As much as it may be a pain in the a** (well, the arm) to have your blood pressure checked at every. single. prenatal checkup, there’s a good reason it’s done. High blood pressure could indicate a variety of pregnancy complications – but the most common one it’s related to is preeclampsia.
So what’s the deal with this condition, and how is it prevented or managed? Read on to get all the deets.
What is preeclampsia?
Preeclampsia is a fairly common pregnancy complication – but it’s not one you want to muck around with, as it can be dangerous for you and your baby if left unchecked. Doctors are trained to look out for signs of preeclampsia, including persistently high blood pressure, organ damage, and excess protein in urine.
In Australia, 1 in 20 women are diagnosed with preeclampsia in pregnancy, would you believe? Signs and symptoms of preeclampsia don’t usually develop until later on in your pregnancy – usually after 20 weeks. But it can even crop up after you’ve delivered your baby (known as ‘postpartum preeclampsia’).
Preeclampsia after birth usually occurs within seven days of delivery, but you could be at risk for up to six weeks into your postpartum period.
So let’s talk about how to know if you have it.
Early signs of preeclampsia might include:
- A sense of ‘just not feeling good’ – I know that’s very vague, and pregnancy doesn’t feel great at the best of times, but some mums can just sense that something’s off in their bodies during pregnancy.
- Bad headaches – more severe than you’d usually experience.
- Nausea, vomiting or shortness of breath – distinctly different from your usual third trimester state of being ‘puffed out’.
- Changes to your vision – which could be sensitivity to light, blurred vision, or even loss of vision.
- Swelling of the hands and feet – distinguishing between preeclampsia swelling versus normal swelling in pregnancy can be tricky, but you can expect large amounts around the face, eyes, hands and feet.
- Upper abdominal pain – which is sometimes mistaken for heartburn.
Hmm… You’ve probably noticed that these preeclampsia signs are all suspiciously similar to regular pregnancy symptoms. Plus, it’s worth noting that you could have preeclampsia without experiencing any of these symptoms.
So how in hell can you confirm that you actually have preeclampsia?
How preeclampsia is diagnosed
The biggest telltale sign of preeclampsia is a rise in blood pressure.
Your doctor will generally pick this up at a routine appointment, but if you’re feeling ‘off’ in between checkups, it’s a good idea to go in sooner for a blood pressure test, or pop into your local chemist for one.
‘Preeclampsia blood pressure’ is generally characterised as higher than 140/90 millimetres of mercury (mm Hg) — documented on two occasions, at least four hours apart. (A once-off high reading isn’t always cause for concern. It could just be because you’re stressed about work, you had to run up a flight of stairs to make your appointment on time, or you’re still emotionally recovering from the season final of Euphoria.)
If preeclampsia is suspected, your doctor might also ask you to do a urine test to check for protein, or a blood test to assess your kidney and liver function.
You could be diagnosed with mild preeclampsia if your symptoms are minimal. Or, if your tests indicate organ damage, a low platelet count, or fluid in your lungs, it could be a sign of more severe preeclampsia.
The trick with preeclampsia is to catch it before it gets out of hand. Because as we’ve already hinted at, it can be very dangerous to you and your baby.
What causes preeclampsia?
The placenta plays a key role. Early in a pregnancy, new blood vessels develop and evolve to effectively send blood to your placenta to nourish your developing baby. But in women with preeclampsia, these blood vessels don’t develop or function properly. They’re narrower and behave differently to how they should (naughty!), so limited blood can flow through.
How’s this for a way to visualise it (offered up by the Preeclampsia Foundation)? – “One might compare the condition to what would happen if a garden hose was hooked up to a fire hydrant.”
Beyond this, no one is really sure what causes preeclampsia in the first place. There are plenty of theories, though. To name a few:
- Insufficient blood flow to the uterus.
- Overproduction of blood vessels in the placenta.
- Disruption of hormones.
- Nutritional deficiencies.
- Preexisting health conditions (maybe undiagnosed).
- Genetic disorders.
It’s highly likely that genetics do play a role, as you’re more likely to develop preeclampsia in pregnancy if family members have had it. But there’s not yet any genetic testing that identifies your chances of getting it. Bummer.
While you may not be able to predict for sure if you’ll get it or not, there are some risk factors that increase your chances.
Preeclampsia risk factors
- If you have chronic hypertension.
- If you had preeclampsia in your first pregnancy.
- If you’re very young (a teenager) or over 35.
- If you’re obese.
- If you have preexisting conditions like diabetes, hyperthyroidism, or lupus.
- If you have a family history of preeclampsia (this is one of the biggest risk factors for preeclampsia).
How does preeclampsia in pregnancy affect you and your baby?
Most of the time, mums with preeclampsia deliver healthy (and probably outrageously adorable) babies. But we won’t skirt around the fact that things can get scary sometimes.
The root of the problem when it comes to preeclampsia in pregnancy is circulation issues. Preeclampsia affects blood flow to your placenta, which limits your baby’s supply of oxygen and nutrients. This can make it difficult for bubs to grow, and could even cause them to stop developing altogether.
Preeclampsia can also be life-threatening for pregnant women. It can affect your kidney function, damage your liver and blood clotting system (which leads to a severe complication called HELLP syndrome), and can develop into eclampsia which causes seizures.
If you develop preeclampsia, you’re more likely to deliver your baby prematurely. The condition is responsible for up to 20 per cent of preterm births. In some cases, the only way to treat preeclampsia is to deliver the baby ASAP – and of course this can be risky if your pregnancy isn’t near its end.
But please remember – as with any type of pregnancy complication – it’s absolutely not your fault. Depending on your situation, your care team will advise on preeclampsia treatment options to try and keep you and your baby safe till it’s delivery go-time.
How to prevent preeclampsia (or treat it)
While studies haven’t revealed any useful prevention methods or ‘magic pills’ to prevent preeclampsia, treatments can keep you and your baby safe until you’re ready to deliver. If your preeclampsia surfaces close to your due date (typically after 37 weeks) and your baby is on track with development, early delivery may be recommended.
Management of preeclampsia, if it develops earlier in pregnancy, might include extra monitoring, medication, supplements, or bed rest. And if you have risk factors for preeclampsia, you may be advised to take a daily low dose of aspirin from around 12 weeks.
If you’re at-risk or worried about preeclampsia, the best thing you can do is watch out for signs and symptoms, and go to all your prenatal appointments. Eating well, trying to keep your weight in range, managing any preexisting conditions to the best of your ability, and getting in some regular physical activity can also help reduce your risk.
One final note on preeclampsia
Preeclampsia can go from zero to hero fairly quickly, so it’s not worth waiting and ‘seeing how you go’.
Just how quickly can preeclampsia develop? In some women it surfaces gradually over the pregnancy, but it could also get very serious literally in a matter of hours. So if you’re feeling ‘off’ during your pregnancy at all, get checked out.
Important: the information in this article shouldn’t replace good advice, diagnosis or treatment from your maternity care team. If you’re experiencing symptoms that concern you, see your doctor immediately.