Preeclampsia is a relatively common pregnancy-related condition that may affect around 5% of women in their pregnancies in Australia. It is characterised by high maternal blood pressure as well as evidence of an impact on other organ systems including the mother’s liver, kidneys or nervous system. Preeclampsia may also impact on the placenta, where it can inhibit growth of the baby.
Preeclampsia results from deficiencies in the early development of the placenta, in the first and early second trimester of the pregnancy. Research is still trying to understand exactly how this causes the symptoms of preeclampsia later in a pregnancy.
In most cases, preeclampsia is diagnosed in the third trimester of pregnancy. It is more common in first time mothers, women who already have medical conditions such as high blood pressure, diabetes or some autoimmune conditions, and those carrying multiple pregnancies.
Early detection and treatment is important, as it may occur without noticeable symptoms to the mother. It has been shown that offering aspirin to this group will significantly reduce their likelihood of developing preeclampsia before 37 weeks. Whilst delivery of the baby and placenta are considered the only cure for preeclampsia, close monitoring of the mother is required for several days after delivery, as the effects can take up to a week to resolve.
At QUFW, we screen all women at the time of their 13-14 week scan to see if they are at increased risk of developing early onset preeclampsia. We’re also proud supporters of Preeclampsia Awareness Month, which is in May.
This fact sheet answers these questions:
- What is preeclampsia?
- What are other signs and symptoms of preeclampsia?
- How is preeclampsia screened?
- How often should I have check-ups to monitor for preeclampsia?
- How is preeclampsia treated?
- Can preeclampsia be prevented?
- Who is at risk of developing preeclampsia?
- How does preeclampsia affect my baby’s health?
- How will preeclampsia affect my delivery plan?
- Can I continue to work if I have been diagnosed with preeclampsia?
- Will I be hospitalised if I’m diagnosed with preeclampsia?
- If I’ve had preeclampsia in a previous pregnancy, will I get it again?
- Can I get preeclampsia after I give birth?
- Can aspirin treat preeclampsia?
- How can I manage stress and anxiety related to a preeclampsia diagnosis?
- Further reading
What is preeclampsia?
Preeclampsia is a pregnancy complication defined by these clinical features:
- Pregnancy-induced hypertension (high blood pressure) greater than or equal to 140/90 mm Hg, alongside:
- Proteinuria (protein in the urine),
- Maternal organ dysfunction (a problem with the mother’s organs or bodily systems),
- And/or uteroplacental dysfunction resulting in fetal growth restriction (problems with the function of the placenta resulting in problems for baby)
What are other signs and symptoms of preeclampsia?
Other signs and symptoms of preeclampsia may include:
- Headaches
- Sensitivity to light
- Pain in your abdomen
- Feeling sick
- Sudden weight gain, or swelling
How is preeclampsia screened?
At QUFW, we routinely screen for preeclampsia at the time of the nuchal and early anatomy scans.
The screening process involves:
- Asking questions to better understand your medical history
- Measuring your height and weight
- Assessing your blood pressure
- Using ultrasound to assess blood flow to the uterus
- Reviewing results of biochemistry testing (PAPP A and/or Placental Growth Factor)
If the risk is calculated to be greater than 1 in 100 of developing early onset preeclampsia before 37 weeks, it is considered a high risk result.
There is good evidence to suggest a benefit in starting aspirin in women who screen high risk for preeclampsia. Whilst this may not stop you getting preeclampsia, it is likely that being on low dose aspirin will delay the onset of preeclampsia. When low dose aspirin (100-150 mg taken at night time) is started before 16 weeks in high risk women, it has been shown to reduce the incidence of early onset preeclampsia (diagnosis made before 32 weeks) by 62%. This is important as, at a later gestation, the option for delivery as a treatment has less impact on a mother and baby. There is a very low side-effect profile of taking low dose aspirin in a pregnancy.
Ultrasound of the blood flow through a uterine artery
(Transabdominal assessment of the uterine artery Doppler waveform in the first trimester)
How often should I have check-ups to monitor for preeclampsia?
It is part of the routine antenatal care. Please speak with your obstetric specialist to learn more.
How is preeclampsia treated?
Other than delivery, there is no cure for preeclampsia. However, it can be managed during your pregnancy with close monitoring of you and baby, and often medication to control your symptoms.
Preeclampsia, and pregnancies, vary so whilst some mothers may be quite stable for weeks after a diagnosis, others may progress more rapidly and require delivery earlier. Your Obstetrician will be able to guide you, and monitor you closely after a diagnosis.
Can preeclampsia be prevented?
Although low dose aspirin reduces the risk of early onset pre-eclampsia in high risk women, there is no way to prevent all cases of preeclampsia. There are some steps that you can take to both reduce your risk factors for developing pre-eclampsia, and to ensure it is detected early. These steps include:
- Attending regular antenatal checkups
- Controlling chronic health conditions like hypertension or diabetes
- Maintaining a healthy weight
Who is at risk of developing preeclampsia?
While any pregnant woman can develop preeclampsia, there are some factors that may increase the risk. These include:
- Having a history of preeclampsia in a previous pregnancy, or a family history of the condition
- Being pregnant for the first time
- Having certain medical conditions such as hypertension or diabetes
- Being over the age of 35
- Carrying multiple babies
- Being overweight
Women who have one or more of these risk factors should be monitored by their treating obstetrician/midwife closely during pregnancy for signs of preeclampsia.
How does preeclampsia affect my baby’s health?
Preeclampsia occurs partly because the early placenta does not develop properly. Later on in pregnancy, in addition to impacting the mothers health, preeclampsia impacts the way the placenta functions and how well it can supply the baby. When placental blood flow is restricted, this can impact delivery of oxygen and nutrients to the baby and result in fetal growth restriction, increasing the chance of preterm birth and stillbirth.
In severe cases of preeclampsia, a condition called ‘placental abruption’ may occur. This is where the uterus and the placenta separate and cause a life-threatening situation for both mother and baby.
How will preeclampsia affect my delivery plan?
The stage of your pregnancy and the severity of your preeclampsia symptoms may impact your birth plan. Your obstetric specialist will work with you to develop a delivery plan that takes into account your individual circumstances and ensures the safest possible outcome for both you and your baby.
Can I continue to work if I have been diagnosed with preeclampsia?
If your preeclampsia is mild and you are able to manage your symptoms, you may be able to continue working with modifications to your job duties or schedule. However, if your preeclampsia is severe or if your job involves physical exertion or high levels of stress, you may need to take time off from work or adjust your duties to reduce the risk of complications.
It is important to discuss your individual circumstances with your obstetric specialist and employer to determine what accommodations may be necessary to ensure a safe and healthy pregnancy.
Will I be hospitalised if I’m diagnosed with preeclampsia?
If your preeclampsia is mild, your obstetric specialist may recommend close monitoring as an outpatient, with regular antenatal checkups and additional testing as needed.
However, if preeclampsia is severe or if the health of the mother or baby is at risk, hospitalisation may be necessary to monitor blood pressure, assess organ function, and ensure a safe delivery if necessary.
Your obstetric specialist will work with you to develop a treatment plan that ensures the best possible outcome for both you and your baby.
If I’ve had preeclampsia in a previous pregnancy, will I get it again?
There is an increased statistical risk of developing preeclampsia again if it was experienced in a previous pregnancy. The likelihood of recurrence will depend on:
- The severity of your previous preeclampsia symptoms
- How early it occurred
- Other risk factors that may be present in the current pregnancy
Your obstetric specialist will closely monitor you for signs of preeclampsia and may recommend additional testing or interventions to manage the condition. It is important to discuss your individual risk factors with your obstetric specialist and to follow their recommendations for a safe and healthy pregnancy.
Can I get preeclampsia after I give birth?
In the majority of cases, preeclampsia is diagnosed during a pregnancy, however it can also be diagnosed for the first time during your labour and delivery, or in the early postpartum phase.
Whilst delivery is the cure for preeclampsia, some of the factors circulating in your bloodstream from the placenta remain for a while after delivery, and this explains how preeclampsia can occasionally become more severe shortly after delivery, or be diagnosed then for the first time. In most cases, this is within the first 2-3 days after birth, and only rarely would a postpartum diagnosis be made weeks after you have delivered your baby.
Can aspirin treat preeclampsia?
The ASPRE trial showed that the chance of developing preeclampsia before 34 weeks was reduced by 82% and before 37 weeks by 62% if the mother was taking low dose aspirin (100-150mg at night, started before 16 weeks).
Aspirin has been used widely now around the world in pregnancy and is considered to be safe to take during pregnancy. Please consult your GP or obstetric doctor before taking any medication.
How can I manage stress and anxiety related to a preeclampsia diagnosis?
Being diagnosed with preeclampsia can be a stressful and anxiety-inducing experience. Seeking support from friends, family, or a mental health professional can also be helpful in managing anxiety. Educating yourself about preeclampsia and its treatment can also help alleviate anxiety and provide a sense of control.
It is important to communicate openly with your obstetric specialist about your concerns and to follow their recommendations for a safe and healthy pregnancy.
Further reading
- Preeclampsia: from early pregnancy to postpartum management – ISUOG
- Preeclampsia: pathophysiology and clinical implications – The BMJ
- Preeclampsia signs and symptoms – The Preeclampsia Foundation
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