You’ve been diagnosed with preeclampsia. Now what?

This is not what you want to hear from your health provider as you prepare excitedly for your baby. But knowing what it is and what to expect can make it easier to manage.

Preeclampsia is a condition unique to pregnancy and affects an estimated 3-8% of pregnancies globally and 12% of first pregnancies in South Africa, according to in a study in the journal Hypertension and Pregnancy.

High blood pressure is one of its many symptoms, and unchecked, preeclampsia puts stress on your heart and can affect your liver, kidneys, lungs and brain, as well as your placenta and unborn child, cutting off their supply of nutrients and oxygen. If eclampsia develops – a more severe presentation of the condition, characterised by seizures – it can lead to coma, stroke, even death.

The causes of preeclampsia are not yet clear, says Pretoria obstetrician and gynaecologist Dr Elizabeth de Gouveia. But factors that put you at higher risk include a first pregnancy or one with a new partner; a history of high blood pressure, kidney disease or diabetes; carrying multiples; a family history of preeclampsia; an autoimmune condition such as lupus; and obesity.

“Interestingly, preeclampsia is thought to be an immune response to the part of the baby inherited from the male partner,” Dr De Gouveia says. “It’s now possible to screen for the risk of preeclampsia in the first trimester – but you’ll have to be referred to a specialist.” 

Symptoms you may have experienced include headaches, high blood pressure, blurred vision or seeing spots or flashes, swelling of your hands, feet and face, shortness of breath, and pain towards the right of your abdomen. But if you didn’t notice any signs before your diagnosis, you’re not alone – the first many women know of their condition is when their doctor detects it on a prenatal check-up.  

This is why it’s vital to go for these check-ups, where blood pressure is routinely taken and your urine tested for protein, an early indication of preeclampsia. Preeclampsia typically occurs after 20 weeks of pregnancy but can strike earlier or later – occasionally even weeks after delivery. 

If your health provider suspects preeclampsia, they will order blood tests to check your kidney and liver functions, and do an ultrasound or other foetal monitoring to check the size of your baby and volume of amniotic fluid.

You will be diagnosed with either mild preeclampsia, if you have high blood pressure and high levels of protein in your urine, or severe preeclampsia, if you also have signs of kidney or liver damage (detected by the blood work), a low platelet count, fluid in your lungs, headaches, dizziness, and blurry or distorted vision.

Your health professional will advise you on the best treatment depending on the severity of your preeclampsia, and how far you are in your pregnancy. If you’re approaching full term (37 weeks or more), your baby may be delivered early, vaginally or by Caesarean. And you may be given medication to help your baby’s lungs develop and control your blood pressure until delivery. 

If preeclampsia is diagnosed earlier in your pregnancy, you’ll be closely monitored, with more prenatal appointments, ultrasounds, and urine and blood tests than usual. You may also be asked to check your blood pressure daily at home. 

If you have severe preeclampsia, you may need to remain in hospital until delivery. This is because the most common complications before delivery are maternal seizures, stroke, liver haemorrhage/rupture or kidney failure, pulmonary oedema (fluid in the lungs), preterm birth and a low birthweight baby, or placental abruption, where the placenta detaches from your uterus.

“It’s important to understand that this condition can result in maternal or foetal death and early diagnosis is crucial,” says Dr De Gouveia.

Preeclampsia usually resolves within days or weeks of delivery, but sometimes your blood pressure may remain raised and require medication. You may also be at increased risk for kidney disease, heart attack and stroke later in life, and for developing preeclampsia in future pregnancies.

Use this as motivation to plan and space your pregnancies appropriately,  says Dr De Gouveia. Go for regular health checks, and to improve your lifestyle – eating healthy foods low in salt, and getting regular exercise, to maintain a healthy weight and control your blood pressure. 

“While it can be alarming to be diagnosed with such a serious condition,  it can help set you on track for a healthier life,” she says.

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