Introduction:

Preeclampsia is a dangerous combination of high blood pressure and too much protein in the urine that can occur in pregnant women after their 20th week of pregnancy. It can range from mild to severe and often develops suddenly. Preeclampsia affects about one in 20 pregnant women and their unborn children, and is the leading cause of maternal death worldwide. If not treated, preeclampsia can worsen into eclampsia, a potentially fatal condition that causes seizures. The cure for preeclampsia is for the baby to be delivered. If it is too early for the baby to be delivered, your doctor will work with you to minimize symptoms and risk of complications until you can deliver safely.

Signs and Symptoms:

• High blood pressure (above 140/90, if your blood pressure was normal before pregnancy) on at least two occasions within 7 days
• Severe headaches
• Sudden weight gain (more than 2-5 pounds in a week)
• Swelling of hands and feet (this often happens in a healthy pregnancy, so it is not a reliable indicator)
• Blurred vision or being sensitive to light
• High levels of protein in your urine
• Pain in the upper right side of the abdomen

What Causes It?:

Nobody knows what causes preeclampsia. However, some women have a higher risk of developing it. Your risk may be greater if this is your first pregnancy, you are in your teens or over 40, you are carrying twins or multiples, you are overweight, you previously had preeclampsia, or you have had high blood pressure, diabetes, or kidney disease.

What to Expect at Your Provider's Office:

You may or may not have any symptoms of preeclampsia. If you do, you should see your doctor immediately. Women often discover they have preeclampsia during a routine pre-natal checkup that includes a urine test and blood pressure check. As you get closer to your delivery date, your doctor may do a non-stress test that checks your baby's heart rate to make sure your baby is getting enough oxygen.

Treatment Options:

If you have a mild case of preeclampsia, your doctor may recommend bed rest. You should lie on your left side, so the weight of the baby won' t press against important blood vessels. Drink a lot of water to help you urinate and get rid of excess fluids. Your health care provider may want to monitor your blood pressure and urine every couple of days. The goal is to manage your symptoms until at least 36 weeks in your pregnancy, when the baby may be safely delivered.

If you have severe preeclampsia, it may not be possible to wait that long. Your doctor may admit you to the hospital, where you will receive drugs to induce labor, or have a cesarean section.

Your doctor may prescribe the following drugs intravenously (IV):

• Magnesium sulfate or hydralazine, to reduce your blood pressure
• Calcium gluconate, if your blood pressure falls too low
• Furosemide, to help you urinate more

In severe cases, your doctor may prescribe medications to lower your blood pressure. Your doctor may also give you corticosteroids to help the baby's lungs develop faster before an early delivery.

Complementary and Alternative Therapies

If you have preeclampsia, you should be under the care of an obstetrician. Do not try to self-treat pre-eclampsia with complementary and alternative therapies. If you want to use complementary and alternative therapies along with conventional medical treatment, be sure that your obstetrician supervises all your therapies. Some of the more common therapies are described below.

Nutrition and Supplements

Some supplements may help prevent preeclampsia but do not help once you have the condition. Others, intended to reduce symptoms once you have the condition, show mixed results in scientific studies. Note: If you are pregnant, do not take any of these supplements without a doctor's supervision.

Preventing preeclampsia:

• Calcium (2,000 mg per day) -- If you have low levels of calcium or are at risk for high blood pressure, some studies show 2,000 mg of calcium per day may lower the risk of developing preeclampsia. Taking calcium does not seem to reduce risk of developing preeclampsia in healthy women, and not all studies show the same result.
• Vitamin D – Some studies suggest that having low levels of vitamin D raise a pregnant woman' s risk for preeclampsia. And one preliminary study found that taking vitamin D supplements appeared to reduce risk of preeclampsia. However, women in the study also consumed high levels of omega-3 fatty acids (found in fish oil), so researchers aren' t sure if it was vitamin D or the combination that reduced risk.
• Folic acid (5 mg per day) and vitamin B6 (250 mg per day) may help prevent symptoms in women with a history of preeclampsia and high homocysteine levels.
• Vitamin C (1,000 mg per day) and vitamin E (400 IU per day) may help reduce risk of preeclampsia. Some studies have found no effect, however. Neither seems to help once you have the condition.
• Lycopene (2 mg two times per day). Further studies are needed to confirm results.
• Magnesium (200 mg two to three times per day) was shown to help reduce risk in one study, but another study showed no effect.

Treatments for preeclampsia:

These treatments require close supervision by your doctor.

• Studies show mixed results for l-arginine, an amino acid, given either intravenously (IV) or orally. Your doctor should determine the dose. Some studies suggest that it may help when given long-term throughout pregnancy.
• Magnesium sulfate, given by injection, can help lower blood pressure.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to determine a diagnosis before pursuing treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink two to four cups per day. You may use tinctures alone or in combination as noted.

Note: Do not use these herbs without your doctor' s supervision.

No studies have found any herbs effective for preeclampsia. Herbs that have traditionally been used to treat mild high blood pressure in pregnancy include:

• Hawthorn berries (Crataegus laevigata)
• Cramp bark (Viburnum opulus)
• Milk thistle (Silybum marianum)

Use equal parts of each in a tincture, 20 drops three to four times a day.

Acupuncture

May help lower blood pressure and increase circulation.

Following Up:

Your health care provider will monitor you carefully for the first few days after you have delivered your child. Your doctor may keep you in the hospital for several days to weeks, depending on the severity of the preeclampsia. You should have checkups at least every 2 weeks for the first several months after leaving the hospital.

Special Considerations:

If you wear rings, take them off as soon as you start having symptoms. Swollen fingers can make it difficult (or even impossible) to remove rings, and they may begin to cut off circulation in your fingers.

Symptoms of preeclampsia can appear gradually and suddenly get worse -- or you may not have any visible symptoms at all. The best way to prevent any complications from preeclampsia is to get regular prenatal care. Your health care provider can recognize early signs of preeclampsia and get treatment for you immediately.

Preeclampsia that happens early in your pregnancy and preeclampsia that is severe may put you at higher risk for heart disease. Your health care provider may recommend more frequent screening for heart disease risk factors.