As part of the SmartStarts program, expectant parents receive information on pregnancy-related conditions/topics on a schedule that corresponds with the needs of each trimester. One such condition that expectant mothers should be aware of, especially during the second trimester, is preeclampsia, where high blood pressure levels can negatively affect mother and baby.What is preeclampsia? Preeclampsia is a disorder, occurring only during pregnancy, which is characterized by high blood pressure and presence of protein in the urine. It occurs typically in the late second or third trimesters. Other similar terms and closely related conditions include Pregnancy Induced Hypertension (PIH), toxemia, HELLP Syndrome, and eclampsia.

What are the signs and/or symptoms associated with preeclampsia?
Some women exhibit few, if any, symptoms. More common signs include:

• Excessive swelling, especially of hands or face
• Hypertension
• Sudden weight gain (more than 2 pounds per week or 6 pounds in a month)
• Migraine-like headaches that don’t respond to over-the-counter medications
• Nausea or vomiting (with onset in the second or third trimester)
• Changes in vision, such as temporary loss of vision, blurred vision, sensations of flashing lights, auras, light sensitivity, etc.
• Racing pulse, mental confusion, heightened anxiety, or trouble catching your breath
• Stomach or right shoulder pain
• Lower back pain
• Hyperreflexia (overactive reflexes)
• Proteinuria (protein in your urine)

Since many signs and symptoms of preeclampsia mirror other normal effects of pregnancy on your body, it is essential to maintain proper prenatal care and discuss any of these symptoms with your doctor as soon as they occur.

How can preeclampsia affect your health or the health of your baby? Unresolved blood pressure issues are dangerous to you because of the risk of stroke, coma, or blood vessel damage. The only “cure” for preeclampsia is to deliver the baby. Obviously, for your baby, pre-term delivery and subsequent low birth weight are major causes for concern.

What are the tests for preeclampsia?
Preeclampsia can be detected through regular blood pressure monitoring, testing the protein levels in your urine, and monitoring your weight gain during pregnancy. If any of these routine tests show cause for concern, your physician may require additional, more in-depth tests, such as blood tests to check your liver and/or kidney functions, and/or a 24-hour urine collection test.

What causes preeclampsia?
Although the causes of preeclampsia are still unknown, it is more likely to develop in women who are pregnant with their first child, women who are younger than 20 and older than 40, women carrying more than one baby, and women who have had preeclampsia during a previous pregnancy. Other risk factors include chronic hypertension, chronic renal disease, autoimmune disorders and diabetes. Some studies suggest that women who are inactive with a body mass index (BMI) of 30 or higher are at an increased risk for developing the disorder.

What are the treatment options for preeclampsia?
The best defenses against preeclampsia are things you’re probably already doing: eating a healthy, balanced diet, including fresh raw fruit and vegetables; taking a prenatal vitamin and folic acid supplement; avoiding excessive salt; drinking plenty of water; and doing regular moderate exercise. More advanced cases of preeclampsia may require hospitalization and/or administering medication to prevent possible seizures. Both mother and baby will be closely followed for the duration of the pregnancy with frequent blood tests, ultrasounds, and fetal monitoring. In some cases, physicians may recommend bed rest.

If you suffer from preeclampsia during pregnancy, what does it mean for your future health?
For the majority of women, the issues of preeclampsia resolve themselves soon after delivery. Women with a previous history of preeclampsia should have any subsequent pregnancies supervised by an obstetrician. The single greatest risk factor for developing preeclampsia is a history of having had it before.