Pre-eclampsia
(Toxemia of Pregnancy; Pregnancy-induced Hypertension; Preeclampsia)
Definition
Pre-eclampsia is a problem in pregnancy that leads to very high blood pressure. It can also lead to kidney and liver damage.
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Causes
The cause is not known.
Risk Factors
Pre-eclampsia is more common in women who have not given birth before. Other things that may raise the risk of this problem are:
- Problems with the immune system, such as lupus
- Pre-eclampsia in a prior pregnancy
- Chronic kidney disease
- Diabetes
- Chronic high blood pressure
- Being pregnant with more than 1 baby
- Being overweight or obese
Symptoms
A woman may not have symptoms. Those who do 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
The doctor will ask about symptoms and past health. A physical exam will be done. Pre-eclampsia is diagnosed if you have high blood pressure.
Other tests that may be done are:
- Urine tests to look for high protein levels
- Blood tests to check for low levels of platelets that are needed to help with blood clotting
Treatment
The only way to cure this condition is to deliver the baby. The decision to do so is based on how far along the pregnancy is.
If it is safe, labor may happen on its own or it may be started by the doctor. Delivery may need to be delayed so the baby has more time to grow.
If the baby needs more time and pre-eclampsia is mild, it may be managed by:
- Bed rest and monitoring at home or in the hospital
- Medicines to lower blood pressure
- Medicine to help the baby's lungs develop faster
Prevention
An aspirin or a calcium supplement may lower the risk of 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:
Women's Health Matters
https://www.womenshealthmatters.ca
The Society of Obstetricians and Gynaecologists of Canada
http://sogc.org
REFERENCES:
High blood pressure during pregnancy. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/high-blood-pressure-during-pregnancy. Accessed October 15, 2020.
Hypertensive disorders of pregnancy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypertensive-disorders-of-pregnancy. Accessed October 15, 2020.
Leeman L, Fontaine P. Hypertensive disorders of pregnancy. Am Fam Physician 2016 Jan 15;93(2):121-127.
Preeclampsia and high blood pressure during pregnancy. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy. Accessed October 15, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Elliot M. Levine, MD, FACOG Last Updated: 4/27/2021