Preeclampsia – What is it? How is it diagnosed? What are the signs and symptoms? Did I do something to cause it?
A million thoughts will go through your mind the minute your doctor mentions the dreaded word “preeclampsia.” The first thing to remember is this: DON’T PANIC. Remember that no matter what, the most important thing is to stay calm and keep your stress level down. Trust the medical professionals… they see this every day.
MY STORY: Around 24 weeks, I started noticing that my blood pressure was higher than usual at my prenatal appointments. My doctors told me that they would just continue to monitor it over the next few weeks.
At 25 weeks, I noticed increased anxiety and feeling “shaky” at work. I checked my blood pressure several times and it ranged from normal to 165/100. I called my doctor and made an appointment. The next day, I felt the same uneasiness at work and checked it again. It was 189/110. My doctor advised me to go straight to the hospital for observation and testing.
At the hospital, I had elevated protein in my urine, but it was not indicative of preeclampsia yet, and my 24 hour urine collection a few days later was normal. Over the next few weeks, I was pulled out of work indefinitely, put on strict bed rest, started taking blood pressure medication, and had numerous tests. My EKG was abnormal, and the echocardiogram showed enlargement of my heart consistent with chronic high blood pressure. I have never had high blood pressure in the past, so this was new for me.
My doctors believe that it is directly related to pregnancy, but I will have follow-up testing postpartum to see if it resolves. My body stabilized after a few weeks of bed rest. Once I removed the biggest stressor in my life – WORK – and took time to relax, my body began to take care of itself again. I am currently 35 weeks and my blood pressure is still stable, with no other symptoms of preeclampsia at this time. Now, that doesn’t mean that I can’t or won’t develop it in the next few weeks, but for now it is not a concern.
Let’s take a closer look at preeclampisa.
Preeclampsia is a rapidly progressive condition that occurs after 20 weeks and up to six weeks postpartum (after delivery). Although it is rare, it can also occur earlier than 20 weeks.
The cause of preeclampisa remains unknown.
Below is a list of signs and symptoms; click on the hyperlink for more information about each.
- No symptoms – Sometimes occurs with rapidly advancing preeclampsia
- High Blood Pressure (Hypertension) – One of the biggest red flags that preeclampsia may be developing. Typical normal BP in pregnancy is 140/90 or lower.
- Proteinuria – Protein in your urine due to normal proteins inability to be filtered by your kidneys, thus spilling into your urine. A reading of 1 + or greater may signify the onset of preeclampsia, even if your blood pressure is normal.
- Swelling (Edema) – Swelling is very common in pregnancy and is usually no cause for alarm. Edema on the other hand, is the accumulation of fluid and can be concerning if it occurs in your face or hands.
- Headache – Headaches are common during pregnancy as well, due to the influx of hormones. A headache that is dull, severe, or will not go away despite the help of medications may be a concern, especially if accompanied by vision changes.
- Nausea or Vomiting – Some women experience “morning sickness” throughout your pregnancy. Nausea or vomiting may be related to preeclampsia if the onset is sudden and happens after mid-pregnancy.
- Abdominal and/or Shoulder Pain – This type of pain is called epigastric pain or upper right quadrant pain, located on the right side under the ribs. Shoulder pain can occur due to referred pain from under the ribs and often feels like pinching. All of these pain symptoms may be a sign of HELLP syndrome or a related problem in the liver.
- Lower back pain – Lower back pain is very common in pregnancy, but it can indicate liver issues if accompanied by other symptoms of preeclampsia.
- Sudden Weight Gain – Weight gain of more that 2 pounds per week may signify preeclampsia due to damaged blood vessels allowing fluid to leak and accumulate in your body’s tissues.
- Changes in Vision – Vision changes are one of the most serious symptoms of preeclampsia and must be reported to your healthcare provider immediately. Common vision changes include flashing lights, auras, light sensitivity, spots, or blurry vision. These symptoms may be associated with central nervous system irritation or can be an indication of swelling of the brain (cerebral edema).
- Hyperreflexia – When your knee is tapped with a rubber hammer and your leg bounces back hard, it could indicate an overreaction of the involuntary nervous system to stimulation.
- Shortness of Breath, anxiety – Shortness of breath, a racing pulse, mental confusion, a heightened sense of anxiety, and a sense of impending doom can be symptoms of preeclampsia. If these symptoms are new to you or have a sudden onset, they could indicate an elevated blood pressure, or more rarely, fluid collecting in your lungs (pulmonary edema).
Advice from an RN:
There is not much you can do to prevent preeclampisa. It can happen to anyone, even if you have done everything right. Below are a few things you can do to optimize your health during your pregnancy.
- Good prenatal care is important for early diagnosis of preeclampsia and any other conditions related to pregnancy. In addition, it allows you to ask questions and become comfortable with your providers.
- A diet full of vitamins and minerals, prenatal vitamins, and folic acid are essential in the development of your baby and should be started BEFORE conception or as soon as possible afterwards. Eat plenty of protein and drink plenty of water to stay hydrated.
- Avoid soft cheeses, unwashed produce, deli meats (unless heated until steaming), and raw meats and fish due to the risks of listeria.
- Eliminate drugs and alcohol immediately, and eliminate or limit caffeine intake.
- REST and RELAX! Some healthcare providers will recommend bed rest, but it may not make a difference with preeclampsia. The theory is that it may help limit stressors and keep your blood pressure down. This was exactly the case for me.
- Exercise regularly, even if it’s just an evening walk a few times a week. Begin pelvic floor exercises to help you prepare for delivery
- Avoid heavy lifting, harsh chemicals, standing for long periods of time, and changing the kitty litter box.
- Avoid saunas, hot tubs, and hot baths. If it is hot enough to raise your body temperature, it will also raise your baby’s temperature.
- Educate yourself about pregnancy. It can be a scary time and your body is constantly changing. If you are unsure of something, ask your health care provider.