Preeclampsia Prevention and Management

Preeclampsia is a condition in which pregnant women experience high blood pressure and signs of damage to the kidneys, liver, or another organ system after the 20th week of pregnancy. The condition is also marked by complications such as high levels of protein in the urine. Although rare, preeclampsia can develop in the postpartum (after childbirth) period, a condition known as postpartum preeclampsia.

If preeclampsia is untreated, it may lead to serious complications (and can even be fatal) for both mother and baby.

Women with preeclampsia often do not feel ill. However, you may experience these symptoms:

• Headaches
• Blurred vision, light sensitivity, or temporary loss of vision
• Abdominal pain (usually felt on the right side, underneath the ribs)
• Pain in the right shoulder
• Shortness of breath
• Decreased urine output
• Nausea and vomiting
• Excess protein in the urine (or other signs of kidney problems)
• Decreased platelet levels in the blood
• Impaired liver function

Other signs and symptoms include sudden weight gain and swelling of the hands, face, and/or eyes, but both can happen during normal pregnancies so are not reliable symptoms on their own.

Seeing your health care provider regularly throughout your pregnancy is the best way to have your health monitored for signs of preeclampsia. For example, your blood pressure reading is typically taken periodically during prenatal visits.

If you experience any sudden or severe symptoms, such as changes in your vision, intense headaches, new shortness of breath, or severe pain in your abdomen, you should contact your doctor immediately (or go to the emergency room).

It's important for your care provider to know if you are at risk for preeclampsia. Women who are at high risk for developing preeclampsia may undergo more frequent testing and be prescribed preventative interventions.

Taking low-dose aspirin beginning after the 12th week of pregnancy may be an effective preventive measure for some women at high risk for developing preeclampsia. Your care provider can assess you and recommend low-dose aspirin if you meet certain criteria.

The World Health Organization (WHO) recommends daily calcium supplementation in people with low dietary calcium intake in order to reduce the risk of pre-eclampsia (particularly among those at higher risk of high blood pressure).

The WHO guideline recommends 1.5 to 2.0 grams of supplemental calcium starting at 20 weeks. If you take iron supplements, taking them separately (with a period of at least several hours in between) can minimize the effect of calcium supplements on reducing iron absorption.

Other methods for preelampsia prevention continue to be investigated, however, many studies have insufficient evidence. For instance, a 2015 review published in PLoS One suggests that levels of vitamin C, E, and other antioxidants are lower in women who develop preeclampsia or have small-for-gestational-age infants.

However, in a review of previously published trials, researchers found no difference in outcomes (severe preeclampsia, preterm birth before 37 weeks, small-for-gestational-age infants, or any perinatal death) among women who took antioxidant supplements compared to those who did not take supplements.

Although the cause of preeclampsia is unknown, possible causes include immune disorders, blood vessel problems, and heredity.

Preeclampsia may be more likely to affect women in their first pregnancy, women who are pregnant with more than one fetus, obese women, women older than 40 or younger than 18, women who conceived using in vitro fertilization, and women with a history of preeclampsia, high blood pressure, diabetes, migraine, lupus, blood clotting disorders, or kidney disease.

Delivery of the baby is the most effective treatment for preeclampsia. However, if the fetus is not fully developed and the preeclampsia is mild, your doctor may recommend managing your condition with strategies such as frequent monitoring and the use of medication. If you have severe preeclampsia, your doctor may recommend hospitalization, additional medication, and/or delivery.

Since preeclampsia is potentially life-threatening for mother and baby, it's important to seek medical attention if you experience any preeclampsia symptoms, rather than attempt to self-treat the disease. Self-treating and avoiding or delaying standard care can have serious consequences.

With few conclusive recommendations, it's best to consult your doctor on strategies that may help improve your overall health, which may improve your chances of avoiding preeclampsia. If your diet is low in certain vitamins, minerals, or nutrients, your care provider may suggest dietary changes, vitamins, or supplements. Just keep in mind that you shouldn't take any supplements, vitamins, or medications without first consulting your doctor. Even common supplements may not be appropriate or safe for you to take during your pregnancy.