Here we are in May, almost halfway through the year. May is the blooming of flowers and the warming of the weather. But, May is also preeclampsia awareness month, and in an effort to provide you with sufficient resources to lead your healthiest possible life, we want to shed light on this condition that so many women face.
We spoke with Naiomi Catron, a registered nurse for certified in-patient obstetrics, an International Board Certified Lactation Consultant, and founder of Milk Diva Lactation Services, to discuss what exactly preeclampsia is and why it’s so important for women to be aware of this condition. Naiomi is a perinatal nurse and has taken care of hundreds if not thousands of patients with preeclampsia. We also spoke with Rebecca, a former patient of Naiomi’s, to provide her personal experience with preeclampsia.
What is preeclampsia and why should pregnant women care?
Preeclampsia is a disease that occurs only during pregnancy and 6-8 weeks postpartum. It can affect the mother and unborn baby. The tricky part about preeclampsia is that many times women don’t feel sick and have very mild symptoms making it difficult to identify, yet the disease may slowly or suddenly surface. This disease can cause organ damage to the mother, most commonly to the liver and kidneys, if left untreated.
Preeclampsia affects as many as 1 in every 12 pregnancies (or 8%) worldwide and is responsible for 76,000 maternal and 500,000 infant deaths each year as estimated by The Preeclampsia Foundation. Women should be well educated on the signs and symptoms of preeclampsia to help identify instead of just thinking the symptoms are part of normal pregnancy discomforts. Preeclampsia can start as early as 20 weeks in pregnancy in women whose blood pressure had been normal (less than 120/80). If left untreated high blood pressure related to preeclampsia can cause several serious issues. Some of these complications are in-utero growth restriction to the baby requiring premature delivery and organ damage to the mother.
What are some of the symptoms to look out for? When should I consult or see my doctor?
The American College of Obstetricians and Gynecologists have released guidelines for the diagnosis of preeclampsia which include persistent high blood pressure that develops during pregnancy or the postpartum period that is associated with high levels of protein in the urine OR the new development of decreased blood platelets, trouble with the kidneys or liver, fluid in the lungs, or signs of brain trouble such as seizures and/or visual disturbances. Don’t skip your routine prenatal visits, as they can detect some of these symptoms.
What makes detection hard for most women is that preeclampsia is characterized by several symptoms which the mother may think are a normal part of pregnancy, such as sudden swelling of hands and face, pain that feels like heartburn or a stomach ache, blurred vision and headache.
It’s important to keep a log of when you get headaches, how intense they are, if they go away with Tylenol. Also pay attention to any visual changes you may experience such as spots, flashing lights or blurred vision. You need to call your provider immediately if you experience these symptoms. Click here for a more complete list of symptoms.
Rebecca: “I had my son 9 months ago and I still have trouble describing exactly what it was like to have preeclampsia. My husband and I tried for 9 years to get pregnant, first on our own and then with the help of doctors. After discovering that we had unexplained infertility, we decided to try Clomid (an oral medication to stimulate ovulation) first and then IUI. We still couldn’t conceive after 3 rounds of each, so we eventually moved on to IVF. I had 26 eggs retrieved, 15 matured, and 10 continued to divide after fertilization. 4 became blastocysts and were PGS tested. 1 came back normal. On November 16, 2018 we transferred our perfect little embryo, and I had a positive pregnancy blood test on November 26. My pregnancy was normal for weeks; healthy scans, normal ranges on all tests. Then at my 20 week appointment everything changed. My OB grew concerned at my high blood pressure. After a few more readings, the numbers had not changed. I was sent home but told to take my blood pressure 3 times a day and to send the log in monthly. I was to immediately call the hospital if I had a reading over a specific number. Weeks came and went with high, but not too high, readings."
What are the causes of preeclampsia?
Unfortunately, we don’t know what exactly causes preeclampsia or how to prevent it. One thing that is generally agreed upon is that the placenta plays a key role in preeclampsia. And women who have high blood pressure, diabetes or are obese before they are pregnant are at high risk for preeclampsia. But, our best method of handling this disease is by early identification of the symptoms and closely monitoring blood pressure, lab results and physical symptoms the mother reports.
Are there any preventative measures that I can take against preeclampsia?
The most important preventative measure a mother can take against preeclampsia is to get consistent and thorough prenatal care and keep all of her appointments. The next most important thing she can do is to report any symptoms of preeclampsia to her provider as soon as possible. A delay in reporting symptoms has been linked to a number of preventable deaths.
There has also been research showing low dose Aspirin to be helpful for the prevention of preeclampsia. Watch this video from The Preeclampsia Foundation to learn more.
Why is preeclampsia so dangerous?
After taking care of hundreds if not thousands of women with preeclampsia, I think the most dangerous part of preeclampsia is how difficult it can be to diagnose. It’s so hard to tell if the woman who has chronic allergy or migraine headaches and who also has had high blood pressure since the beginning of her pregnancy, is truly preeclamptic or not? Should we keep this person in the hospital for the next month and monitor her potentially serious symptoms or should we discharge her home and schedule her to be seen by her doctor twice per week. Keeping someone in the hospital for 1-3 months before birth can cause serious financial, physical and psychological stresses. Yet allowing them to go home can pose a serious and sometimes lethal risk, since preeclampsia can rapidly progress.
In a matter of hours mild preeclampsia can escalate to the most severe form called HELLP syndrome (H (hemolysis, which is the breaking down of red blood cells) EL (elevated liver enzymes) LP (low platelet count)). HELLP syndrome is a variant of preeclampsia and its mortality rate is as high as 30%, yet most pregnant women know very little about the symptoms of preeclampsia or HELLP (headache, nausea, indigestion, right upper abdominal pain, bleeding anywhere, pain when breathing deeply, changes in vision and swelling).
Rebecca: “One day, I went to the restroom and there was blood. Lots of it. My husband and I rushed to an ER close by. Once there, the doctor discovered that the bleeding had stopped, and I was transferred to my OB’s hospital. I had an ultrasound, and the baby was fine but they couldn’t tell where the blood came from. I was monitored for a few hours and since there was no more bleeding, I was discharged and placed on a 24 hour bedrest. I made it about 4 hours at home before the bleeding started again. This time I was admitted and monitored for 3 days. I was given a steroid shot for my baby’s lungs in case I had to deliver. I was also given a magnesium drip for 24 hours and placed on a catheter. My husband spent the whole time fanning my face with a damp washcloth. There were constant blood pressure readings and daily scans. When nothing else happened, I was again discharged and placed on permanent bedrest. This time I only made it about 2 hours at home until I started bleeding again. I knew this meant I would be admitted to the hospital until I delivered. I had chronic abruption, a complication of my preeclampsia. I spent the next 6 weeks and 1 day at the hospital until I delivered my son via C-section. I am so grateful for my son. I hope that other women become more aware of this condition and its symptoms, so that they can lead their own safest pregnancies.”
After reading this, you’ll now know much more than most pregnant women about this disease, but you may also feel a tremendous burden or stress about all of the things mentioned above. While I don’t want to steal the joy that comes with pregnancy, I want to save as many lives as possible. It has been proven that just by knowing some of the signs and symptoms to report to your provider, you can significantly improve your risk for preeclampsia related complications.
Just try to remember two or three symptoms of preeclampsia to report to your provider and keep all your prenatal appointments. Share this information with as many women who may be or become pregnant and help increase awareness about a disease that can be treated and overcome, if identified early.