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Preeclampsia

Toxemia; Pregnancy-induced hypertension (PIH); Gestational hypertension

Preeclampsia is when a pregnant woman develops high blood pressure and protein in the urine after the 20th week (late 2nd or 3rd trimester) of pregnancy.

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Preeclampsia

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Preeclampsia

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Causes

The exact cause of preeclampsia is unknown. It occurs in about 3 to 7% of all pregnancies.

Risk factors include:

Symptoms

Often, women who have preeclampsia do not feel sick.

Symptoms of preeclampsia can include:

Note: Some swelling of the feet and ankles is considered normal during pregnancy.

Symptoms of severe preeclampsia include:

Exams and Tests

The doctor will do a physical exam. This may show:

Blood and urine tests will be done. This may show:

Tests will also be done to:

The results of a pregnancy ultrasound, non-stress test, and other tests will help your doctor decide whether your baby needs to be delivered right away.

Women who had low blood pressure at the start of their pregnancy, followed by a significant rise in blood pressure need to be watched closely for other signs of preeclampsia.

Treatment

The only way to cure preeclampsia is to deliver the baby.

If your baby is developed enough (most often at 37 weeks or later), your doctor may want your baby to be delivered so the preeclampsia does not get worse. You may get medicines to help trigger labor, or you may need a C-section.

If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has matured. The doctor will probably recommend:

Sometimes, a pregnant woman with preeclampsia is admitted to the hospital. This allows the health care team to watch the baby and mother more closely.

Treatment in the hospital may include:

You and your doctor will continue to discuss the safest time to deliver your baby, considering:

The baby must be delivered if there are signs of severe preeclampsia. These include:

Outlook (Prognosis)

Sign and symptoms of preeclampsia usually go away within 6 weeks after delivery. However, the high blood pressure sometimes gets worse the first few days after delivery.

If you have had preeclampsia, you are more likely to develop it again in another pregnancy. However, it is not usually as severe as the first time.

If you have high blood pressure during more than one pregnancy, you are more likely to have high blood pressure when you get older.

Possible Complications

Rare but severe immediate complications for the mother can include:

Having a history of preeclampsia makes a woman a higher risk for future problems such as:

When to Contact a Medical Professional

Call your health care provider if you have symptoms of preeclampsia during your pregnancy.

Prevention

There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy.

Related Information

Protein urine test
Diabetes
High blood pressure
Eclampsia
Premature infant

References

Chiang, Chern-En; Wang, Tzung-Dau; Ueng, Kwo-Chang, et al. 2015 guidelines of the Taiwan society of cardiology and the Taiwan hypertension society for the management of hypertension. J Chin Med Assoc. 2015 Jan;78(1):1-47. PMID: 25547819 www.ncbi.nlm.nih.gov/pubmed/25547819.

Markham KB, Funai EF. Pregnancy-related hypertension. In: Creasy R. ed. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 48.

Sibai BM. Hypertension. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 35.

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Review Date: 7/28/2014  

Reviewed By: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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