Pre-eclampsia

(Toxemia of Pregnancy; Pregnancy-induced Hypertension; Preeclampsia)

Pronounced: pre-ee-clamp'-see-ah

Definition

Pre-eclampsia is high blood pressure during pregnancy. You may also have too much protein in your urine. This condition can harm your organs.

Cardiovascular System and Kidneys

Woman with BP
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Causes    TOP

The cause is unknown.

Risk Factors    TOP

Pre-eclampsia is more common in women aged 40 years and older.

Other factors that may raise your chance are:

  • Pre-eclampsia in a prior pregnancy
  • Antiphospholipid antibody syndrome
  • Diabetes
  • Carrying multiple babies such as twins
  • First pregnancy
  • Chronic high blood pressure
  • Overweight or obese

Symptoms    TOP

You may not have symptoms. If you do have symptoms, you may have:

  • Rapid weight gain
  • Swelling of the hands and face
  • Headaches
  • Problems seeing
  • Nausea and vomiting
  • Upper belly pain
  • Overactive reflexes
  • Chest pain
  • Problems breathing

Diagnosis    TOP

The doctor will ask about your symptoms and health history. A physical exam will be done. Preeclampsia is diagnosed if you have high blood pressure.

You may also have:

  • Urine tests to look for high protein levels
  • Blood tests

Treatment    TOP

Early treatment can help prevent eclampsia, which is seizures caused by severe pre-eclampsia.

You may have:

Delivery of the Baby

The only way to cure this condition is to deliver the baby. The decision to do so depends on many things, such as:

  • How many weeks along you are in your pregnancy
  • The health of you and your baby
  • Severity of the pre-eclampsia
  • Risk of other problems

Labor may happen on its own or it may be started by your doctor. If there are life-threatening problems for either you or your baby, a cesarean section may be done. During labor, you may need medicine to control your blood pressure and prevent seizures.

Medication

Mild pre-eclampsia can often be managed with rest and medicine if the baby is close to term. Your doctor may advise medicines to:

  • Lower your blood pressure
  • Lower the risk of seizures
  • Help the fetus’ lungs develop if there is a chance it may be born too early

Home Treatment    TOP

If you live close to the hospital, your doctor may advise that you rest at home in a quiet setting. At home, you may need to:

  • Taking frequent blood pressure readings
  • Have help to make meals, do housework, and care for other children you may have
  • Check your baby's health, which may mean:
    • Watching for fetal movement
    • Tracking kick counts
    • Follow-up visits to monitor conditions inside the uterus

Admission to the Hospital    TOP

If pre-eclampsia is moderate or your home setting is not restful, the doctor may admit you to the hospital. This may mean:

  • Lowering your blood pressure with medicine
  • Taking medicines to prevent eclampsia
  • Monitoring your baby's health
  • Making sure you get enough rest

Prevention    TOP

If you have had pre-eclampsia in the past, ask your doctor whether you should take aspirin. It has been shown to prevent this health problem in women who are at risk.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

The Canadian Women's Health Network
http://www.cwhn.ca
The Society of Obstetricians and Gynaecologists of Canada (SOGC)
http://sogc.org

References:

Hypertensive disorders of pregnancy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 30, 2018. Accessed August 9, 2018.
Kumar A, Devi SG, Batra S, Singh C, Shukla DK. Calcium supplementation for the prevention of pre-eclampsia. Int J Gynaecol Obstet. 2009;104(1):32-36.
Preeclampsia and high blood pressure during pregnancy. The American College of Obstetricians and Gynecologists website. Available at:
...(Click grey area to select URL)
Updated May 2018. Accessed August 9, 2018.
Pregnancy-induced hypertension. American Academy of Family Physicians Family Doctor website. Available at:
...(Click grey area to select URL)
Updated April 1, 2014. Accessed August 9, 2018.
Samuels-Kalow ME, Funai EF, Buhimschi C, et al. Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality. Am J Obstet Gynecol. 2007;197(5):490.e1-e6.
7/6/2006 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Villar J, Abdel-Aleem H, Merialdi M, et al. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. Am J Obstet Gynecol. 2006;194(3):639-649.
8/6/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Bujold E, Roberge S, Lacasse Y, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116(2 Pt 1):402-414.
6/9/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Qin JZ, Pang LH, Li MJ, Fan XJ, Huang RD, Chen HY. Obstetric complications in women with polycystic ovary syndrome: A systematic review and meta-analysis. Reprod Biol Endocrinol. 2013;11:56
Last reviewed June 2018 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG
Last Updated: 8/9/2018

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