Preeclampsia Prevention and Management

preeclampsia

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Preeclampsia is a condition in which pregnant people 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.

Signs and Symptoms

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

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

Weight gain and swelling of the hands and face can happen during normal pregnancies, so these are often 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).

Prevention

It's important for your care provider to know if you are at risk for preeclampsia. People 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 people at high risk for developing preeclampsia. If you have more than one moderate risk factor (history of preeclampsia, pregnancy of multiples, kidney disease, autoimmune disorder, high blood pressure, and diabetes), you may be a candidate for low-dose aspirin during pregnancy. Talk to your doctor if you think you may meet the criteria.

Calcium

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 early in pregnancy. 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.

Antioxidants

Other methods for preelampsia prevention continue to be investigated, but many studies have insufficient evidence. For instance, a 2015 review suggests that levels of vitamin C, E, and other antioxidants are lower in people who develop preeclampsia or have small-for-gestational-age infants. However, causality has not been proven.

Older reviews showed no difference in outcomes between those who received antioxidant supplementation and those who did not. Research on the topic is limited and inconclusive.

Causes

The exact cause of preeclampsia is unknown. You may be at higher risk for developing preeclampsia if you have certain health conditions, a history of preeclampsia, are older, or have excess weight.

Postpartum preeclampsia can occur even in people who did not have preeclampsia during pregnancy. The cause is unknown, but certain factors tend to place people at greater risk for developing postpartum preeclampsia. Obesity, hypertension, a family history of preeclampsia, age, and carrying multiples are risk factors.

Management of Preeclampsia

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 close, frequent monitoring. If you have severe preeclampsia, your doctor may recommend hospitalization, medication, and delivery.

Since preeclampsia is potentially life-threatening for parent and baby, it's important to seek medical attention if you experience any preeclampsia symptoms. Never attempt to self-treat the disease. Self-treating and avoiding or delaying standard care can have serious consequences.

The Takeaway

With few conclusive recommendations for prevention, it's best to consult your doctor on strategies that may improve your chances of avoiding preeclampsia. If your diet is low in certain vitamins, minerals, or nutrients, your doctor may suggest dietary changes, vitamins, or supplements.

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.

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Article Sources
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  1. American College of Obstetricians and Gynecologists. Preeclampsia and high blood pressure during pregnancy. Updated December 2020.

  2. American College of Obstetricians and Gynecologists. Low-dose aspirin use during pregnancy.

  3. World Health Organization. Calcium supplementation during pregnancy to reduce the risk of pre-eclampsia. Updated September 17, 2019.

  4. Cohen J, Beddaoui M, Kramer M, Platt R, Basso O, Kahn S. Maternal antioxidant levels in pregnancy and risk of preeclampsia and small for gestational age birth: A systematic review and meta-analysis. PLoS One. 2015;10(8):e0135192. doi:10.1371/journal.pone.0135192

  5. Rumbold A, Duley L, Crowther CA, Haslam RR. Antioxidants for preventing pre-eclampsia. Cochrane Database Syst Rev. 2008 Jan 23;2008(1):CD004227. doi:10.1002/14651858.CD004227.pub3. PMID:18254042.

  6. Centers for Disease Control and Prevention. High blood pressure during pregnancy. Updated May 6, 2021.

  7. Cleveland Clinic. Postpartum preeclampsia: Risks, symptoms, diagnosis & treatments. Updated January 29, 2018.

  8. Gestational hypertension and preeclampsia. Obstetrics & Gynecology. 2020;135(6):e237-e260. doi:10.1097/aog.0000000000003891

Additional Reading