What Is Preeclampsia and Eclampsia?
Preeclampsia is a part of a spectrum of high blood pressure that can occur during pregnancy. A serious, progressing condition that occurs during pregnancy and/or the postpartum period that affects the mother and baby. It generally occurs after 20 weeks of gestation and up to six weeks postpartum. It can prevent the baby from getting enough blood and oxygen and cause harm to the mother’s liver, kidney and brain function. The earlier that preeclampsia begins, the more severe it may be which increases the risk of preterm birth resulting in higher risk of complications for the baby. Preeclampsia is diagnosed by persistent high blood pressure (≥140/90mmHg) and the presence of protein in the urine (proteinuria) or high blood pressure and new development of decreased blood platelets, trouble with the kidney or liver, fluid in the lungs or signs of brain trouble such as seizures (eclampsia). Preeclampsia occurs in approximately 5 – 7% of pregnancies and it is one of the leading causes of maternal and perinatal death.
Signs and Symptoms
In some cases, women do not experience any signs or symptoms of preeclampsia. It can be hard to know what a normal part of pregnancy is and what may be a warning sign. Many women who develop preeclampsia have no warning signs and may feel surprised or frustrated with the diagnosis as they don’t feel “sick”. The following signs and symptoms are associated with preeclampsia and should be communicated with your healthcare provider.
- Swelling of the feet, hands and/or face (especially around the eyes)
- Sudden weight gain
- Severe headache that will not go away even after taking pain medication
- Blurred or altered vision (flashing lights, seeing spots, light sensitivity)
- Sudden nausea or vomiting after mid pregnancy (not morning sickness)
- Abdominal pain on the upper right side
- Shortness of breath or difficulty breathing
- High blood pressure
The risk of preeclampsia does not end even after the baby has been delivered. Whether you have had high blood pressure during pregnancy or not, you are still at risk. It is important to pay attention to how you are feeling and to notify your healthcare provider if you experience any signs and symptoms.
Risk Factors
There is no way to predict or prevent preeclampsia, but some people may be more at risk than others. The list below includes the most significant risk factors for a female developing preeclampsia.
- Hypertension, diabetes, obesity, kidney disease or organ transplants
- Previous history of preeclampsia
- Pregnant with more than one baby
- First pregnancy
- Under the age of 20 or older than 35 years
- Maternal family history of preeclampsia
- Polycystic Ovary Syndrome (PCOS)
- Autoimmune disorders including rheumatoid arthritis, lupus, sarcoidosis and multiple sclerosis
- In-vitro fertilization (IVF)
- Sickle cell disease
There are also some specific paternal risk factors for preeclampsia which include being a first-time father or having previously fathered a preeclamptic pregnancy in another female.
Causes
The exact cause of preeclampsia is still unknown. Current research is investigating several factors that may contribute to the condition. One main theory is that the problems may arise with the implantation of the placenta. The placenta develops in a woman’s uterus during pregnancy and is responsible for providing oxygen and nutrients to the growing baby. When the placenta doesn’t develop the normal network of blood vessels this leads to poor blood flow and can cause complications. Some additional theories include genetic factors, hormone imbalances, inflammation and cardiovascular changes.
Treatment
There is no “cure” for preeclampsia , but it is treatable with medical supervision. Early detection and quick treatment are important for the health of the mother and baby. The mother and baby are monitored throughout the pregnancy and blood pressure is checked often. Medications to lower blood pressure and prevent seizures may be prescribed. The earlier in the pregnancy that preeclampsia develops, the more severe it becomes and there is a greater risk for a preterm birth. Treatment for preeclampsia depends on the health of the mother and the health of the baby and delivery may need to be induced or a c-section may be performed.
What You Can Do
Although the exact cause of preeclampsia is not known many complications and deaths from the disorder can be prevented. Early detection and monitoring are essential. Here is what you can do:
- Attend all your pre-natal appointments for continuous monitoring of your health and the health of your baby.
- Regularly check your blood pressure. This can be done at your pre-natal appointments, but your healthcare provider may ask you to use a home blood pressure monitor as well. Click here to learn more about monitoring your blood pressure.
- Monitor yourself and contact your healthcare team immediately if you have any signs and/or symptoms. Continue to be aware of the signs and symptoms and check your blood pressure in the post-partum period. Use the Pregnancy Passport Tool to help you track.
- Maintain physical activity. Pregnant women should aim for 30 minutes of moderate activity most days of the week. However, with some complications such as high blood pressure and preeclampsia it may not be recommended. Consult with your healthcare team before engaging in physical activity.
- Aim for a healthy diet of fruits and vegetables, whole grains, healthy fats, and protein (lean meats and/or plant based). Choose items that are high in salt, sugar and fat less often.
Preeclampsia And Heart Disease
Although most women who develop preeclampsia will recover and deliver healthy babies, there are lasting complications. Preeclampsia doubles the risk of a woman having cardiovascular disease over the next 15 years. This risk increases with the number of pregnancies a woman has had where preeclampsia occurred. Currently, cardiovascular disease (CVD) is on the rise and is leading cause of death for women worldwide.
The precise reason why preeclampsia increases the risk of CVD is still unknown. One main theory as to why the increased risk occurs is that pregnancy is a “stress test” for the heart and that the development of preeclampsia or other hypertensive conditions during pregnancy identifies a woman who was destined to develop CVD. Another supported theory is that damage to the blood vessels during hypertensive pregnancy may speed up the process of atherosclerosis (hardening of the arteries from plague build-up).
There are several risk factors for developing preeclampsia such as high blood pressure, diabetes, excess body weight, PCOS, auto-immune disorders which are also risk factors for developing heart disease for women. The good news is that health behaviours play a leading role in cardiovascular health, and it is estimated that 80-90% of premature heart disease can be prevented with lifestyle modifications.
Know Your Risk
Speak to your healthcare provider. Inform your healthcare provider about your pregnancy history, including the number of pregnancies, history of preeclampsia, gestational hypertension and/or diabetes, number of miscarriages and/or stillbirths, babies born early or small size. It is also important to note any family history of preeclampsia or high blood pressure, high cholesterol, or heart disease. Don't have a healthcare provider or need help interacting with your healthcare provider? Click here to learn more.
Know your numbers. It is recommended that women who have had preeclampsia be routinely screened for risk of CVD. This includes checking blood pressure, cholesterol, and glucose levels. Use the Pregnancy Passport Tool to help you track.
Reduce the Risk
There are a number of lifestyle factors that help reduce the risk of heart disease. You can improve your chances of being heart healthy by being aware of the risks and keeping the following factors in optimal range.
- Smoking cessation. Quitting smoking is the most important thing you can do to positively affect your heart health. It is never too late to quit.
- Get moving. Aim to engage in at least 150 minutes of moderate to vigorous exercise every week. That is an average of 30 minutes per day and can be broken down to as little as 10 minutes at a time.
- Follow a healthy heart diet. Look to incorporate lots of fruits and vegetables, whole grains, lean meat and/or plant-based proteins into all your meals. Reduce the number of foods that have high saturated fat and high salt content.
- Aim to achieve your best weight. Best weight is the weight you can maintain when living the healthiest life you are able.
- Reduce your alcohol intake. Less is best. We recommend you do not drink alcohol. But if you do, no more than 2 drinks/day or 6 drinks/week.
- Manage stress. Make time for yourself and discover what helps you relax. Stay connected to others and seek support if stress becomes a concern.