When you’re pregnant after loss, you might find yourself analyzing every ache and tingle, worrying that something has gone wrong with you or the baby. One of your concerns might be preeclampsia, a serious condition that causes 10,500 infant deaths in the United States each year[1]“Frequently Asked Questions,” Preeclampsia Foundation, https://www.preeclampsia.org/faqs.

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But preeclampsia can have no signs — or symptoms that are similar to common pregnancy discomforts. So, how can you look out for preeclampsia without making yourself crazy? Self-education and regular prenatal care are the keys. With diagnosis and treatment, most pregnant folks who develop preeclampsia go on to have healthy babies.

What is Preeclampsia?

Preeclampsia is a high blood pressure condition that can develop after 20 weeks of pregnancy or, less commonly, in the postpartum period[2]“Preeclampsia,” American Pregnancy Association, https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/preeclampsia/. It can negatively affect kidneys and liver function, put stress on the heart, and cause other problems. In the United States, preeclampsia leads to about 15 percent of premature births, which is when a baby is born before 37 weeks.

The risk factors for preeclampsia include the following[3]“Preeclampsia,” March of Dimes, October 2020, https://www.marchofdimes.org/complications/preeclampsia.aspx.

  • You’ve had preeclampsia in a previous pregnancy.
  • You’re pregnant with multiples.
  • You had high blood pressure or kidney disease before getting pregnant.
  • You’ve never had a baby before, or it’s been more than 10 years since you had a baby.
  • You have a family history of preeclampsia.
  • You’re obese, meaning your BMI is 30 or greater.
  • You had complications in a previous pregnancy, especially giving birth to a baby with low birth weight, which is defined as less than 5 pounds, 8 ounces.
  • You’re younger than 20 or older than 35.
  • Your baby was conceived with in vitro fertilization (IVF).
  • You’re African-American.

What are the Signs of Preeclampsia?

One of the tricky things about preeclampsia is that for some pregnant people, there are no signs. You might feel perfectly well but end up needing to be admitted to the hospital or put on bed rest. Meanwhile, others have signs that mimic normal pregnancy symptoms, so preeclampsia might go unnoticed.

For these reasons, it’s extremely important to keep all of your prenatal appointments. Here are the signs and symptoms of preeclampsia[4]“Signs and Symptoms of Preeclampsia,” Preeclampsia Foundation, November 2020, https://www.preeclampsia.org/signs-and-symptoms.

High Blood Pressure

Also called hypertension, high blood pressure is a reading of 140/90 or greater, measured on two separate occasions at least four hours apart.

Protein in Urine

Sometimes referred to as proteinuria, this happens when proteins, which typically stay in the blood thanks to the kidneys doing the work of filtering, spill into the urine. The most common way to screen for protein in urine is with a simple dipstick test at each prenatal visit.

Changes in Vision

These include blurriness, seeing spots, auras, flashing lights, or being sensitive to light. Vision changes can be the result of central nervous system irritation or may even indicate swelling of the brain.

Persistent Headache

When a migraine-like headache won’t go away, it’s a red flag. This could be a dull ache or a throbbing pain.

Edema

Some swelling during pregnancy, especially in the feet and ankles, is normal. However, edema is when fluid accumulates and you have significant swelling in the legs, hands, or face, or around the eyes.

Nausea

Again, nausea or vomiting is common, particularly during the first trimester, but a sudden onset of “morning sickness” in the second or third trimester can be a sign of preeclampsia. These feelings are sometimes accompanied by dizziness.

Abdominal or Shoulder Pain

Upper right quadrant pain typically occurs under the ribs on the right side, while shoulder pain is actually referred pain that is radiating from the liver. People who have felt the shoulder pain describe it as deep pinching, often adding that it’s painful to lie on the right side.

Sudden Weight Gain

When weight gain happens suddenly, adding 3-5 pounds in a week, it can signal a problem. This happens because damaged blood vessels allow more water to leak into and stay in the body’s tissue and not to pass through the kidneys to be excreted.

Trouble Breathing

High blood pressure sometimes causes shortness of breath, a fast pulse, mental confusion, and anxiety. In rare cases, pulmonary edema, which is when fluid collects in the lungs, can lead to breathing troubles.

How is Preeclampsia Treated?

If your provider identifies you as someone who’s at high risk for preeclampsia, they may recommend you take aspirin daily as early as 12 weeks of pregnancy. According to the American College of Obstetricians and Gynecologists (ACOG), daily baby aspirin may help prevent preeclampsia and is considered safe during pregnancy[5]“Low-Dose Aspirin Use During Pregnancy,” Community Opinion, The American College of Obstetricians and Gynecologists, July 2018, … Continue reading.

When preeclampsia is identified later in pregnancy, it’s usually categorized as mild or severe. If you have preeclampsia earlier than 37 weeks, your provider will monitor your blood pressure and urine by seeing you in the office more frequently or perhaps asking you to stay in the hospital. You’ll also be asked to track your baby’s movements, and sometimes blood pressure medication can help. For those who have mild preeclampsia at or after 37 weeks, your physician might suggest induction[6]“Preeclampsia,” Mayo Clinic Staff, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-20355751.

If you have severe preeclampsia, it’s usually best to stay in the hospital, and your care team may recommend taking medicine that will speed up the baby’s lung development. If your condition worsens, you and your baby are typically safer if you give birth early, either by induction or C-section. About two out of ten pregnant people with severe preeclampsia develop HELLP syndrome, which is a life-threatening medical emergency.

Finally, some parents experience postpartum preeclampsia, a rare condition that usually occurs within 48 hours of giving birth, although it can happen up to six weeks postpartum. The signs are the same as preeclampsia during pregnancy and are equally as dangerous.

Takeaways about Preeclampsia

Preeclampsia is a serious condition that can have significant health impacts for both the gestational parent and the baby. According to the Preeclampsia Foundation, stillbirths are much more likely to occur with severe preeclampsia or HELLP syndrome. That’s why it’s crucial to attend all prenatal appointments, track fetal movement, and contact your provider if you notice a change.

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