5 Things You Need to Know About Preeclampsia

You’ve maybe heard about preeclampsia, but you’re not sure why you should know about it, or why it might apply to you? Today I want to share 5 things that every pregnant person should know about preeclampsia. We’re going to talk about decreasing your risk from it, how to know if you have it and how it can have long-term consequences if not solved.

Before we get going, I truly think that preeclampsia is one of the biggest things that can make a change to your birth plan. Knowing about unexpected or unplanned events is one of the things that can really make your birth better. Taking a class that reviews common things that happen in labor, but aren’t planned for is so smart. I recommend this one.

Ok, let’s get going.

Aspirin Can Decrease Your Risk

This one’s for my friends who are still early in your pregnancy. You want to start this prior to 20 weeks (but talk with your provider about you and your specific needs).

Low-dose aspirin is recommended to be given to pregnant woman who are at risk of preeclampsia. The list of who’s at risk is long, and is sometimes shifting, so I’ll leave that up to a discussion between you and your provider.

It is not recommend for EVERY pregnant patient, and in fact — some should NOT be taking it. BUT, your provider should go through some specifics to decide if it is right for you. If they haven’t please ask them about it. Some of it is based on your current medical history, as well as a family history — so they need to ask the questions.

Studies have proven that in those of risk of preeclampsia aspirin can decrease your chances of getting preeclampsia — meaning:

• You get it later in pregnancy (allowing baby to grow longer inside)
• You get it less bad (meaning we don’t have to treat you as vigorously)
• You don’t get it at all vs without aspirin.

Now, aspirin is something we USED To say was a big no-no during pregnancy, so I’m really grateful for the studies on it. I did a whole podcast episode on it if you want more info (it’s not long).

This is a big soapbox for me, because it’s SUCH a change from when our moms were pregnant. Just like how we started laying babies on their back it is something we all have to talk about and discuss with our pregnant friends until this is normal. Yes, your mom may freak out when you tell her you’re on aspirin, but let’s all work together to educate each other!

The crazy part about aspirin is that we really don’t monitor for preeclampsia until about after 20 weeks — while it’s always worthwhile to talk to your provider about the symptoms we’ll talk about in here, we generally don’t think preeclampsia until after 20 weeks (and honestly, usually later).

Want to know more early pregnancy tips — check out these posts:

• 5 Do’s and Don’ts of the First Trimestser
• When to Announce Your Pregnancy
• 10 Things to Do When You Find-Out You’re Pregnant
• The Fear of Miscarriage or Loss
• Should You Buy Your Own Fetal Doppler?

BTW want other awesome tips like this that can make pregnancy easier, come join my newsletter:

Want to know more about preeclampsia — the signs, symptoms and treatment << that post on my sister site has a ton more info! It goes a bit more in-depth as to what it DOES to your body.

It Is Easily Detected

Some providers act like it’s a huge deal to test for, but it’s not.

If you are having symptoms of preeclampsia which include:

• Blurry Vision
• Headaches that don’t go away with Tylenol, hydration and sleep
• Right sided pain under your ribs

Most often in the doctor’s office they find it with a blood pressure check which triggers us checking other things — it can be a symptom of preeclampsia (but not always) and we will talk more about that.

Fun Facts: Swelling used to be a symptom, but it’s not really anymore — however if you notice suddenly you are VERY swollen when you wake up, I’d definitely call your provider — especially facial swelling. Swelling up after a long day on your feet, or swelling that happens daily tends to just be a symptom of pregnancy, not so much preeclampsia.

If you’re in the second half of your pregnancy, and having symptoms — they should be willing to do some preeclampsia labs. Most places call this a PIH panel (PIH is an anacronym that we used to use for preeclampsia, not anymore). It includes (although every facility varies a bit by what they order):

• A urine test to check for protein in your urine (sometimes just a urine test, or sometimes it’s a protein creatinine ratio check)
• A CBC to check platelets and for anemia
• A CMP (complete metabolic panel) or something that checks for liver enzymes and uric acid.

If you’re in the hospital to get the check (along with an NST) we’ll do blood pressures every 15 minutes or so to check it a few times as you lay in different positions (we call these serial blood pressures).

It can be helpful to remember that these labs are looking for HELLP syndrome which stands for:

• Hemolysis — destruction of blood cells which can lead to anemia and organ damage if left unchecked
• EL — elevated liver enzymes — because your liver function is being effected
• LP – lowered platelets — which can cause bleeding issues

This always reminded me that the big things we look for in those labs are:

• Liver Enzymes –are they elevated? This shows your liver is being compromised by the condition (and may enlarge — which is why you get that right sided pain)
• Platelets — are they low?
• Uric acid — is it increased (it rises due to how your kidneys filter urine if you have preeclampsia)
• Are you spilling protein in you urine, and if you are what’s the protein creatinine ratio (some places still do a 24-hour urine but it’s SO inconvenient, I don’t know why they don’t use that protein/creatinine ratio) — this also increases as your kidneys change how they filter with preeclampsia

All of those lab tests can be done at most labs, they don’t have to be sent out and are ordered VERY frequently.

In fact, often at the Dr’s office they can at least spot check your urine for protein, and they check your blood pressure. That’s a start.

While you can have preeclampsia with “normal” blood pressure, most often you’ll see it rise from what your baseline is (so, if you started off low, and now it’s a bit above what’s “normal” — that’s an increase for you and should be noted).

It is also possible to have preeclampsia with a normal blood pressure (but you’d have other symptoms and the lab work will show it).

All of this to say that lab work can really give us the full picture of if or how it is affecting your body.

One thing I’ve heard a lot of experienced practitioners say is that if the patient is saying “this is the worst headache of my life” we really need to take it seriously and it is often due to preeclampsia — if your headache is that, PLEASE contact your provider right away.

It’s not JUST High Blood Pressure

If you have high blood pressure, but all your labs are normal — that’s gestational hypertension (hypertension is just a fancy word for high blood pressure). This can often be helped with medications like Labetalol or Hydralazine — both of which are blood pressure meds routinely given to people to lower their blood pressure.

While also not great, high blood pressure isn’t just a sign of preeclampsia.

Note: If your blood pressure is elevated, but your labs come back fine — your provider should be considering blood pressure medication for you. As you can imagine just having high blood pressure for days on end isn’t great for your system, especially when medications can be effective in lowering it. If they don’t, I think it’s worth asking about.

Sometimes this high blood pressure starts to resolve once baby is born, or you may end-up with longer term hypertension — so, that’s definitely something to keep an eye on. They should be checking it after baby is born as well.

ONE high blood pressure doesn’t mean that you have high blood pressure. Mine was always high first thing in the office. I think I just found being called back stressful (often with a child in tow) — but if they’d take it after I settled into the room for a bit it was fine. However, it’s always something to keep an eye on.

It Can Be a Reason to Deliver Early

Preeclampsia is one of the most frequent reasons that we induce people early.

It is believed the MOST often preeclampsia is resolved by removal of the placenta. That doesn’t mean it’s immediately resolved, but that is the best “cure” for it. It can still show-up later-on (keep reading for more info on that).

The other things we do are just to manage to keep you and baby healthy through the remains of your pregnancy.

Really quickly, I’m going to talk about how we treat preeclampsia, but this section may not be for everyone. Some of you may want to just skip to the next heading. If you have no signs of preeclampsia, I don’t think there’s any reason to dive into the treatments if it makes you worried.

In case you’re wondering, the main treatment of preeclampsia is magnesium sulfate via IV in the hospital. It’s definitely not my favorite drug. It can make you feel pretty hot and miserable, but it helps your blood vessels relax so we don’t head into eclampsia — which is when you start seizing. We are trying to avoid that at all cost.

Any Downton Abby fans out there? — that’s what Lady Sybil had.

They may also give you high blood pressure medications if your blood pressure is high.

And, they will induce you to get the baby out. If things are extreme enough they may recommend a cesarean section because they think getting baby out fast is the best thing for you and baby.

Want to know more about inductions — check out these posts:

• 5 Things NOT to do Before Your Induction
• Pitocin to Induce Labor
• 5 Reasons to NOT Get Induced
• What to Expect at A Foley Bulb Induction
• What Happens if Your Induction Doesn’t Work?

It Can Show-Up Postpartum Too!

One of the MOST annoying parts of preeclampsia is that even though we think it’s best treatment is to get the baby OUT — it can still show-up postpartum.

EVEN IF YOU DIDN’T HAVE ANY SIGNS OR SYMPTOMS OF IT DURING PREGNANCY.

Did you see I put that part big and in cap’s? Because I really mean it.

EVERYONE needs to watch out for it postpartum. The signs are the same as above.

• Blurry Vision
• Headaches that don’t go away with Tylenol, hydration and sleep (especially that “worst headache of my life part”)
• Right sided pain under your ribs

Too often moms ignore the signs in themselves because they’re so busy watching out for the baby.

I recommend that EVERY pregnant family know the signs and symptoms of problem signs postpartum so everyone can be watching out for them.

The good news? You don’t have to wait to be discharged from the hospital to learn them. I go through them in Postpartum Care Made Easy. I think pregnant patients, partners and even grandparents or other support people should run through the symptoms so they know them. I’ll send them all right to you (it’s free):

I really do believe that preeclampsia is something that catches a LOT of people off-guard. It is most often found in generally healthy individuals who haven’t had serious health problems prior to pregnancy — so it really catches you unaware it can be as big of an issue as it can be.

Honestly, there’s a lot in pregnancy, and third trimester testing (like PIH labs) that catches people off-guard — but it doesn’t need to.

You have the time to get prepared and I 100% recommend you do so. I recommend this class. It isn’t going to take over your life, it encourages partners to come learn too and it’s taught by an expert you can trust to get you prepared.

Oh, and it includes three whole sections on both what to expect postpartum and staying vigilant for problem signs, because far too many moms are dying from things we can prevent. I’m here to help those, one pregnant couple at a time.

Ok, those are the 5 things. I wanted to keep it simple so you knew what to keep an eye on. These will help you watch out for them, and know a bit more as you talk with your provider if you see any problem signs.

Did YOU have issues with preeclampsia? Tell us in the comments!