Preeclampsia

KEY POINTS

  • Preeclampsia is a kind of high blood pressure some women get after the 20th week of pregnancy or after giving birth.

  • Most women with preeclampsia have healthy babies. But if not treated, it can cause serious problems, like premature birth and even death.

  • Preeclampsia symptoms include blurred vision, swelling in the hands and face, severe headaches and belly pain.

  • If you have any preeclampsia symptoms, call your health care provider right away. 

  • You can have mild preeclampsia without any symptoms, so it’s important to go to all of your prenatal care visits, even if you’re feeling fine.

What is preeclampsia?

Preeclampsia is a condition that can happen after the 20th week of pregnancy or after giving birth. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Some of these signs include having protein in the urine, changes in vision and severe headache. 

Preeclampsia is a serious health problem for pregnant women around the world. It affects 2 to 8 percent of pregnancies worldwide (2 to 8 in 100). It’s the cause of 15 percent (3 in 20) of premature births in the United States. Premature birth is birth that happens too early, before 37 weeks of pregnancy.  

Most women with preeclampsia have healthy babies. But if it’s not treated, it can cause severe health problems for mom and baby.

What are the signs and symptoms of preeclampsia?

Signs and symptoms of preeclampsia include: 

  • High blood pressure 
  • Protein in the urine 
  • Severe headaches 
  • Changes in vision, like blurriness, flashing lights, seeing spots or being sensitive to light 
  • Pain in the upper right belly area or pain in the shoulder
  • Nausea or vomiting 
  • Dizziness 
  • Sudden weight gain (2 to 5 pounds in a week) 
  • Swelling in the legs, hands and face 
  • Trouble breathing

Many of these signs and symptoms are normal discomforts of pregnancy. But if you have severe headaches, blurred vision or severe upper belly pain, call your health care provider right away.

What health and pregnancy complications can preeclampsia cause? 

Without treatment, preeclampsia can serious health problems and even death. It may cause kidney, liver and brain damage. Preeclampsia also may affect how your blood clots and may cause serious bleeding problems. In rare cases, preeclampsia can become a life-threatening condition called eclampsia. Eclampsia is when a pregnant woman has seizures following preeclampsia. Eclampsia sometimes can lead to coma.

If you have preeclampsia, your health care provider can help you manage most health complications through regular prenatal care. Women with preeclampsia are more likely than women who don’t have preeclampsia to have these pregnancy complications:

  • Premature birth. Even with treatment, a pregnant woman with preeclampsia may need to give birth early to avoid serious health problems for her and her baby. 
  • Placental abruption. In this condition the placenta separates from the wall of the uterus before birth. It can separate partially or completely. If this happens, your baby may not get enough oxygen and nutrients. Vaginal bleeding is the most common symptom of placental abruption after 20 weeks of pregnancy. If you have vaginal bleeding during pregnancy, contact your health care provider immediately.
  • A baby with intrauterine growth restriction (also called IUGR). This is poor growth in the womb. High blood pressure can narrow blood vessels in the uterus (womb) and placenta. The placenta grows in the uterus and supplies your baby with food and oxygen through the umbilical cord. Your baby may have IUGR if he doesn’t get enough oxygen and nutrients, causing him to grow slowly. 
  • low birthweight baby. This is when a baby weighs less than 5 pounds, 8 ounces. 

What causes preeclampsia?

We don’t know what causes preeclampsia. But there are some things that may make you more likely than other women to have it. These are called risk factors. Some risk factors put you at high risk for preeclampsia, including: 

  • You have a history or preeclampsia. This means you had it in a previous pregnancy. The earlier in pregnancy you had preeclampsia, the higher your risk is to have it again in another pregnancy. You’re also at higher risk if you had preeclampsia along with other pregnancy complications.
  • You’re pregnant with multiples (twins, triplets or more).
  • You have high blood pressure, diabetes, kidney disease or an autoimmune disease like lupus or antiphospholipid syndrome. An autoimmune disease is a health condition that happens when antibodies (cells in the body that fight off infections) attack healthy tissue by mistake.

Other risk factors for preeclampsia include:

  • This is your first pregnancy.
  • You’re older than 35.
  • You’re obese. Obese means being very overweight with a body mass index (also called BMI) of 30 or higher. To find out your BMI, go to www.cdc.gov/bmi.
  • You have a family history of preeclampsia. This means that other people in your family have had preeclampsia. 
  • You had complications in a previous pregnancy, like having a baby with low birthweight. 
  • It’s been more than 10 years since your last pregnancy.
  • You had a fertility treatment called in vitro fertilization (also called IVF) to help you get pregnant. 

If your provider thinks you’re at risk of having preeclampsia, he may want to treat you with low-dose aspirin to help prevent it. Talk to your provider to see if treatment with aspirin is right for you.

How is preeclampsia diagnosed? 

Your provider measures your blood pressure and checks your urine for protein at every visit. Because you can have mild preeclampsia without symptoms, it’s important to go to all of your prenatal care visits.

The cure for preeclampsia is the birth of your baby. Treatment depends on how severe your preeclampsia is and how far along you are in your pregnancy. Even if you have mild preeclampsia, you need treatment to make sure it doesn't get worse.

How is mild preeclampsia treated? 

Most women with mild preeclampsia after 37 weeks of pregnancy don’t have serious health problems. If you have mild preeclampsia before 37 weeks, your provider checks your blood pressure and urine regularly to make sure your preeclampsia doesn't get worse. You may be able to stay at home, or your provider may want you to stay in the hospital. 

Your provider may check your baby’s health using: 

  • Ultrasound. This is a prenatal test that uses sound waves and a computer screen to show a picture of your baby inside the womb. Ultrasound checks that your baby is growing at a normal rate. It also lets your provider look at the placenta and the amount of fluid around your baby to make sure your pregnancy is healthy. 
  • Nonstress test. This test checks your baby’s heart rate. 
  • Biophysical profile. This test combines the nonstress test with an ultrasound. 

If your preeclampsia gets worse, your provider may induce labor. This means your provider gives you medicine or breaks your water (amniotic sac) to make you start labor. Inducing labor can help prevent possible problems from preeclampsia that gets worse.

How is severe preeclampsia treated? 

If you have severe preeclampsia before 34 weeks of pregnancy, you need to stay in the hospital for close monitoring. Your provider may treat you with medicines called antenatal corticosteroids (also called ACS). These medicines help speed up your baby’s lung development. If your preeclampsia gets worse, you may need to give birth early. Most babies of moms with severe preeclampsia before 34 weeks of pregnancy do better in the hospital than if they stay in the uterus.

If you have severe preeclampsia at 34 weeks of pregnancy or after, you need to be in the hospital, and your provider may induce labor.

If you have severe preeclampsia and HELLP syndrome, you almost always need to give birth early to prevent serious health problems. HELLP syndrome is a rare but life-threatening liver disorder. It happens in about 1 to 2 of 1,000 pregnancies. About 2 in 10 women (20 percent) with severe preeclampsia develop HELLP syndrome. You may need medicine to control your blood pressure and prevent seizures. Some women also need blood transfusions. A blood transfusion means you have new blood put into your body.

If you have preeclampsia, can you have a vaginal birth? 

Yes. A vaginal birth may be better than a cesarean birth (c-section) if you have preeclampsia. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. Having a vaginal birth lets you avoid the stress of surgery. It’s safe for most women with preeclampsia to have an epidural to cope with pain during labor and birth as long as their blood clots normally.

Last reviewed: September, 2016

What is preeclampsia?

Preeclampsia is a condition that can happen after the 20th week of pregnancy or after giving birth. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Some of these signs include having protein in the urine, changes in vision and severe headache. 

Preeclampsia is a serious health problem for pregnant women around the world. It affects 2 to 8 percent of pregnancies worldwide (2 to 8 in 100). It’s the cause of 15 percent (3 in 20) of premature births in the United States. Premature birth is birth that happens too early, before 37 weeks of pregnancy.  

Most women with preeclampsia have healthy babies. But if it’s not treated, it can cause severe health problems for mom and baby.

What are the signs and symptoms of preeclampsia?

Signs and symptoms of preeclampsia include: 

  • High blood pressure 
  • Protein in the urine 
  • Severe headaches 
  • Changes in vision, like blurriness, flashing lights, seeing spots or being sensitive to light 
  • Pain in the upper right belly area or pain in the shoulder
  • Nausea or vomiting 
  • Dizziness 
  • Sudden weight gain (2 to 5 pounds in a week) 
  • Swelling in the legs, hands and face 
  • Trouble breathing

Many of these signs and symptoms are normal discomforts of pregnancy. But if you have severe headaches, blurred vision or severe upper belly pain, call your health care provider right away.

What health and pregnancy complications can preeclampsia cause? 

Without treatment, preeclampsia can serious health problems and even death. It may cause kidney, liver and brain damage. Preeclampsia also may affect how your blood clots and may cause serious bleeding problems. In rare cases, preeclampsia can become a life-threatening condition called eclampsia. Eclampsia is when a pregnant woman has seizures following preeclampsia. Eclampsia sometimes can lead to coma.

If you have preeclampsia, your health care provider can help you manage most health complications through regular prenatal care. Women with preeclampsia are more likely than women who don’t have preeclampsia to have these pregnancy complications:

  • Premature birth. Even with treatment, a pregnant woman with preeclampsia may need to give birth early to avoid serious health problems for her and her baby. 
  • Placental abruption. In this condition the placenta separates from the wall of the uterus before birth. It can separate partially or completely. If this happens, your baby may not get enough oxygen and nutrients. Vaginal bleeding is the most common symptom of placental abruption after 20 weeks of pregnancy. If you have vaginal bleeding during pregnancy, contact your health care provider immediately.
  • A baby with intrauterine growth restriction (also called IUGR). This is poor growth in the womb. High blood pressure can narrow blood vessels in the uterus (womb) and placenta. The placenta grows in the uterus and supplies your baby with food and oxygen through the umbilical cord. Your baby may have IUGR if he doesn’t get enough oxygen and nutrients, causing him to grow slowly. 
  • low birthweight baby. This is when a baby weighs less than 5 pounds, 8 ounces. 

What causes preeclampsia?

We don’t know what causes preeclampsia. But there are some things that may make you more likely than other women to have it. These are called risk factors. Some risk factors put you at high risk for preeclampsia, including: 

  • You have a history or preeclampsia. This means you had it in a previous pregnancy. The earlier in pregnancy you had preeclampsia, the higher your risk is to have it again in another pregnancy. You’re also at higher risk if you had preeclampsia along with other pregnancy complications.
  • You’re pregnant with multiples (twins, triplets or more).
  • You have high blood pressure, diabetes, kidney disease or an autoimmune disease like lupus or antiphospholipid syndrome. An autoimmune disease is a health condition that happens when antibodies (cells in the body that fight off infections) attack healthy tissue by mistake.

Other risk factors for preeclampsia include:

  • This is your first pregnancy.
  • You’re older than 35.
  • You’re obese. Obese means being very overweight with a body mass index (also called BMI) of 30 or higher. To find out your BMI, go to www.cdc.gov/bmi.
  • You have a family history of preeclampsia. This means that other people in your family have had preeclampsia. 
  • You had complications in a previous pregnancy, like having a baby with low birthweight. 
  • It’s been more than 10 years since your last pregnancy.
  • You had a fertility treatment called in vitro fertilization (also called IVF) to help you get pregnant. 

If your provider thinks you’re at risk of having preeclampsia, he may want to treat you with low-dose aspirin to help prevent it. Talk to your provider to see if treatment with aspirin is right for you.

How is preeclampsia diagnosed? 

Your provider measures your blood pressure and checks your urine for protein at every visit. Because you can have mild preeclampsia without symptoms, it’s important to go to all of your prenatal care visits.

The cure for preeclampsia is the birth of your baby. Treatment depends on how severe your preeclampsia is and how far along you are in your pregnancy. Even if you have mild preeclampsia, you need treatment to make sure it doesn't get worse.

How is mild preeclampsia treated? 

Most women with mild preeclampsia after 37 weeks of pregnancy don’t have serious health problems. If you have mild preeclampsia before 37 weeks, your provider checks your blood pressure and urine regularly to make sure your preeclampsia doesn't get worse. You may be able to stay at home, or your provider may want you to stay in the hospital. 

Your provider may check your baby’s health using: 

  • Ultrasound. This is a prenatal test that uses sound waves and a computer screen to show a picture of your baby inside the womb. Ultrasound checks that your baby is growing at a normal rate. It also lets your provider look at the placenta and the amount of fluid around your baby to make sure your pregnancy is healthy. 
  • Nonstress test. This test checks your baby’s heart rate. 
  • Biophysical profile. This test combines the nonstress test with an ultrasound. 

If your preeclampsia gets worse, your provider may induce labor. This means your provider gives you medicine or breaks your water (amniotic sac) to make you start labor. Inducing labor can help prevent possible problems from preeclampsia that gets worse.

How is severe preeclampsia treated? 

If you have severe preeclampsia before 34 weeks of pregnancy, you need to stay in the hospital for close monitoring. Your provider may treat you with medicines called antenatal corticosteroids (also called ACS). These medicines help speed up your baby’s lung development. If your preeclampsia gets worse, you may need to give birth early. Most babies of moms with severe preeclampsia before 34 weeks of pregnancy do better in the hospital than if they stay in the uterus.

If you have severe preeclampsia at 34 weeks of pregnancy or after, you need to be in the hospital, and your provider may induce labor.

If you have severe preeclampsia and HELLP syndrome, you almost always need to give birth early to prevent serious health problems. HELLP syndrome is a rare but life-threatening liver disorder. It happens in about 1 to 2 of 1,000 pregnancies. About 2 in 10 women (20 percent) with severe preeclampsia develop HELLP syndrome. You may need medicine to control your blood pressure and prevent seizures. Some women also need blood transfusions. A blood transfusion means you have new blood put into your body.

If you have preeclampsia, can you have a vaginal birth? 

Yes. A vaginal birth may be better than a cesarean birth (c-section) if you have preeclampsia. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. Having a vaginal birth lets you avoid the stress of surgery. It’s safe for most women with preeclampsia to have an epidural to cope with pain during labor and birth as long as their blood clots normally.

Last reviewed: September, 2016