About Postpartum Preeclampsia
Postpartum preeclampsia usually occurs in the first few days after childbirth; however, it could occur several weeks after childbirth. The exact causes of postpartum preeclampsia are not fully understood and may be related to hormonal changes and fluid shifts in the body after childbirth.
Risk factors of postpartum preeclampsia include:
- Obesity: Being overweight or obese before pregnancy increases the likelihood of developing postpartum preeclampsia.
- Maternal age: Being older than 40 years old increases the risk. There also may be increased risk in people under age 20.
- History of preeclampsia or postpartum preclampsia during a prior pregnancy
- Family history of preeclampsia or postpartum preeclampsia
- Chronic hypertension: Having high blood pressure before becoming pregnant
- Gestational hypertension: Developing high blood pressure during pregnancy
- Diabetes: Having diabetes before pregnancy or gestational diabetes (diabetes that developed during pregnancy)
- Multiple gestation: Carrying more than one baby, such as twins or triplets.
It's important to note that having these risk factors does not guarantee that someone will develop postpartum preeclampsia. However, being aware of these factors can help individuals and healthcare providers monitor for signs and symptoms and take appropriate measures to manage their health. If you have any concerns or questions about postpartum preeclampsia, it's always a good idea to speak with your healthcare provider.
It is important to be aware of the symptoms of postpartum preeclampsia, as it can develop even if you did not have preeclampsia or high blood pressure during pregnancy. Symptoms of postpartum preeclampsia include:
- High blood pressure: Postpartum preeclampsia can cause an increase in blood pressure. A blood pressure reading higher than 140/90 millimeters of mercury (mm Hg) may signal preeclampsia.
- Changes in vision: Some women with postpartum preeclampsia may experience changes in their vision, such as seeing spots or having blurry vision.
- Severe headache: A persistent and severe headache that does not go away with massage, exercise, water, or other headache management strategies can be a symptom of postpartum preeclampsia.
- Swelling: Swelling of the face, hands, or feet may occur in women with postpartum preeclampsia.
- Nausea or stomach pain: Some women may experience nausea or stomach pain as a symptom of postpartum preeclampsia.
- Shortness of breath: Difficulty breathing or shortness of breath can also be a symptom of postpartum preeclampsia.
Additional symptoms of progressing or more severe postpartum preeclampsia may include:
- Excess protein in the urine (proteinuria): This is a sign of kidney problems and may be detected through a urine test.
- Dizziness: Feeling lightheaded or dizzy
- Vomiting
- Blurry vision or temporary loss of vision: Vision changes can become more pronounced or worsen.
- Upper abdominal pain: Pain near the ribs
- Decreased urination: Women with severe postpartum preeclampsia may notice they pee less than usual.
- Rapid weight gain: A sudden increase in weight can be a sign of worsening postpartum preeclampsia.
People recently giving birth and experiencing any of these symptoms should seek immediate medical care. Prompt diagnosis and treatment are critical to avoid complications.
To diagnose postpartum preeclampsia, doctors may perform the following examinations, tests, and procedures:
- Blood pressure monitoring: Your doctor will regularly check your blood pressure to see if it is elevated, which is a common sign of preeclampsia.
- Blood tests: Your doctor may order blood tests to check your red blood cells and platelet counts and assess the function of your liver and kidneys. Abnormal results can indicate preeclampsia.
- Urinalysis: A urine test can help determine the levels of protein in your urine. High levels of protein may indicate preeclampsia.
- Medical history and physical examination: Healthcare providers will collect information about when the symptoms started and how severe they are. This information helps in assessing the stage and severity of postpartum preeclampsia. During the physical exam, they will check for signs of postpartum preeclampsia, such as high blood pressure, swelling, changes in reflexes, trouble breathing, or pain—especially in the upper belly or chest.
Additional examinations, tests, and procedures may be performed based upon individual factors or findings from initial examinations and tests.
It's important to note that diagnosing and determining the stage or severity of postpartum preeclampsia requires a combination of medical evaluations and tests. Diagnosis is performed in a hospital so that treatment can quickly be started after diagnosis. Your healthcare provider will guide you through this process to ensure you receive appropriate care.
The immediate goals of treatment for postpartum preeclampsia are to lower blood pressure and prevent or treat complication. Treatment is usually started in the hospital with close monitoring of blood pressure and other symptoms. Treatment may include:
Medication:
- Blood pressure medication: Your doctor may prescribe medication to help lower your blood pressure. This can help reduce the risk of complications such as stroke or organ damage.
- Anti-seizure medication: In some cases, your doctor may prescribe anti-seizure medication, such as magnesium sulfate. This is to prevent seizures that can occur with severe preeclampsia.
- Blood thinners (anticoagulants): Blood thinners may be prescribed to help prevent blood clots, which can be a complication of postpartum preeclampsia.
Additional treatment information:
- Hospitalization if necessary: Some women with preeclampsia may need to be hospitalized for adequate treatment and monitoring, while others can be managed at home with frequent check-ups.
- Regular check-ups and monitoring: Your healthcare provider will monitor your blood pressure, weight, urine protein levels, liver enzymes, kidney function, and clotting factors in your blood.
- Mental health screening: Postpartum women with preeclampsia may benefit from mental health screening. This can help identify any potential mental health issues and ensure timely referral and treatment if needed.
Specific treatment may vary depending in symptoms, severity and individual factors and preferences (for example, if you are breastfeeding).
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.
Postpartum preeclampsia is a condition that can occur after giving birth and is characterized by high blood pressure and possible organ failure. Without prompt treatment, it can lead to serious complications, some of which are:
- Stroke: One of the most severe outcomes of postpartum preeclampsia is a stroke. This occurs when there is a disruption in blood flow to the brain, which can result in permanent brain damage or even maternal death.
- Excess fluid in the lungs (pulmonary edema): Postpartum preeclampsia can cause fluid to accumulate in the lungs, making it difficult to breathe and increasing the risk of respiratory problems.
- Blocked blood vessel due to a blood clot (thromboembolism): Blood clots can form in the blood vessels, obstructing blood flow. This can lead to serious complications such as deep vein thrombosis or pulmonary embolism.
- Postpartum eclampsia: This condition affects brain function and results in seizures. It can cause permanent damage to the eyes, liver, kidneys, and brain.
- HELLP syndrome: HELLP stands for hemolysis (destruction of red blood cells), elevated liver enzymes, and low platelet count. It is a life-threatening condition that can lead to liver failure and other complications.
The natural progression of postpartum preeclampsia over time can be severe if left untreated. However, with prompt diagnosis and treatment, the outlook for full recovery is good.
If you suspect you may have postpartum preeclampsia or are experiencing any concerning symptoms after giving birth, it's important to reach out to your healthcare provider for proper evaluation and guidance.