What is Preeclampsi?

Preeclampsia is the development of elevated blood pressure and protein in the urine after the 20th week of pregnancy. It may be associated with swelling of the face and hands. Types of:
Causes and Risk Factors Return to top
The exact cause of preeclampsia is not known. Many unproved theories of potential causes exist, including genetic, dietary, vascular (blood vessel), and autoimmune factors. Preeclampsia occurs in approximately 8% of all pregnancies. Increased risk is associated with first pregnancies, advanced maternal age, African-American heritage, multiple pregnancies, and a past history of diabetes, high blood pressure, or kidney disease. Symptoms Return to top

Edema (swelling of the hands and face present upon arising)
Weight gain
In excess of 2 pounds per week
Of sudden onset, over 1 to 2 days
Headaches
Note: Some swelling of the feet and ankles is considered normal with pregnancy. Additional symptoms that may be associated with this disease:
Decreased urine output
Nausea and vomiting
Facial swelling

High blood pressure
Agitation
Vision changes (flashing lights in the eyes)
Abdominal pain
Signs and tests Return to top
Documented weight gain
Swelling in the upper body
Elevated blood pressure
Proteinuria (protein noted in urine)

Thrombocytopenia (platelet count less than 100,000)
Elevated liver function tests
Preeclampsia may also alter the results of some laboratory tests. Treatment
Return to top
Currently, the only way to cure preeclampsia is to deliver the baby. However, if that delivery would be very premature, the disease may be managed by bed rest, close monitoring, and delivery as soon as the fetus has a good chance of surviving outside the womb. Patients are usually hospitalized, but occasionally they may be managed on an outpatient basis with careful monitoring of blood pressure, urine checks for protein, and weight. Optimally, attempts are made to manage the condition until a delivery after 36 weeks of pregnancy can be achieved. Labor may be induced if any of the following occur:

Diastolic blood pressure greater than 100 mmHg consistently for a 24 hour period, or any confirmed reading over 110 mmHg
Persistent or severe headache
Abdominal pain
Abnormal liver function tests
Rising serum creatinine
HELLP syndrome
Pulmonary edema (fluid in lungs)
Eclampsia
Thrombocytopenia (low platelet count)
Non-reassuring fetal monitoring tracings
Failure of fetal growth noted by ultrasound

Abnormal biophysical profile (a test to monitor the health of the fetus) In cases of severe preeclampsia when the pregnancy is between 32 and 34 weeks, delivery is the treatment of choice. For pregnancies less than 24 weeks, the induction of labor is recommended, although the likelihood that the fetus will survive is very small. Prolonging pregnancies has been shown to result in maternal complications, as well as infant death in approximately 87% of cases. Pregnancies between 24 and 34 weeks gestation present a “gray zone,” and the medical team and the parents may decide to attempt to delay delivery in order to allow the fetus to mature. During this time, the mother is treated with steroid injections which help speed the maturity of some fetal organs including the lungs. The mother and baby are closely monitored for complications. During induction of labor and delivery, medications are given to prevent seizures and to keep blood pressure under good control. The decision for vaginal delivery versus Cesarean section is based on how well the fetus is able to tolerate labor. Expectations (prognosis) Return to top

Maternal deaths caused by preeclampsia are rare in the U.S. Fetal or perinatal deaths are high and generally decrease as the fetus matures. The risk of recurrent preeclampsia in subsequent pregnancies is approximately 33%. Preeclampsia does not appear to lead to chronic high blood pressure. Complications Return to top

Preeclampsia may develop into eclampsia, the occurrence of seizures. Fetal complications may occur because of prematurity at time of delivery. Calling your health care provider Return to top
Call your health care provider if symptoms occur during pregnancy. Prevention Return to top
Although there are currently no known prevention methods, it is important for all pregnant women to obtain early and ongoing prenatal care. This allows for the early recognition and treatment of conditions such as preeclampsia.