Understanding preeclampsia: Symptoms, causes and treatment

Preeclampsia is a pregnancy complication characterized by high blood pressure and, in some cases, signs of injury to organs like the liver and kidneys. It is usually not seen until after 20 weeks of pregnancy and when left untreated, it can lead to serious — sometimes fatal — complications for both the mother and the baby. Read on to explore the symptoms, causes and treatment options for preeclampsia and to gain a better understanding of this complex condition.

What is preeclampsia?

Preeclampsia (previously called toxemia) affects roughly 5-8% or 1 out of every 12 to 20 pregnant women, typically in the second half of their pregnancy or immediately after delivery. It's marked by a sudden increase in blood pressure and signs that some organs, most commonly the kidneys and liver, may not be working properly.

Preeclampsia symptoms

The signs and symptoms of preeclampsia can be subtle and may seem like normal pregnancy complaints, but they can quickly become severe. Common symptoms include:

• High blood pressure
• Swelling of extremities, such as hands and feet
• Excess protein in the urine or other signs of kidney problems
• Severe headaches
• Changes in vision, including temporary loss of vision, blurred vision or sensitivity to light 
• Upper abdominal pain, usually under the ribs on the right side
• Nausea or vomiting
• Decreased urine output
• Decreased levels of platelets in your blood (referred to as thrombocytopenia)
• Impaired liver function
• Shortness of breath caused by fluid in the lungs

Preeclampsia risk factors

Certain factors can increase the risk of developing preeclampsia, including:

• History of preeclampsia
• First pregnancy
• New paternity (each pregnancy with a new partner)
• Age (under 20 or over 35)
• Obesity
• Pregnancy with multiples (twins, triplets, etc.) 
• History of certain conditions, such as chronic high blood pressure, migraines, type 1 or type 2 diabetes, kidney disease or organ transplant
• In vitro fertilization
• Family history of preeclampsia

What causes preeclampsia?

While the exact causes of preeclampsia are not fully understood, it's believed to involve several factors. Here are some of the known potential causes:

Placental development issues

Preeclampsia often starts with issues in the development of the placenta early on in pregnancy. Blood vessels that fail to develop or change properly with pregnancy may restrict blood flow to the placenta, leading to the onset of preeclampsia.

Genetic factors

There may be certain genes that predispose a woman to developing preeclampsia. Research continues to explore these genetic connections.

Immune system factors

Research shows some women may have particular immune system responses to the father's sperm, the placenta or the baby that contributes to the development of preeclampsia.

Chronic medical conditions

Preeclampsia is more common in women who have certain chronic medical conditions, such as diabetes and high blood pressure.

Other factors

In some cases, other contributing factors may lead to preeclampsia, including blood vessels damage prior to pregnancy, a diet low in certain nutrients (like vitamin D and calcium), insulin resistance, obesity and excessive gain during pregnancy.

Preeclampsia complications

Preeclampsia poses serious risks to both the mother and the baby. If left untreated, it can lead to the following complications:

• HELLP syndrome, which is a more severe form of preeclampsia that affects the blood and liver
• Eclampsia, which is preeclampsia that leads to seizures
• Premature birth
• Low birth weight
• Placental abruption
• Cardiovascular disease
• Organ damage or failure

Managing preeclampsia

Managing preeclampsia involves proper monitoring and treatment to ensure the safety of both the mother and baby throughout pregnancy. Pregnant women should attend all prenatal appointments as their providers will check for any potential blood pressure concerns and can test urine samples as needed for the presence of protein. Monitoring for preeclampsia symptoms is essential, especially during the second half of pregnancy.

How to treat preeclampsia

The only definitive treatment for preeclampsia is the delivery of the baby. However, when preeclampsia develops early in pregnancy, delivery might not be the best option. Other treatments could include:
 

• Medications to lower blood pressure
• Hospitalization to carefully monitor both mother and baby 
• Antenatal (prior to birth) corticosteroids given to the mother to prevent respiratory complications for the baby if early labor occurs and to help stabilize the baby’s brain and intestinal blood vessels

“For individuals with certain risk factors, your midwife or doctor may recommend a nightly baby aspirin to help prevent preeclampsia and its complications. Your provider will work with you to determine the safest, best treatment options for you and your pregnancy.” – Kenneth Merkitch, MD, Gundersen Obstetrics & Gynecology

While medical treatment may be essential, some lifestyle and home remedies can also support health during preeclampsia, such as:
 

• Resting and lying on the left side to take the weight of the baby off major blood vessels in the body
• Drinking plenty of water and staying hydrated 
• Eating less salt
• Avoiding unhealthy and fried foods

Preeclampsia is a complex pregnancy-related disorder with potentially significant risks for both mother and baby. Understanding the symptoms, risk factors, causes and treatment options can help expectant mothers and their healthcare providers manage this condition effectively. If you're pregnant, it's crucial to attend all prenatal appointments and to communicate any concerns to your provider immediately. With careful management, many women with preeclampsia can go on to deliver healthy babies.

Visit Gynecology | Gundersen Health System for more information and to connect with a Gundersen provider. Click here for more helpful support, information and educational resources on maintaining a healthy pregnancy.