What expectant moms need to know about preeclampsia

Preeclampsia, a severe type of high blood pressure during pregnancy, is a significant health concern for expecting mothers and their babies. In 2018, the condition gained attention when Beyoncé revealed that she had experienced toxemia, also known as preeclampsia, when she carried her twins. In an interview with Vogue Magazine, she said that the condition led to her having an emergency cesarean section (C-section) to safeguard her health and that of her babies. When her twins were delivered, they also spent weeks in a neonatal intensive care unit (NICU). 

We’re happy to hear that Beyoncé, and her twins, Rumi and Sir, now six years old, are happy and healthy, but blood pressure issues have continued to affect new moms and their babies over recent years. Current data from the Journal of Clinical Medicine shows that preeclampsia affects around two to eight percent of pregnancies worldwide. Beyond preeclampsia, another recent study shows that pregnancy complications from high blood pressure doubled between 2007 and 2019 in the U.S.

So, what can expectant moms do to prevent and manage preeclampsia? Read on to learn more about preeclampsia, how to prevent it and how to know if you have it.

What are the risk factors for preeclampsia?

According to March of Dimes, some circumstances might affect the likelihood of developing preeclampsia, including:

• First pregnancies, especially young parents' and relatively older parents’ first pregnancies
• Pregnancies more than 10 years apart
• Preeclampsia in a previous pregnancy 
• Pre-existing medical conditions like high blood pressure, diabetes, obesity, chronic kidney disease and lupus
• Family history of preeclampsia
• Obesity, or a body mass index (BMI) over 30
• African-American women and men who conceive via in vitro fertilization (IVF) are at slightly increased risk

Additionally, if you are concerned about postpartum preeclampsia, some additional risk factors include: 

• Gestational hypertension — high blood pressure that starts after 20 weeks of pregnancy
• BMI over 30
• Giving birth via C-section

Can preeclampsia be prevented?

Although there is no way to completely prevent preeclampsia, there are actions you can take to lower your risks, including:

• Scheduling and keeping all prenatal and postpartum appointments
• Managing chronic health conditions
• Monitoring your blood pressure regularly
• Maintaining a healthy weight before and during pregnancy

What are the symptoms of preeclampsia?

Preeclampsia arises primarily during the second half of pregnancy, including delivery and postpartum periods. Noticeable preeclampsia symptoms include:

• Rapid swelling and puffiness, especially in the hands and face that doesn't diminish
• Persistent headaches that may also be accompanied by vision problems
• Upper abdominal pain resembling bad heartburn that doesn't go away
• Sudden weight gain, e.g., two to five pounds in a week
• New onset of high blood pressure (140/90 or higher) when taken twice at least four hours apart or blood pressure of 160/110 or higher in a woman with previously normal blood pressure

However, there are certain symptoms that you can only find through medical examination or testing. Preeclampsia symptoms your obstetrician/gynecologist (OB-GYN) will check for at each prenatal visit include elevated blood pressure and protein in the urine.

What complications can arise because of preeclampsia?

Fortunately, preeclampsia that occurs during pregnancy, resolves after delivery. In rare cases, it can also occur after childbirth and is known as postpartum preeclampsia. It is typically diagnosed within 48 hours after delivery but can occur up to six weeks later. This is one reason to schedule postpartum checkups with your OB-GYN.

Complications of preeclampsia can lead to:

• Premature separation of the placenta
• Stroke
• Fluid in the lungs (pulmonary edema), causing difficulty breathing
• Low blood platelet count
• Abnormal kidney or liver function, resulting in sudden weight gain, edema or upper abdominal pain
• And more rarely:
  • Seizures (eclampsia)
  • Abnormalities of the blood, or inability of the patient's blood to clot, which can lead to excessive bleeding.

Preeclampsia is a common but potentially dangerous condition. Thankfully, the hospitals at HCA Virginia Health System are well equipped to care for all cases of preeclampsia. We provide a comprehensive suite of women's health services across our hospital network. These services include expert gynecologic care, treatment for infertility, specialized support for high-risk pregnancies, as well as prenatal and labor and delivery services. Additionally, we offer a variety of classes and events tailored for new and expectant parents, including tours of our maternity units, designed to prepare you for the journey ahead.

This blog was originally written for Medical City Healthcare in 2018. It was medically reviewed and repurposed for HCA Healthcare Capital Division in 2024.