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Preeclampsia during pregnancy

What you may be experiencing: Usually appearing after the 20th week of pregnancy, preeclampsia (sometimes called "toxemia") is accompanied by high blood pressure, swollen hands and feet, and protein in the urine. This condition is one of the most common complications of pregnancy, striking about 5 percent of all expectant mothers. There is no "cure" for preeclampsia other than delivery of the baby (the disease almost always disappears within several weeks after birth). All prenatal healthcare providers offer regular blood-pressure and urine checks to screen for preeclampsia. If a mild case is detected, it usually can be managed until delivery is possible (preferably, after 36 weeks of gestation, but earlier if the health of mother or baby demand it). A severe case almost always calls for the immediate delivery of the baby. If left untreated, preeclampsia can have serious consequences for mother and/or baby, and, in rare instances, can be fatal.


Certain groups are at greater risk for developing preeclampsia: women who are pregnant for the first time, are in their early teens or over 40, are carrying multiples, are obese, are African-American, and/or who have a history of high blood pressure, diabetes, kidney disease, or blood vessel problems. If you have a family history of pregnancy-induced hypertension, you may also be at increased risk.


About 25 percent of women who had severe preeclampsia during their first pregnancy will experience a recurrence of the condition during subsequent pregnancies (with mild preeclampsia, the recurrence rate is only 5 to 10 percent). Fortunately, when preeclampsia does recur, it is often less severe than it was the first time around.


Even if you don't belong in a high-risk category, you should still be monitored for high blood pressure and preeclampsia. Call your healthcare provider immediately if you have any of the following signs: swelling of the hands and face, pain in the upper right part of the abdomen, sudden weight gain, dizziness, or blurred vision.


What helps: Early diagnosis and diligent monitoring are essential for women with preeclampsia. If you have a milder case, you may be treated at home with bed rest, but you'll probably need to make frequent visits to your healthcare provider's office for tests such as urinalysis, ultrasound, and electronic monitoring of the fetal heartbeat. You may be asked to monitor your blood pressure at home. Many women who develop preeclampsia will need to be hospitalized so that the health of both mother and baby can be closely monitored. If the well-being of either is at risk, the practitioner may recommend early delivery by cesearean or induction. Medication may be prescribed to prevent seizures, which are a threat to women with preeclampsia. In some cases, delivery must take place before the fetus is at term, which can have serious consequences for the baby's health. But in many instances, both mother and baby come through the experience well, with no lasting damage to their health.

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