What you need to know about preeclampsia before — and after — pregnancy

A condition of pregnancy called preeclampsia can lead to serious, and sometimes fatal, complications for you and your baby. Physicians and researchers at the University of Chicago Medicine and around the world are working to better understand the cause of preeclampsia and to reduce —and one day eliminate — the effects of this disease.

What is preeclampsia?

Preeclampsia is a very serious medical condition that can occur anytime during the second half of your pregnancy and up to six weeks after your delivery. Currently, preeclampsia is a major cause of death during and after pregnancy in this country. The condition is characterized by high blood pressure, which can become dangerously high and cause damage to several organ systems. If preeclampsia progresses — and it can do so rapidly — you may be at risk for eclampsia, which is the development of seizures or coma. This can be deadly.

Your baby is also at risk for serious complications, including premature birth and death, if you develop preeclampsia.

Who is at high risk for preeclampsia?

The cause of preeclampsia is not known. But we do know that these factors make you more susceptible to developing the condition during your pregnancy:

• Younger than 18 or older than 40
• Black race (including African Americans and others with African ancestry)
• Obesity
• Pre-existing high blood pressure, diabetes, kidney disease or organ transplant
• Autoimmune disease, including lupus and multiple sclerosis
• Sickle cell disease
• First pregnancy
• Previous personal or family history of preeclampsia
• Multiple pregnancy (such as twins)
• In-vitro fertilization

What are the early warning signs of preeclampsia?

In some cases, preeclampsia can develop without any symptoms or with symptoms that overlap with normal pregnancy. Many people don’t know this, but it can also occur up to six weeks after delivery. Signs and symptoms of preeclampsia include:

• High blood pressure (higher than 140/90 mmHg)
• Protein in the urine, which may cause dark-colored urine, less urine or burning during urination
• Severe headaches that don’t go away with medication
• Blurry vision or seeing “flashing” lights
• Heartburn that is not relieved by antacids
• Rapid weight gain of several pounds in a week
• Significant swelling of the face and hands because your body is retaining water
• Abdominal pain, typically on the right side by the ribs
• Nausea or vomiting that appears in the second half of your pregnancy
• Shortness of breath, which could be a sign of high blood pressure or fluid in your lungs

Regular prenatal visits with your doctor can help you catch some of these signs, including high blood pressure and protein in your urine. If you are at high risk for developing preeclampsia, your doctor can suggest measuring your blood pressure at home to alert you. If you have sudden symptoms like severe headaches or abdominal pain, call your doctor right away.

Can I develop preeclampsia after delivery?

Yes, you may develop persistent high blood pressure up to six weeks after delivery, or what’s known as postpartum preeclampsia. This serious condition can occur even if you never had high blood pressure during pregnancy.

Can I do anything to prevent preeclampsia or eclampsia?

I can’t emphasize enough the importance of getting good prenatal care. As part of your regular visits, your obstetrician should monitor your blood pressure, check your urine for protein, and review signs and symptoms of preeclampsia. If preeclampsia is found early, close monitoring can help you and your baby stay healthy. If you have risk factors for preeclampsia, taking low-dose aspirin every day starting early in your pregnancy can help prevent the development of preeclampsia. Ask your doctor first to confirm whether or not aspirin therapy may be a safe option for you.

Monitoring also can reduce the risk for postpartum preeclampsia. At UChicago Medicine, we offer a Postpartum Telehealth and Remote Patient Monitoring Program to manage your risk for preeclampsia while you recover at home. In this program, you’ll use your smartphone and an app to monitor your blood pressure, track your medications and help you recognize early signs of preeclampsia.

Does preeclampsia have long-term effects?

If you develop preeclampsia, you have a significantly higher risk for developing high blood pressure, cardiovascular disease and stroke later in life. Be sure to follow up with your primary care doctor or cardiologist, who can help you modify your health risks after preeclampsia so you can live your live to its fullest. In addition to offering postpartum remote patient monitoring to help you manage your blood pressure for six weeks after delivery, our team will refer you for follow-up care with UChicago Medicine preventative cardiology experts who specialize in postpartum cardiovascular risk reduction.

Can preeclampsia be cured?

Control of blood pressure and careful monitoring may prolong the pregnancy in some cases, increasing the chance of the baby’s survival and good health. However, this should only be done in select cases and under the care of expert physicians with knowledge of the disease.

Delivering the baby can resolve signs and symptoms of preeclampsia. However, preeclampsia can persist after delivery. Or it may occur for the first time after delivery.

Our team is developing therapies for preeclampsia, but currently none of these are available for clinical use.

Should I have another baby if I had preeclampsia in an earlier pregnancy?

The decision to become pregnant is very personal whether or not you have a history of preeclampsia. But if you had preeclampsia with a previous pregnancy and are thinking about becoming pregnant again, talking with your doctor can help you make an informed decision. If your doctor suggests that you avoid getting pregnant, you may want to consider getting a second opinion from a maternal-fetal medicine specialist. Sometimes described as high-risk obstetricians, maternal-fetal medicine specialists are experts in managing preeclampsia and other serious conditions during pregnancy. With the right care to manage their risks, many patients who develop preeclampsia experience safe outcomes in future pregnancies.

How can I prevent preeclampsia again?

A maternal-fetal medicine specialist can work with you to develop a plan to reduce your risk for preeclampsia with a future pregnancy. This may include getting you as healthy as possible before you become pregnant and managing risk factors like your weight and blood pressure. Your doctor also may suggest taking low-dose aspirin each day, starting as early as your twelfth week of pregnancy, to help reduce your risk of developing preeclampsia. However, it is necessary to consult your doctor first to determine whether aspirin therapy may be safe for you.

What’s new in preeclampsia research?

For more than a decade, our team of researchers in the Rana Preeclampsia Laboratory has been involved in the development of biomarkers (angiogenic factors) linked to preeclampsia. Biomarkers will help us identify those at risk for complications and improve clinical management of those with the condition.

Based on our earlier studies, these biomarkers are approved in countries in Europe, Canada and Asia. We are working on studies to obtain FDA approval for these markers for clinical use in the United States.

Our lab is also currently studying strategies to reduce the risk for cardiovascular disease after preeclampsia.