Preeclampsia - When the Unexpected Happens When You're Expecting
January 28, 2020
When Shelby Seefeldt and her husband, Garrett, learned they were expecting their first child, they were very excited – just like any expectant parents would be. But, when Shelby’s blood pressure started to rise during her pregnancy and then again after she returned home from the hospital after delivering her son Owen, it wasn’t something she was expecting.
Her pregnancy had been mostly normal, and she had only experienced morning sickness for the first 14 weeks – like many women do. Then shortly before she was 30 weeks along, her blood pressure started to go up and she was diagnosed with preeclampsia.
Preeclampsia is a serious blood pressure disorder that can occur as early as 20th week of pregnancy. It can also cause protein to spill over into the urine as well as liver or kidney problems, according to Dr. Elyse Brock, a board-certified obstetrician and gynecologist at Huron Regional Medical Center (link to find-a-doc)
About 80% of preeclampsia cases occur within 37-41 weeks of pregnancy, while about 20% the other 20% occur earlier, like Shelby’s did. While very rare, preeclampsia also may occur after delivery, most often within 48 hours. This is called postpartum, or onset, preeclampsia.
How do I know if I am at risk?
While the exact cause of the condition is unknown, preeclampsia occurs in 3-5% of pregnancies and is thought to start in the placenta. Risk factors for the condition include:
- First pregnancy (twice as likely)
- History of preeclampsia
- Multiple pregnancy (twins or more)
- Family history of preeclampsia
- Being very young, under age 18, or older than age 35
- Being African American
- History of diabetes, high blood pressure or kidney disease
- While this was Shelby’s first pregnancy, she did not have any of the other risk factors.
- The best defense – is a good offense
- According to Dr. Brock, some of the best defenses are starting prenatal care early and being aware of the symptoms, which include:
- Blurry vision, black spots or light spots
- Upper abdominal pain (some women describe it as a very bad case of acid reflux)
- Nausea and vomiting
- Feeling lightheaded or faint
It’s also important to tell your provider about any symptoms or changes in how you feel – and don’t feel like you are being a bother. Your provider will routinely ask how you are feeling and they will also be monitoring for high blood pressure and can test your urine to look for signs of protein.
How is preeclampsia treated?
If diagnosed early, like Shelby was, treatment includes managing blood pressure by reducing stressors and taking care of yourself – getting plenty of rest, eating healthy and exercising. Bed rest is not recommended because it can lead to weight gain, which can cause blood clots and other issues. Dr. Brock encouraged Shelby to take breaks during her shift as a waitress to rest and reduce the amount of time she was on her feet. Her preeclampsia was managed as an outpatient with clinic visits twice a week.
For preeclampsia that is diagnosed closer to the due date, the treatment is delivery. This decision will depend on how far along you are, how high your blood pressure is and if there are other signs such as protein in urine or organ dysfunction. Your provider will schedule you to come to the hospital to have labor induced.
For post-partum preeclampsia, which Shelby experienced after she returned home from delivering Owen, treatment is inpatient care. Because she knew the symptoms to watch for – severe headaches and very high blood pressure – Shelby knew to alert HRMC’s Birthing Center staff who directed her to the nearest emergency room. Once she arrived at HRMC, staff began treatment with magnesium to remove fluid buildup and reduce the risk of seizures or other complications.
Can I prevent preeclampsia?
Preeclampsia is one of the top four causes of maternal death in the U.S., but only 7 out of 100,000 women die from it. If preeclampsia is not caught and treated, it can result in seizures, strokes and long-lasting dysfunction or impairment of the kidneys or liver. It also impacts your baby potential growth restriction or low fluid levels.
If you are considering becoming pregnant, it’s a good idea to schedule a well-woman exam and talk with your provider about your risks and get screened for any conditions such as diabetes or kidney disease. Getting any conditions under control and being at a healthy weight will help make sure you enter pregnancy as healthy as possible.
If you are already pregnant, making sure your provider is monitoring you for risk factors and reporting changes in how you feel is the best prevention. For those with risk factors, your provider may recommend taking a baby aspirin during pregnancy (only as recommended). To learn more about preeclampsia, listen to this podcast with Dr. Elyse Brock or visit HRMC's Pregnancy Center.
The rest of the story
Because Shelby was vigilant, by seeing Dr. Brock regularly and reporting post-partum symptoms right away, her blood pressure is back to normal and her son Owen is a happy, healthy baby. To watch a video of Shelby’s journey, visit www.huronregional.org/preeclampsia.
If you are pregnant or considering starting a family, be sure learn your risk factors and make an appointment with a physician: https://www.huronregional.org/find-a-doc.
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