What should a pregnant woman know about preeclampsia?

You've probably noticed that each time you go to your prenatal appointment, your doctor checks your blood pressure. And this is because we want to know what you were at the beginning of pregnancy so that we can compare it in the future to blood pressures that might be higher than your norm. Preeclampsia is a condition of pregnancy that causes your blood pressure to go up. A normal blood pressure for most people is about 120 over 80, and so if your blood pressure is much higher than that, usually about 140 over 90 or greater, then we need to look into it and determine if you're developing preeclampsia. If your doctor discovered that you had high blood pressure in the office, they would probably send you over to the hospital for further monitoring and investigation. This would involve watching the pattern of the baby's heart rate, seeing what your blood pressure does over a period of time at rest, and drawing your blood, and also getting a urine sample. And then they combine all of the pieces of the puzzle together and decide if you are developing preeclampsia, or if maybe you have chronic hypertension, or maybe you have white coat syndrome. Some people just have really high blood pressure when they first get to the doctor's office because they're scared, and then all of their other blood pressures are fine, their labs are normal, so maybe we could attribute it to that. But we always have to rule out the most serious complication first. Some women who have preeclampsia feel nothing. And it's hard for them when their doctor tells them to be on bed rest, or says you have to have your baby when you're preterm because it's so severe, if you feel fine, and you're wondering why everyone is so excited by this and telling you that you're sick. There may also be symptoms associated with preeclampsia, though, that you should watch out for, and if you have these in between doctor's appointments, call your doctor and let them know so they can check your blood pressure. The biggest one is a headache. Watch for a headache that's different than usual. We all get headaches from time to time if we haven't eaten, or we haven't slept well, or we're really tense, we have a tension headache. Eliminate these possibilities, and if you still have a persistent headache, then get your blood pressure checked for sure, and let your doctor know that you're having a headache. Other symptoms might include seeing spots before your eyes, or having little blind spots in your field of vision, having a new onset of nausea or vomiting, or having pain underneath your ribs, especially if it's off to the right side. So let your doctor know if you're experiencing any of these things, and they'll check your blood pressure and decide if further investigation is necessary for you. If it is determined that you have preeclampsia, the doctor will decide how severe it is, and that determines the plan of care. Sometimes we can just put you on bed rest, and watch you for a little while, and buy some time, because, especially if you're preterm, we have to weigh out the risks of preterm delivery to the risks of this disease. Ultimately, we do worry about seizures and strokes, and it can cause decreased blood-flow through the placenta and affect the baby's well-being if it's not taken care of and addressed. But if a mother just has a mild case, if she's like 35 weeks along, maybe we can buy some time until she gets to full term, and just continue to monitor blood work and labs, and see how things go. But maybe it's so severe that she needs to deliver now, because all of the signs are telling us that if we don't get this baby out, then it could be a risk to the mother and the baby. Basically, we have to weigh out the risks of preterm delivery to the risk of staying pregnant, and once the risk to the mother is greater than the risk of the baby being born preterm, that's when the doctor would decide to deliver. Or if this starts to happen once you're over 37 weeks, you just are done, because the fact of the matter is that pregnancy is causing this issue, so that means that the cure is delivery. Once the placenta is delivered, then the process usually starts to reverse itself. And a mother is still at risk for those complications that I discussed before for a few days after delivery, sometimes it extends a little bit longer, depending on the severity of the case, but nonetheless, it does start to reverse itself once delivery happens. So the take-home message of all of this is to keep your prenatal appointments and call your doctor if you have suspicions that you might have symptoms associated with preeclampsia, especially a headache. If you have any other questions for me in the future, feel free to ask them on our Facebook page at   / intermountainmoms  , and recommend us to your friends and family too.