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Toxemia; Pregnancy-induced hypertension (PIH)
The exact cause of preeclampsia is not known. Possible causes include:
Preeclampsia occurs in a small percentage of pregnancies. Risk factors include:
Often, women who are diagnosed with preeclampsia do not feel sick.
Symptoms of preeclampsia can include:
Note: Some swelling of the feet and ankles is considered normal with pregnancy.
Symptoms of more severe preeclampsia:
The doctor will perform a physical exam and order laboratory tests. Signs of preclampsia include:
The physical exam may also reveal:
Blood and urine tests will be done. Abnormal results include:
Your doctor will also order tests to see how well your blood clots, and to monitor the health of the baby. Tests to monitor the baby's well-being include pregnancy ultrasound, non-stress test, and a biophysical profile. The results of these tests will help your doctor decide whether your baby needs to be delivered immediately.
Women who began their pregnancy with very low blood pressure, but had a significant rise in blood pressure need to be watched closely for other signs of preeclampsia.
The only way to cure preeclampsia is to deliver the baby.
If your baby is developed enough (usually 37 weeks or later), your doctor may want your baby to be delivered so the preeclampsia does not get worse. You may receive different treatments to help trigger labor, or you may need a c-section.
If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has a good chance of surviving after delivery. The doctor will probably recommend the following:
Immediately call your doctor if you gain more weight or have new symptoms.
In some cases, a pregnant woman with preeclampsia is admitted to the hospital so the health care team can more closely watch the baby and mother.
Treatment may involve:
You and your doctor will continue to discuss the safest time to deliver your baby, considering:
The baby must be delivered if you have signs of severe preeclampsia, which include:
Usually the high blood pressure, protein in the urine, and other effects of preeclampsia go away completely within 6 weeks after delivery. However, sometimes the high blood pressure will get worse in the first several days after delivery.
A woman with a history of preeclampsia is at risk for the condition again during future pregnancies. Often, it is not as severe in later 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.
Death of the mother due to preeclampsia is rare in the U.S. The infant's risk of death depends on the severity of the preeclampsia and how prematurely the baby is born.
There can be other severe complications for the mother, including:
However, these complications are unusual.
Severe preeclampsia may lead to HELLP syndrome.
Call your health care provider if you have symptoms of preeclampsia during your pregnancy.
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.
Proper prenatal care is essential. At each pregnancy checkup, yor health care provider will check your weight, blood pressure, and urine (through a urine dipstick test) to screen you for preeclampsia.
As with any pregnancy, a good prenatal diet full of vitamins, antioxidants, minerals, and the basic food groups is important. Cutting back on processed foods, refined sugars, and cutting out caffeine, alcohol, and any medication not prescribed by a doctor is essential. Talk to your health care provider before taking any supplements, including herbal preparations.
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.
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