Postpartum Preeclampsia: A Rare But Real Risk

Preeclampsia is a life-threatening situation for both mother and baby and something we look out for in patients – especially during their last trimester. However, even more rare – but real – is the potential for preeclampsia in postpartum women.

Prenatal & Postpartum Preeclampsia

Preeclampsia occurs due to a sudden rise in blood pressure that doesn’t self-regulate (and is often accompanied by elevated protein levels in the urine) and causes complications for between 5% and 8% of all pregnancies in the United States.

When left undiagnosed or uncontrolled, side effects become extreme, including seizures, strokes, and organ failure. This risks the life of both mother and child. Sadly, preeclampsia is one of the leading causes of maternal death in the United States and other developed nations. This link between preeclampsia and the risk of maternal/infant death is one of the many reasons we emphasize the importance of attending every prenatal appointment – and why no question or concern is “too small” to bring to the attention of your doctor or our physician/midwife on-call after hours.

While preeclampsia is scary to think about, the good news is that when we catch symptoms early on, there are rarely any life-threatening situations to contend with – and mother and baby thrive.

Preeclampsia is almost always discussed and screened for as a potential pregnancy or prenatal risk – but preeclampsia can also happen during the early postpartum period (the fourth trimester).

Preeclampsia rates are on the rise

Healthcare providers, especially those of us working with pre- and postpartum women, are mainly concerned because preeclampsia rates are on the rise – even for women who are considered otherwise completely healthy and without the typical preeclampsia risk factors (more on those below).

Researchers are working to determine the reasons why preeclampsia cases are on the rise. However, most believe it is because the number of pregnant women with existing risk factors is also increasing in number – particularly those with high blood pressure or early heart disease, type 2 diabetes, and obesity.

Symptoms During and After Pregnancy

Whether you’re pregnant or in the fourth trimester (the first 12 weeks after the baby is born), the symptoms for pre-eclampsia are the same:

• A sudden or unusually severe headache (and that typically remains despite taking pregnancy-friendly OTC headache medications).
• Swelling in the face and extremities (some swelling or edema is normal, but any questionable swelling should be evaluated by your healthcare provider.
• Blurred vision.
• Light sensitivity.
• Black spots occurring in your vision
• Pain or discomfort in the upper-right side of your abdomen.
• Shortness of breath.

Any of these symptoms warrant a call to your healthcare provider. If they are not available, head to your nearest hospital so they can assess the situation. Symptoms of preeclampsia should always be treated as if they were an emergency because if you are preeclamptic, you need treatment ASAP.

However, in most cases, the patient does not notice any symptoms of preeclampsia until it has progressed. Routine prenatal appointments uncover higher-than-healthy blood pressure and elevated proteins in the urine, which lead to an early preeclampsia diagnosis – and the best chances for a safe labor and delivery.

Postpartum Preeclampsia Shares the Same Symptoms

While most episodes of preeclampsia occur during the third trimester, women are still at risk for the condition during the initial postpartum period. Most cases of postpartum or fourth-trimester preeclampsia occur during the first 48 hours but can happen up to six weeks after giving birth.

If you experience postpartum preeclampsia symptoms, you need to contact your provider immediately. In most cases, the simple act of using blood pressure medications is all that is needed to keep postpartum preeclampsia in check until it fades away.

Risk Factors for Pregnancy & Postpartum Preeclampsia

The risk factors for preeclampsia are divided into “high risk” and “moderate risk” categories.

High-risk factors for preeclampsia:

• Expecting twins, triplets, or higher-order multiples
• Existing high blood pressure or heart disease
• Kidney disease
• Diabetes
• Having preeclampsia during a previous pregnancy
• Certain autoimmune disorders (such as lupus)

Moderate risk factors for preeclampsia:

• First-time pregnancies
• You’re 35 years old or older
• Obesity
• Type 2 diabetes
• Family history of preeclampsia
• History of pregnancy complications, including low birth weight

In most cases, preeclampsia begins after the 20-week mark and typically not until the third trimester when your body is working harder to support the development of a healthy, full-term baby.

Northwest Women’s Clinic Proactively Works to Prevent Preeclampsia

Here at Northwest Women’s Clinic, we work closely with our patients to proactively prevent situations leading to preeclampsia. We provide ample information and education about preeclampsia and offer well-rounded access to all levels of care.

We help patients make healthy pre-conception, pregnancy, and postpartum choices that can minimize their risk of developing preeclampsia. And, of course, our diligent attention to prenatal and postpartum checkups means we have the chance to catch any early signs of preeclampsia before it can harm you or your baby. Contact us to schedule your first appointment with us, automatically boosting your chances of a healthy, full-term pregnancy and delivery.