Definition

Pre-eclampsia is a problem that occurs in some women during pregnancy. Blood pressure increases and protein appears in the urine. This usually occurs during the second half of pregnancy.

Causes

The cause of pre-eclampsia is unknown.

Risk Factors

Pre-eclampsia is more common in African-American women, and in women aged 40 years and older. Other factors that may increase your chance of pre-eclampsia:

• Pre-eclampsia in a previous pregnancy
• First pregnancy
• Family history, such as a mother and sister who also had the condition
• Carrying multiple babies such as twins
• Chronic high blood pressure
• Obesity
• Kidney disease
• Diabetes
• Overweight or obese
• Sleep-disordered breathing—abnormal breathing during sleep ranging from snoring to sleep apnea
• History of polycystic ovary syndrome
• Antiphospholipid antibody syndrome

Symptoms

Women with pre-eclampsia may have no symptoms. It is important to see your doctor regularly during pregnancy to detect problems early.

In women with symptoms, pre-eclampsia may cause:

• Headaches
• Bloating or water retention
• Noticeably swollen ankles or feet, outside of normal swelling that occurs during pregnancy
• Swelling of the face and upper body
• Vision troubles
• Upper abdominal pain
• Nausea or vomiting
• Feeling short of breath
• Chest pain
• Urinating less

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Preeclampsia is diagnosed if a pregnant women has high blood pressure and significant protein in her urine.

Tests may include:

• Blood pressure measurement to see if blood pressure is 140/90 or higher
• Urine tests to look for elevated protein levels
• Blood tests—to check general body health and kidney and liver function

Treatment

Treating pre-eclampsia early can prevent its progression to eclampsia, which are seizures caused by severe pre-eclampsia.

Treatment may include:

Prevention

To help reduce your chance of pre-eclampsia or other pregnancy complications:

• Get early and regular prenatal care. Early treatment of pre-eclampsia may prevent eclampsia.
• If you have chronic high blood pressure, keep it under control during pregnancy.
• Get your doctor’s approval before taking any prescription or over-the-counter medications.
• Do not smoke or drink alcohol during pregnancy.
• Eat regular, healthful meals, and take prenatal vitamins.
• Ask your doctor if you should take a daily calcium supplement. In women who have a low calcium intake, supplementation may reduce the risk of pre-eclampsia, eclampsia, and premature birth.
• Your doctor may recommend that you take aspirin to lower your risk of pre-eclampsia.

Family Doctor—American Academy of Family Physicians http://familydoctor.org

Women’s Health Matters http://www.womenshealthmatters.ca

Hypertensive disorders of pregnancy. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed.ebscohost.com
Updated May 28, 2013. Accessed August 5, 2013.

Preeclampsia and high blood pressure during pregnancy. American Congress of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/~/media/For%20Patients/faq034.pdf?dmc=1&ts=20130314T1318525934
Accessed August 5, 2013.

Pregnancy-induced hypertension. American Academy of Family Physicians Family Doctor website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/pregnancy-induced-hypertension.html
Updated August 2010. Accessed August 5, 2013.

9/30/2008 DynaMed’s Systematic Literature Surveillance
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7/6/2006 DynaMed’s Systematic Literature Surveillance
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Villar J, Abdel-Aleem H, Merialdi M, et al. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. Am J Obstet Gynecol. 2006;194(3):639-649.

7/6/2009 DynaMed’s Systematic Literature Surveillance
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Kumar A, Devi SG, Batra S, Singh C, Shukla DK. Calcium supplementation for the prevention of pre-eclampsia. Int J Gynaecol Obstet. 2009;104(1):32-36.

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Bujold E, Roberge S, Lacasse Y, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116(2 Pt 1):402-414.

6/9/2014 DynaMed’s Systematic Literature Surveillance
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Qin JZ, Pang LH, Li MJ, et al. Obstetric complications in women with polycystic ovary syndrome: A systematic review and meta-analysis. Reprod Biol Endocrinol. 2013;11:56