Babies & newborns Pregnancy Women's health

I have preeclampsia, now what?

Woman getting her blood pressure taken
Written by Dr. Noor Ladhani

Hearing the words, “you have preeclampsia” may come as a shock to many pregnant women. Often your pregnancy is ticking along normally, then, following your blood pressure and urine tests, you learn you have the condition. We estimate preeclampsia occurs in 11 or 12 of every 1000 pregnancies in Canada. I’ve cared for many women with preeclampsia, here is a little background and my advice.

What is preeclampsia?

Preeclampsia is a pregnancy condition that is marked by high blood pressure and protein in your urine. You may also have some swelling in your feet, legs and hands, but these symptoms don’t necessarily mean you have the condition. Most women haven’t had high blood pressure before receiving a preeclampsia diagnosis. Usually it’s diagnosed later in pregnancy, often after your 34th week, but it can occur earlier, or even after you deliver your baby. Preeclampsia is thought to be the result of reduced blood flow to the placenta (the organ that provides oxygen and nutrients to your baby) and the fetus. It used to be called “toxemia.”

What causes preeclampsia?

We don’t know the exact causes of preeclampsia, but suspect it’s a disorder of the lining of blood vessels in your uterus or it signifies a problem with your placenta.  None of these things are your fault; you haven’t done anything wrong either before or during your pregnancy.

Are certain women at higher risk?

We’ve noticed there are different things that put you at a higher risk for developing preeclampsia, including:

  • Your age – if you’re in your teen years or over 40
  • Your history – if you’ve had preeclampsia in an earlier pregnancy, or had high blood pressure before coming pregnant, you’re at higher risk. Certain diseases like kidney disease, as well as diabetes, rheumatoid arthritis and lupus can also put you at higher risk
  • Being overweight or obese
  • Genetics – if your mom or a sister had preeclampsia
  • You’re carrying more than one – being pregnant with twins or triplets

What symptoms will I notice?

If your preeclampsia is mild, you may not notice any symptoms. If it’s more moderate or severe, here are some common symptoms:

  • Sudden weight gain or swelling: Swelling of the feet, legs and hands is relatively common in normal pregnancies, but often when you’re diagnosed with preeclampsia, you’ll have a sudden weight gain over a short time period
  • Severe headaches
  • Blurred or altered vision
  • Decreased voiding or peeing
  • Nausea or vomiting
  • Stomach pain in your upper-right side

Is there any way to prevent preeclampsia?

Women with a history of preeclampsia in a previous pregnancy might benefit from starting low dose aspirin early in their pregnancy and should discuss this with their doctors. The good news is, by attending your prenatal appointments regularly, we can diagnose preeclampsia quickly and manage the condition before you deliver your baby.

How do you treat it? Is there a cure?

If you develop preeclampsia early, it might be managed with rest, frequent monitoring, and possibly blood pressure medications (these are safe for your baby). If we think you will need to deliver before 34 weeks, we will give you steroid injections to help mature your baby’s lungs. The only way to really cure preeclampsia is to deliver the baby, and sometimes we might have to do that in the preterm period.

When preeclampsia is severe, we may have to give you magnesium sulfate through an IV in the Birthing Unit. Your health-care team with look at your health, and the baby’s health, and decide when and how to deliver the baby.

What I tell my patients

Receiving a preeclampsia diagnosis may be scary at first, but if you keep your regular checkups and take your health-care team’s advice, the outcomes for you and your baby should be very good. Don’t be afraid to ask lots of questions of your health-care team about how they plan to care for you during your pregnancy and what your labour and delivery will look like.

About the author

Dr. Noor Ladhani

Dr. Ladhani is a maternal fetal medicine specialist at Sunnybrook.