“What I Wish I’d Known About Preeclampsia”: A Patient’s Experience, a Doctor’s Thoughts

Preeclampsia is a condition that begins with new-onset high blood pressure after 20 weeks of pregnancy. The Centers for Disease Control and Prevention notes that it affects 5% to 7% of all pregnancies, and is a leading cause of problems during pregnancy.

“It encompasses a spectrum of conditions, some of which are more concerning than others and which can affect many different organs in the body,” says Kristrun Kristinsdottir, MD, a board-certified OB/GYN at AdventHealth Parker. She points out that it can impact organs such as the kidneys, liver, and brain, and even affect blood-clotting factors.

In severe cases, preeclampsia can escalate to dangerously high blood pressure levels, increasing the risk of strokes and seizures. These seizures, known as eclampsia, are a severe form of preeclampsia and can occur with or without previous preeclampsia symptoms, according to the Cleveland Clinic. They can cause confusion, disorientation, and in extreme cases, coma, stroke, or even death. Fortunately, most cases of preeclampsia are managed well before they progress to this severe stage.

“Preeclampsia can develop quietly,” Dr. Kristinsdottir shares, but notes there can be warning signs. These can include high blood pressure, a persistent headache unrelieved by common pain relievers like Tylenol, vision changes such as seeing spots, pain in the upper right abdomen, chest pain, shortness of breath, new or worsening nausea and vomiting, and sudden, significant weight gain and swelling in the hands and face.

Women who have experienced preeclampsia—particularly those who had early or severe cases—face a higher risk of recurrence in future pregnancies. However, many women have healthy pregnancies following a preeclampsia diagnosis. It’s important for women contemplating another pregnancy to discuss their specific risks and health status with their healthcare provider.

Ahead, Dr. Kristinsdottir and Gwen Lee, a 38-year-old who was diagnosed with preeclampsia and later delivered a healthy baby boy, share their experience on managing and understanding preeclampsia.

Preeclampsia risk factors

“It’s not always clear why some women develop preeclampsia, but certain risk factors have been identified,” explains Dr. Kristinsdottir. These risk factors are usually grouped into two categories: high or moderate.

High-risk factors include:

• Having preeclampsia in a previous pregnancy
• High blood pressure outside of pregnancy
• Diabetes
• Kidney disease
• Multifetal pregnancy (twins, triplets, etc.)
• Autoimmune conditions, such as lupus

Moderate risk factors include:

• First-time pregnancy
• A BMI over 30
• Age over 35
• IVF pregnancy
• Previous pregnancy complications, such as having a low birth-weight baby
• A family history of preeclampsia in mother or sister
• Patient is Black
• Lower socioeconomic status

Gwen, who had her first child at 36, was diagnosed with preeclampsia. “Before pregnancy, my blood pressure was always on the higher end of normal. High blood pressure runs in my family … but I was never officially diagnosed or prescribed medication,” she recalls.

How preeclampsia can affect the health of the mother and the baby

“Many different maternal organ systems can be affected by preeclampsia. This can include injury to the kidneys and liver, changes to the blood that can result in decreased ability to clot, strokes, and seizures,” according to Dr. Kristinsdottir. She points out that it also puts mom at a greater risk of high blood pressure even after the pregnancy is over.

Babies, too, face serious risks. “Preeclampsia is often seen in association with poor blood flow through the placenta, and can cause fetal growth restriction, low amniotic fluid, placental abruption, and stillbirth,” she says. Placental abruption, a serious condition where the placenta separates from the uterus, can cause severe pain and bleeding and is life-threatening.

Preeclampsia prevention

Being in your best health before pregnancy is key. Strive for a healthy weight and control any existing high blood pressure using medications safe for pregnancy if needed, advises Dr. Kristinsdottir. She adds, “Women with any high-risk factors or two or more moderate-risk factors…should start low-dose aspirin [81 milligrams] between 12 to 16 weeks after discussing it with their healthcare provider.”

Preeclampsia treatment and management

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“Management can vary widely depending on the severity of preeclampsia. There will typically be more frequent office visits and extra ultrasounds to monitor baby’s growth starting around 28 to 32 weeks,” explains Dr. Kristinsdottir. It’s important for women with preeclampsia or those who have high blood pressure outside of pregnancy to check their blood pressure at home every day and understand when it’s important to call their doctor. In cases of mild preeclampsia, doctors usually recommend inducing labor a few weeks before the due date.

This is what happened to Gwen. “I was induced at 37 weeks. My doctors wanted to monitor the situation as long as possible without risking my health or the baby’s,” she shares. “Although I really hoped to reach my due date, understanding the risks and following my doctor’s advice felt like the safest path.” Besides daily blood pressure checks and frequent ultrasounds to assess the baby’s growth, Gwen also had to undergo urine tests to check for protein—a marker of preeclampsia—and blood tests to evaluate her liver and kidney functions.

“More severe forms of preeclampsia may require admission to the hospital for monitoring of both mom and baby,” Dr. Kristinsdottir adds. Treatment options often include the administration of oral or intravenous blood pressure medications, as well as intravenous magnesium sulfate, which is essential for preventing seizures. Sometimes, an early delivery might also be recommended to ensure the safety of both mother and child.

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