Postpartum preeclampsia

Description

Postpartum preeclampsia is a rare condition that occurs when you have high blood pressure and excess protein in your urine soon after childbirth. Preeclampsia is a similar condition that develops during pregnancy and typically resolves with the birth of the baby.

Most cases of postpartum preeclampsia develop within 48 hours of delivery. But, postpartum preeclampsia sometimes develops up to six weeks or more after birth. This is known as late postpartum preeclampsia.

Postpartum preeclampsia requires immediate treatment. Left untreated, postpartum preeclampsia can lead to seizures and other serious complications.

Symptoms

Postpartum pre-eclampsia can be difficult to detect on your own. Many of the women who experience postpartum pre-eclampsia show no signs or symptoms during pregnancy. Also, it may be that you don't suspect that something is wrong when you're focused on the postpartum recovery and newborn care.

The signs and symptoms of postpartum preeclampsia — which are usually equal to the symptoms of pre-eclampsia before delivery — may include:

  • High blood pressure (hypertension) — 140/90 millimeters of mercury (mm Hg) or higher
  • The excess protein in the urine (proteinuria)
  • Severe headaches
  • Changes in vision, including temporary loss of vision, blurred vision, or sensitivity to light
  • Pain in the upper abdomen, usually under the ribs on the right side
  • Nausea and vomiting
  • Shortness of breath
  • The decrease of the urine

When to see a doctor

If you have signs or symptoms of postpartum pre-eclampsia shortly after delivery, contact your health care provider immediately. Depending on the circumstances, you might need immediate medical attention.

Contact your health care provider if you have questions or concerns about your health as you recover from childbirth.

Causes

The causes of postpartum preeclampsia preeclampsia that occurs during pregnancy is not well understood.

Risk factors

Some research suggests that the risk factors for postpartum preeclampsia may include:

  • High blood pressure during the most recent pregnancy. You are at greater risk of postpartum preeclampsia if you have developed high blood pressure after 20 weeks of pregnancy (gestational hypertension).
  • Obesity. The risk of postpartum preeclampsia is higher if you are obese.
  • Have multiples. Having twins, triplets or more increases the risk of pre-eclampsia.
  • Chronic high blood pressure. Have uncontrolled high blood pressure before pregnancy increases the risk of pre-eclampsia and post-partum pre-eclampsia.
  • Diabetes. Having type 1 or type 2 diabetes or gestational diabetes increases the risk of pre-eclampsia and post-partum pre-eclampsia.

Complications

Complications of postpartum pre-eclampsia include:

  • Postpartum Eclampsia. Postpartum Eclampsia is essentially postpartum preeclampsia plus seizures. Postpartum Eclampsia can cause permanent damage to the vital organs, including the brain, eyes, liver and kidneys.
  • The pulmonary edema. This life-threatening lung condition occurs when excess fluid that develops in the lungs.
  • Stroke. A stroke occurs when the blood supply to a part of brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. A stroke is a medical emergency.
  • Thromboembolism. The embolism is the obstruction of a blood vessel by a blood clot that travels from another part of the body. This condition is a medical emergency.
  • The HELLP syndrome. HELLP syndrome — which is characterized by hemolysis (destruction of red blood cells), elevated liver enzymes, and low platelet count — can quickly become life-threatening. The symptoms of hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome include nausea and vomiting, headache, and upper right abdominal pain. The HELLP syndrome is particularly dangerous because it represents the damage to multiple organs and systems. At times, it can develop suddenly, even before the high blood pressure is detected, or it may develop without any symptoms at all.

Prevention

Your doctor can:

  • Discuss the signs and symptoms of pre-eclampsia with you
  • We recommend taking baby aspirin (81 mg) for the prevention of preeclampsia during the pregnancy following
  • Encourage you to have an active lifestyle and eat a healthy diet

Postpartum preeclampsia

Diagnosis

If you have already been discharged from the hospital after childbirth and your health care provider suspects that you have postpartum preeclampsia, you might need to be readmitted to the hospital.

Postpartum preeclampsia is usually diagnosed with lab tests:

  • Blood tests. These tests can determine how well your liver and kidneys are functioning and whether your blood has a normal number of platelets — the cells that help the blood to clot.
  • Analysis of urine. Your health care provider might test a sample of your urine to see if it contains proteins, or he or she might have to collect the urine in 24 hours, so that can be tested by the total amount of protein.

Treatment

Postpartum pre-eclampsia can be treated with medications, including:

  • Medicine to lower high blood pressure. If your blood pressure is dangerously high, your doctor might prescribe a medication to lower the blood pressure (antihypertensive medication).
  • Medicine to prevent seizures. Magnesium sulfate can help to prevent seizures in women with post-partum pre-eclampsia who have severe signs and symptoms. Magnesium sulfate is usually taken for 24 hours. After treatment with magnesium sulphate, your doctor will closely monitor your blood pressure, urine, and other symptoms.

If you're breastfeeding, it is generally considered safe to breastfeed while taking these medications. Ask your health care provider if you have any questions or are not sure.

Preparing for your appointment

If you've recently given birth and have signs or symptoms of postpartum preeclampsia, contact your health care provider immediately.

Here's some information to help you prepare for your appointment, as well as what to expect from your health care provider.

What you can do

Before your appointment, you may want to:

  • Make a list of the symptoms that you are having. Include detailed descriptions and include any of the symptoms that may seem unrelated.
  • Find a loved one or friend who can join you to your appointment. Fear and anxiety can make it difficult to concentrate on what the doctor says. To have someone that can help you remember all the information.
  • Make a list of questions to ask your health care provider. That way, you won't forget anything important that you want to do, and you can make the most of your time with your health care provider.

Basic questions to ask your health care provider may include:

  • How serious is my condition?
  • What are the treatment options?
  • What kinds of tests do I need?
  • I can continue with breastfeeding and the care of my newborn son?
  • How can I better manage other health conditions along postpartum preeclampsia?
  • What are the signs or symptoms should prompt you to call or go to the hospital?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your health care provider is likely to ask a series of questions, too. For example:

  • Have ever had any unusual symptoms lately, such as blurred vision or headache?
  • When did you first notice the signs or symptoms?
  • Tend to have high blood pressure?
  • Did the experience of pre-eclampsia or postpartum preeclampsia with any previous pregnancies?
  • Have had complications during a previous pregnancy?
  • Do you have any other health conditions?
  • Do you have a history of headache or migraine?
Symptoms and treatment of pre-eclampsia, Postpartum