Fertility

Postpartum Preeclampsia: Symptoms, Risk Factors, & Treatment

Updated on 13 March 2022 • 4 minute read

 

Overview

As many as 0.3% to 27.5% of new moms can experience postpartum preeclampsia and hypertension. That’s alarming because hypertension is linked to 10-26% of maternal deaths in the postpartum period (the first six weeks after childbirth). (1)(2)

Postpartum preeclampsia happens when you have high blood pressure (higher than 140/90 mm Hg) and excess proteins in your urine soon after childbirth. It’s the same as preeclampsia which develops during pregnancy; the only difference is that it happens after delivery. (2)

Most postpartum preeclampsia cases develop within 48 hours of childbirth. Early diagnosis and prompt treatment can help you avoid serious complications, including seizures and maternal death. (1)(3)

 

How Serious Is Postpartum Preeclampsia?

Like other hypertensive disorders of pregnancy, postpartum preeclampsia is serious because it can lead to maternal death. (2)

Researchers believe that the high rate of maternal deaths from postpartum hypertension might be because it’s beyond the routine care window for new moms. (1)

They recommend monitoring blood pressure at home and extra counseling for those with higher risk, such as women with hypertensive disorders before pregnancy.

 

What Are The Signs Of Postpartum Preeclampsia?

The most common warning signs: (4)(5)

  • High blood pressure (regularly over 140/90 mm Hg)
  • Proteinuria (high levels of protein in urine)
  • Severe headaches
  • Blurred vision
  • Rapid weight gain
  • Abdominal pain (upper right side of the abdomen)
  • Swelling of your face, hands, feet, and/or limbs
  • Nausea
  • Vomiting
  • Decreased urination

 

When Should You Go To The ER For Postpartum Preeclampsia?

Call 911 or go to the emergency room if you experience the following after birth: (4)

  • Severe hypertension (blood pressure of 160/110 or higher)
  • Confusion
  • Shortness of breath
  • Trouble breathing
  • Chest pain

 

How Does Preeclampsia Affect The Mother After Birth?

If left untreated, it can lead to these life-threatening, serious complications: (6)(7)

  • Postpartum eclampsia (seizures) 
  • Permanent organ damage (kidneys, liver, and brain)
  • Pulmonary edema (fluid in your lungs)
  • Thromboembolism (a blood clot that blocks blood vessels in your legs, lungs, brain, or kidneys, leading to stroke, coma, or death)
  • HELLP syndrome: Hemolysis (red blood cell damage), Elevated Liver enzymes, and Low Platelet count

 

What’s The Difference Between Eclampsia And Preeclampsia?

Preeclampsia and eclampsia are related but different. Eclampsia is a severe form of preeclampsia. It’s a complication if preeclampsia is left untreated. (8)

 

What Does Postpartum Preeclampsia Do To The Baby?

Preeclampsia (during pregnancy) can cause growth problems, preterm birth (before 37 weeks have been completed), or stillbirth (infant death). However, postpartum preeclampsia doesn’t affect your baby because they’re already born during this period. (9)

 

Why Does Postpartum Preeclampsia Happen?

The causes of this condition remain a mystery, but researchers are trying to discover why it happens. 

Although pregnant women with a history of hypertension have a higher risk, it still happens to those who didn’t have hypertension in pregnancy.

 

Risk Factors

New moms can have a higher risk for postpartum preeclampsia if they have the following: (10)

  • Obesity
  • High blood pressure or hypertension (140/90 mm Hg or higher) during pregnancy
  • Family history of postpartum preeclampsia
  • Being a young mother (under 20)
  • Being an older mother (over 35)
  • Having multiple babies
  • Cesarean delivery
  • Higher rates of IV (intravenous) fluid infusion during labor and delivery (10)(11)

 

Does Stress Cause Preeclampsia?

Studies show that chronic hypertension and stress can increase the risk of preeclampsia 20-fold. (12)

Stress factors can include: (12)

  • Life stress
  • Psychological stress
  • Pregnancy stress
  • Job stress (especially during the third trimester)
  • Violence
  • Lack of family or partner support
  • Low household income
  • Unplanned pregnancy

 

Prevention

The American College of Obstetricians and Gynecologists (ACOG) recommends preventive low-dose aspirin (60-80 mg) for high-risk pregnant women. (13)(14)

After birth, go to your scheduled follow-up checkup even if you think you’re feeling fine. Sometimes, it might not be easy to notice the symptoms yourself. 

Currently, preeclampsia prevention focuses primarily on lowering high blood pressure, but researchers also recommend stress management. (12)

There isn’t evidence that salt restriction or bed rest reduces preeclampsia risks. (14)

 

Diagnosis

  • Blood pressure check
  • Urinalysis (urine test) to check for protein in your urine 
  • Blood tests for platelet count check and liver or kidney function  

 

If you had a seizure, your healthcare provider might also perform a brain scan to check for possible brain damage.

 

Treatment: How Do You Get Rid Of Postpartum Preeclampsia?

These are the most common treatment options prescribed for this condition: (15)(16)

  • Blood pressure medicine
  • Anti-seizure or anticonvulsant medicine (to prevent seizures, a common risk of postpartum preeclampsia) such as magnesium sulfate
  • Anticoagulant medications or blood thinners to reduce the risk of a blood clot
  • Beta-blockers to lower heart rate
  • Vasodilators to open small blood vessels
  • Diuretics to get rid of excess fluid through urination

 

Be sure to let your doctor know if you’re breastfeeding so they can prescribe medications that are safe for your baby.

 

How Long Does Postpartum Preeclampsia Last?

Mild preeclampsia can take around six to eight hours to stabilize. The signs are expected to disappear about four to six weeks after childbirth. (8)

Most cases develop within 48 hours or seven days of childbirth. But you’re still at risk for postpartum preeclampsia up to six weeks after delivery. (1)(3)

 

 

 

REFERENCES

(1) https://www.researchgate.net/publication/303799320_Postpartum_Preeclampsia

(2) https://journals.lww.com/greenjournal/Abstract/2020/06000/Gestational_Hypertension_and_Preeclampsia__ACOG.46.aspx

(3) https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16545

(4) https://www.insider.com/postpartum-preeclampsia

(5) https://www.beaconhealthsystem.org/library/diseases-and-conditions/postpartum-preeclampsia/

(6) https://middlesexhealth.org/learning-center/diseases-and-conditions/postpartum-preeclampsia

(7) https://www.uofmhealth.org/health-library/hw20560

(8) https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/preeclampsia-and-eclampsia.html

(9) https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/risk-fetus

(10) https://www.ajog.org/article/S0002-9378(20)31201-1/fulltext

(11) https://www.researchgate.net/publication/318655764_Labor_therapeutics_and_BMI_as_risk_factors_for_postpartum_preeclampsia_A_case-control_study

(12) Yu, Y., Zhang, S., Wang, G., Hong, X., Mallow, E. B., Walker, S. O., Pearson, C., Heffner, L., Zuckerman, B., & Wang, X. (2013). The combined association of psychosocial stress and chronic hypertension with preeclampsia. American Journal of Obstetrics and Gynecology, 209(5), 438.e1–438.e12. https://doi.org/10.1016/j.ajog.2013.07.003https://www.researchgate.net/publication/249319213_The_Combined_Association_of_Psychosocial_Stress_and_Chronic_Hypertension_with_Preeclampsia

(13) https://www.jwatch.org/na50178/2019/10/28/delayed-onset-postpartum-preeclampsia-filling-clinical

(14) https://journals.lww.com/greenjournal/fulltext/2013/11000/Hypertension_in_Pregnancy___Executive_Summary.36.aspx

(15) https://www.nhs.uk/conditions/pre-eclampsia/treatment/

(16) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719299/

 

 

 

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