Why Preeclampsia Monitoring is an Important Part of Prenatal Care
By Michele Godorecci, MD, Virtua OB/GYN
Preeclampsia is a pregnancy complication that can cause life-threatening complications for expectant moms, including water in the lungs, stroke, heart failure, bleeding problems, kidney failure and liver failure. It also can cause a condition called placental abruption, which occurs when the placenta detaches suddenly from the wall of the uterus. If left untreated, preeclampsia can affect your baby’s growth and lead to a condition called eclampsia, which causes seizures.
Because the only cure for preeclampsia is to deliver the baby, preeclampsia is one of the leading causes of preterm delivery. It typically goes away within a few weeks after delivery.
Although routine preeclampsia screening is an important part of each prenatal visit, understanding the condition can help you to spot potential problems so you can bring them to you provider’s attention.
What causes preeclampsia and who is at risk?
The exact cause of preeclampsia is unknown. However, researchers believe preeclampsia may be the result of problems in the placenta, which attaches to the wall of the uterus and provides oxygen and nutrients to your unborn baby.
First-time expectant moms, expectant moms who are teens or who are older than age 40, and moms who are carrying more than one baby are at a higher risk of developing preeclampsia. You may be at a higher risk for developing preeclampsia if you have a history of diabetes, high blood pressure, kidney problems, lupus or rheumatoid arthritis or a personal or family history of preeclampsia.
What are preeclampsia signs and symptoms?
There are three main symptoms of preeclampsia:
- High blood pressure
- Excess protein in the urine
- Sudden weight gain or abnormal swelling in the face and hands
Preeclampsia typically occurs after the 20th week of pregnancy, but can occur earlier. In rare cases, preeclampsia can develop after childbirth.
A blood pressure reading that exceeds 140/90 mmHg in an expectant mom who has no history of high blood pressure is usually the first sign of preeclampsia. High blood pressure can develop over time or suddenly. Preeclampsia also can cause rapid weight gain or sudden, new swelling in your face or hands. Other signs of preeclampsia include:
- Abdominal pain on the upper right side
- Decreased urination
- Nausea or vomiting
- Severe headaches
- Vision changes, including sensitivity to light, blurred vision, floaters or temporary vision loss
If you notice any of these symptoms, you should bring them to the attention of your provider right away. However, it’s possible to have preeclampsia and not have any noticeable symptoms. It’s important to go to every prenatal appointment and have routine preeclampsia screenings.
How is preeclampsia diagnosed?
During each prenatal visit, your prenatal care provider will check your blood pressure to make sure it’s within normal ranges and test a sample of your urine for the presence of excess protein. Your provider also will monitor your weight gain and look for signs of abnormal swelling.
If your provider detects protein in your urine, you may be asked to collect urine samples over a 24-hour period to determine how much protein your body is losing. If you’re showing any symptoms of preeclampsia, your provider also may order blood tests to see how your liver and kidneys are functioning and look for other problems.
How is preeclampsia treated?
Preeclampsia can only be cured by delivering your baby. However, your treatment will depend on the severity of your condition, the health of your unborn baby and how close you are to a full-term pregnancy.
If you have reached the 37-week mark in your pregnancy, your baby likely will be developed enough to be safely delivered. In this case, your provider may recommend inducing labor or performing a cesarean section (C-Section) to prevent your preeclampsia from progressing.
Prior to the 37-week mark in your pregnancy, your provider will attempt to treat the preeclampsia and give your baby as much time as possible to develop in your womb. If you have mild preeclampsia, your provider likely will put you on restricted activity or bed rest and monitor your condition with frequent blood pressure checks and blood and urine tests. Your provider also will monitor your baby’s condition through regular ultrasounds and fetal heart rate monitoring.
If you need additional monitoring, your doctor may admit you to the hospital. You may receive a medication called magnesium sulfate through an intravenous (IV) line to protect your brain from seizures. Your provider also may give you steroid injections to speed up the development of your baby’s lungs and reduce your baby’s risk of complications related to preterm delivery. In the instance that a patient’s blood pressure is high enough to put her at risk for a stroke, the doctor will administer medication and deliver the baby immediately.
If you’re experiencing severe preeclampsia, your doctor may need to deliver your baby immediately.
Having routine preeclampsia screenings at your prenatal visits and knowing the warning signs can help prevent serious complications for you and your baby.
Learn more about prenatal care, or call 1-888-VIRTUA-3 to schedule an appointment with a Virtua OB/GYN.
Updated March 5, 2018