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Pre-eclampsia is a serious complication of pregnancy that often arrives with no symptoms, or such mild and gradual symptoms that an expectant mom might assume they are normal. The first signs of the disorder are high blood pressure coinciding with excessive protein in the urine.
Our writer developed a severe form of pre-eclampsia called HELLP Syndrome when she went into labor with her first son. She had no idea it was happening until she and baby were safe and sound and getting to know each other in the maternity ward.
Read on to learn about her experience with pre-eclampsia, the importance of regular prenatal care, and how people at high-risk of developing the illness could benefit from home blood pressure monitoring to catch the disorder at the earliest signs.
“One of the scariest things about preeclampsia is that, since it’s so hard to pin down what causes it, there’s not really a way to do anything to prevent it. The best thing to do is to monitor for it closely and catch it as early as possible, which is one of the reasons why regular prenatal visits, and personal symptom tracking are so important.” -Sidney Dritz, team member at Ovia, a fertility, pregnancy, and baby development app.
No warning signs
My first pregnancy was blessedly routine. I ate healthfully, stayed active and was early for all prenatal visits. My blood pressure was firmly in the normal range for the entire pregnancy. Then I went into labor, headed for the hospital, and it was discovered that my blood pressure readings had skyrocketed. When I think back on that day, I always see my husband and I driving on quiet streets in the early-morning dark, nervous and excited about the pending birth, completely unaware that something was terribly wrong.
The doctor and nurses wanted me to focus on delivering my baby, which is the only cure for pre-eclampsia, so I didn’t get many details other than “your blood pressure is higher than we’d like.” I was sure I had the best obstetrician on the planet because he was in my room every ten minutes from the start, unlike stories I’d heard about doctor’s arriving when it’s time to push. The reason for his near-constant presence didn’t dawn on me until later. My husband was aware of the situation and terrified, but he maintained his best “it’s all good” expression and fed me ice-chips like a champ.
I was given magnesium sulfate to prevent the seizures that can occur with HELLP Syndrome and pre-eclampsia that progresses to eclampsia. After a watch-and-wait period as my labor progressed, I delivered a healthy baby. We held him close, but I was loopy from the medicine, could barely focus and was beyond tired. I slept a lot and remember being insanely hot, a side-affect of the magnesium sulfate. My symptoms subsided after delivery and I slowly emerged from my daze. That’s when I finally got a good look at my son, said, “Oh, hello. You’re adorable,” and fell in love. Because of the pre-eclampsia, it wasn’t the first few moments, hours and days with him I’d imagined, but that didn’t matter since we’d made it through.
At home, as I adjusted to being a new mom, I went through a short phase where I read all I could about pre-eclampsia and HELLP Syndrome while my son napped. I was scared and bewildered that something so serious could have shown no symptoms. I quickly learned that much about pre-eclampsia remains a mystery, including the exact cause. But it is well established that being aware of your risk factors and keeping a close eye on blood pressure is crucial in detecting the illness early.
Here’s what else they know about this puzzling illness:
- Pre-eclampsia affects between 2 and 8 percent of pregnancies worldwide and is responsible for almost one-third of premature births globally.
- Though many women with pre-eclampsia feel normal, symptoms occur for some, including: persistent headaches, blurred or changing vision, swelling in the hands and face, nausea and vomiting, rapid weight gain, upper right abdominal pain, difficulty breathing, and decreased urination. These are all reasons to seek medical care.
- The risk of pre-eclampsia is higher in first pregnancies and when a woman is carrying multiples. Women are also at higher risk if they are have had a previous pregnancy with pre-eclampsia, are obese, have high blood pressure or other pre-existing illness, are older than age 35, or have a mother, aunt, or sisters who had pre-eclampsia. If possible, women who are planning on becoming pregnant are advised to take steps to lose weight and manage their high blood pressure prior to pregnancy.
- The American College of Obstetricians and Gynecologists, the European Society of Hypertension, and the European Society of Cardiology recommend home monitoring of blood pressure for women at high risk of developing pre-eclampsia or who have pre-existing hypertension when they become pregnant. With daily monitoring between prenatal visits, a sudden spike in blood pressure will be noticed and management can begin immediately, reducing the risk of complications.
- Though the cause is unknown, pre-eclampsia is believed to arise from problems with the development of the placenta, specifically the blood vessels delivering blood to the placenta. The damage to the placenta is thought to trigger problems with the mother’s blood vessels, causing high blood pressure. When left untreated, pre-eclampsia can evolve into eclampsia, which is characterized by seizures and poses a serious threat to mother and baby.
- Pre-eclampsia usually appears in the second half of the pregnancy, after 20-weeks gestation. If it occurs close to full-term, an early delivery or C-section may be scheduled to avoid complications. However, pre-eclampsia often occurs before the baby is ready for delivery. In those cases, treatment will focus on giving the baby time to grow while protecting the health of the mother.
- Women with moderate cases, will be required to closely monitor their blood pressure at home and visit their doctor frequently for blood tests and ultrasounds to watch for complications.
- For women with dangerously high blood pressure, antihypertensive medications may be needed to lower their blood pressure. In severe cases, magnesium sulfate may be prescribed to prevent the onset of seizures. Hospitalization may also be necessary, for close monitoring of the physical states of mom and baby. Complete bed rest was once routinely recommended for pre-eclampsia, but is now discouraged because of the increased risk of blood clots.
The condition I had is a rare subset of pre-eclampsia, occurring in about 15 percent of women with severe pre-eclampsia. This is an emergency condition in which the red blood cells begin to break down, liver enzymes rise, and platelet counts drop. Delivery is necessary as soon as possible following diagnosis to avoid severe complications and risk of death for mother and child.
When I became pregnant with our second baby, my blood pressure was closely monitored and I practically lived at the doctor’s office. My delivery was induced a week before my due date just in case HELLP was waiting in the wings for a repeat performance. Our second son arrived, healthy and handsome, and I was overjoyed to be awake and aware for our first meeting.
With no plans for a third pregnancy, I thought pre-eclampsia was firmly in my past. But it turns out it’ll be with me a bit for the rest of my life because women who have had the condition have elevated risks of future heart attack and stroke. If you’ve had the condition, it’s crucial to alert your doctor to your history, maintain a healthy diet, exercise regularly, and closely monitor your blood pressure. In the hopes of enjoying as many precious days with my family as I can – that’s my plan.
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Sources:
NYTimes
NHS
MayoClinic
Columbia University
