What Is Postpartum Preeclampsia?

Everything you need to know about preeclampsia after delivery.
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Many expectant women have heard of preeclampsia, a condition in pregnancy characterized by high blood pressure that usually develops after the 20-week mark. But this extremely serious condition can occur after your baby has been delivered, too. Postpartum preeclampsia is less common -- affecting roughly 600 women a year -- and is difficult to quantify because some women who suffer from preeclampsia after birth already had preeclampsia, while others develop a new case of it.

"The scary part of postpartum preeclampsia is the delay that can occur between the onset of symptoms and diagnosis, which means a serious illness can become life-threatening," says Ira Bernstein, M.D., professor of obstetrics and gynecology at the University of Vermont College of Medicine. Indeed, according to the Preeclampsia Foundation, about 15 percent of postpartum preeclampsia patients go on to experience more severe aspects of this condition: eclampsia, or seizures.

Read on for important information about preeclampsia after birth.

What is postpartum preeclampsia?
Postpartum preeclampsia is a rare condition that can develop soon after birth (usually within the first 48 to 72 hours after delivery) and is marked by high blood pressure and excess protein in the urine. In rare cases, preeclampsia onset can be delayed up to about one month postpartum; it is usually called late postpartum preeclampsia if the onset is more than 48 hours postpartum. "It takes time for the uterus to shed its lining after birth, so this process may be behind the delay that's sometimes seen in late onset preeclampsia after delivery," says James N. Martin, M.D., past president of the American College of Obstetricians and Gynecologists. It's also possible this condition begins during pregnancy but doesn't show signs or symptoms until after the baby has arrived.

What are the risk factors for postpartum preeclampsia?
It's difficult to determine who will develop preeclampsia after birth, but there are a few factors that may increase the risk. Gestational hypertension, or high blood pressure after 20 weeks, during a past pregnancy is one red flag; being diagnosed with preeclampsia, a combination of high blood pressure often with abnormal amounts of protein in the urine, at the same point in pregnancy is another. The risk of postpartum preeclampsia can also rise if you are obese.

What are the symptoms and signs?
Signs of postpartum preeclampsia may include:

  • A blood pressure of 140/90 or higher
  • Excess protein in the urine
  • Nausea or vomiting
  • Severe headache
  • Abdominal pain, especially under the ribs on the right side
  • Very little urine output
  • Sudden weigh gain (more than 2 pounds a week)
  • Sudden shortness of breath

"If you notice any of these signs or symptoms, contact your health care provider right away," says Dr. Martin.

Treatment and prevention of postpartum preeclampsia
If your doctor suspects you have developed postpartum preeclampsia, you may be hospitalized for evaluation and treatment. Preeclampsia after birth can often be diagnosed with lab tests, which include a blood draw and urinalysis. Your blood will be tested to determine whether you have the right number of platelets (these help the blood to clot) and to be sure your liver and kidneys are working well. A sample of urine is taken to see if it contains protein.

Seizures are the main concern with this condition, so preeclampsia after delivery is treated with an anticonvulsive medication (usually magnesium sulfate) that's taken for 24 hours. After you've had the medication, your doctor will carefully check your blood pressure, urine, and other symptoms. Antihypertensive medication may be prescribed if your blood pressure is too high.

Unfortunately, there isn't a known method for preventing postpartum preeclampsia. Your best bet is to be aware of how you're feeling and report any symptoms to your doctor. Don't wave away a bad headache or other pain as mere new-mom problems -- get it checked out.

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