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Alternative Names Return to topToxemia; Pregnancy-induced hypertension
Definition Return to top
Preeclampsia is high blood pressure and protein in the urine that develops after the 20th week of pregnancy.
Causes Return to top
The exact cause of preeclampsia is not known. Possible causes include:
Preeclampsia occurs in a small percentage of pregnancies. Risk factors include:
Symptoms Return to top
Symptoms of preeclampsia can include:
Note: Some swelling of the feet and ankles is considered normal with pregnancy.
Other symptoms that can occur with this disease:
Exams and Tests Return to top
Treatment Return to top
The only way to cure preeclampsia is to deliver the baby. However, if that delivery would be very early (premature), the disease can be managed by bed rest, close monitoring, and delivery as soon as the fetus has a good chance of surviving outside the womb. Sometimes, medicines are prescribed to lower the mother's blood pressure.
The pregnant mother is usually admitted to the hospital, but some women may be allowed to stay at home with careful monitoring of their blood pressure, urine, and weight, and the baby.
Ideally, the condition is managed until the baby can be delivered after the 37th week of pregnancy.
Labor may be induced if any of the following occur:
Delivery is the treatment of choice for women with severe preeclampsia who are between 32 - 34 weeks pregnant.
For those who are less than 24 weeks pregnant, inducing labor is recommended, although the chance that the fetus will survive is very small.
Pregnancies between weeks 24 and 34 are considered a "gray zone." Prolonging a pregnancy has been shown to lead to problems for the mother in most cases. Infant death also can occur. The medical team and parents may decide to delay delivery to allow the fetus to develop.
Treatment during 24 - 34 weeks includes giving the mother steroid injections to help tspeed up the development of the baby's organs (including the lungs). The mother and baby are closely monitored for complications.
When labor and delivery are induced, the mother will be given medication to prevent seizures and to keep blood pressure under control. The decision to have a vaginal delivery versus cesarean section is based on the health of the mother, the baby's ability to tolerate labor, and other factors.
Outlook (Prognosis) Return to top
Death of the mother from preeclampsia is rare in the U.S. The infant's risk of death generally decreases as the pregnancy continues.
A woman with a history of preeclampsia is at risk for the condition again during future pregnancies.
Women who have high blood pressure problems during more than one pregnancy have an increased risk for high blood pressure when they get older.
Possible Complications Return to top
Preeclampsia can develop into eclampsia if the mother has seizures. Complications can occur if the baby is delivered prematurely.
Severe preeclampsia may lead to HELLP syndrome.
When to Contact a Medical Professional Return to top
Call your health care provider if you have symptoms of preeclampsia during your pregnancy.
Prevention Return to top
Although 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. This allows the health care provider to find and treat conditions such as preeclampsia early.
References Return to top
Sibai BM. Hypertension. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics - Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 33.
Cunnigham FG, Leveno KL, Bloom SL, et al . Hypertensive disorders in pregnancy. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 22nd ed. New York, NY; McGraw-Hill; 2005:chap 34.Update Date: 10/28/2008 Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.