at Baptist Health South Miami Hospital

Warning signs

May is Preeclampsia Awareness Month and, according to Dr. Buckson, there are some key symptoms to watch out for during your pregnancy. Among them are:

·      High blood pressure – Ask your doctor about regular monitoring and more frequent checks at home if you are already prone to high blood pressure

·      Headache – Particularly a headache that doesn’t go away with a low dose of acetaminophen

·      Swelling – Fluid retention in the hands, legs, feet or face

·      Vision disturbances – Blurry or spotty vision or other changes in your eyesight

·      Abdominal pain

·      Proteinuria – A high level of protein in the urine

·      A general sense that you don’t feel quite right

Preeclampsia affects approximately one in 25 pregnancies and is on the rise, according to the U.S. Centers for Disease Control and Prevention. Although doctors don’t know exactly what causes it, preeclampsia is largely preventable if women know their risks and get help at the first sign of a problem.

Risk factors

Having no risk factors for preeclampsia doesn’t guarantee you won’t develop the condition, but there are some things that make it more likely. They include a previous history of high blood pressure, carrying multiples (twins, triplets, etc.), having diabetes, and having had preeclampsia with a prior pregnancy.

Moderate risk factors are obesity, age over 35 and a 10-year or higher interval between your pregnancies. In addition, Black women are 60 percent more likely than white women to get preeclampsia, according to the Preeclampsia Foundation.

“It’s very important to go to all of your OB visits as they are scheduled,” Dr. Buckson stressed. “With certain risk factors, such as a history of high blood pressure, it is often recommended that you take a baby aspirin a day for prevention.”

Dr. Buckson added that concerns should be brought to the attention of your provider, no matter how small they seem to be, and that a trip to the ER is warranted if you feel unwell during your pregnancy and can’t be seen quickly by your obstetrician. “We may find nothing,” she said. “But it’s better to find nothing than to have something terrible happen.”

Treatment options

Treatment for preeclampsia depends on its severity and how far along a woman is in her pregnancy. “If she is near full-term, we can usually put her on bed rest, give her blood pressure medications and give steroids to mature the baby’s lungs, as well as some other medications to protect the baby,” Dr. Buckson said. “But if preeclampsia has progressed too far and a patient has some renal, cardiac or hepatic [liver] compromise, we can’t really wait. We need to deliver the baby as quickly as possible.”

A small percentage of women develop an even more dangerous variant of preeclampsia known as HELLP syndrome. It is characterized by hemolysis (the breakdown of red blood cells), elevated liver enzymes and low platelets. This can affect blood clotting, which can lead to maternal hemorrhage and death.

Although it’s more common later in pregnancy, preeclampsia can occur weeks after the baby’s birth. That is one of the reasons that many obstetricians now suggest a check-in at two weeks post-partum rather than waiting the traditional six weeks.