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Preeclampsia and Hypertension

What Is Preeclampsia? Preeclampsia is a condition that typically starts after the 20th week of pregnancy and is related to increased blood pressure and protein in the mother's urine (as a result of kidney problems).

Preeclampsia affects the placenta, and it can affect the mother's kidney, liver, and brain. When preeclampsia causes seizures, the condition is known as eclampsia--the second leading cause of maternal death in the U.S. Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth.

There is no proven way to prevent preeclampsia. Most women who develop signs of preeclampsia, however, are closely monitored to lessen or avoid related problems. The way to "cure" preeclampsia is to deliver the baby.

How Common Are High Blood Pressure and Preeclampsia in Pregnancy?

High blood pressure problems occur in 6 percent to 8 percent of all pregnancies in the U.S., about 70 percent of which are first-time pregnancies. In 1998, more than 146,320 cases of preeclampsia alone were diagnosed.

Although the proportion of pregnancies with gestational hypertension and eclampsia has remained about the same in the U.S. over the past decade, the rate of preeclampsia has increased by nearly one-third. This increase is due in part to a rise in the numbers of older mothers and of multiple births, where preeclampsia occurs more frequently. For example, in 1998 birth rates among women ages 30 to 44 and the number of births to women ages 45 and older were at the highest levels in 3 decades, according to the National Center for Health Statistics. Furthermore, between 1980 and 1998, rates of twin births increased about 50 percent overall and 1,000 percent among women ages 45 to 49; rates of triplet and other higher-order multiple births jumped more than 400 percent overall, and 1,000 percent among women in their 40s.

Who Is More Likely to Develop Preeclampsia?

  • Women with chronic hypertension (high blood pressure before becoming pregnant).
  • Women who developed high blood pressure or preeclampsia during a previous pregnancy, especially if these conditions occurred early in the pregnancy.
  • Women who are obese prior to pregnancy.
  • Pregnant women under the age of 20 or over the age of 40.
  • Women who are pregnant with more than one baby.
  • Women with diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma.

How Is Preeclampsia Detected?

Unfortunately, there is no single test to predict or diagnose preeclampsia. Key signs are increased blood pressure and protein in the urine (proteinuria). Other symptoms that seem to occur with preeclampsia include:

  • persistent headaches
  • blurred vision
  • sensitivity to light
  • abdominal pain
  • excessive swelling of feet or hands
  • blood in urine or low/no urine flow
  • ringing/buzzing in the ears
  • excessive nausea
  • vomiting blood

All of these sensations can be caused by other disorders; they can also occur in healthy pregnancies. Regular visits with your doctor help him or her to track your blood pressure and level of protein in your urine, to order and analyze blood tests that detect signs of preeclampsia, and to monitor fetal development more closely.

How Is Preeclampsia Treated?

Delivery of the baby is the best option to treat Preeclampsia, but this may not always be possible. If it's too early to deliver your baby, your doctor can takes steps to manage the preeclampsia until the baby is ready to be born. This includes a variety of high blood pressure medicines and bed-rest. It is not a good idea to decrease your salt intake yourself. While reducing sodium intake is generally a good way to control high blood pressure, when you are pregnant, your body needs the salt to keep up the flow of fluid in your body. Consult with your doctor to determine how much salt to eat and how much water to drink each day. Other things your doctor may suggest to treat your preeclampsia include:

  • taking aspirin
  • extra calcium
  • lie on your left side while resting (improves blood flow)
  • magenisum sulfate (during labor and a few days afterwards to prevent eclampsia).

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