Toxemia - Preeclampsia

Preeclampsia is high blood pressure that develops or increases during pregnancy. The condition usually occurs after the 20th week of pregnancy.

What is going on in the body?

The placenta is the spongy material in the mother's uterus that nourishes the fetus. Some experts believe that a problem with the placenta causes preeclampsia. The mother has spasms of the blood vessels, which increase her blood pressure. The blood flow to the placenta is impaired. If the blood pressure is not controlled, it can damage the placenta and cause death of the fetus.

Preeclampsia develops in 5% of pregnant women. It usually occurs after the 20th week of pregnancy. It may be mild or severe. The high blood pressure can affect the brain, kidneys, liver, and lungs. If the woman develops seizures or coma, the condition is known as eclampsia.

What are the causes and risks of the condition?

Following are factors that increase a woman's risk of preeclampsia:

Additional factors that increase the risk of preeclampsia are as follows:

What are the signs and symptoms of the condition?

The symptoms of preeclampsia may include:

How is the condition diagnosed?

Diagnosis of preeclampsia begins with a medical history and physical exam. The woman's blood pressure will be measured. The healthcare provider may order the following tests:

What can be done to prevent the condition?

There are no known ways to prevent preeclampsia. All pregnant women should have early prenatal care. Blood pressure changes should be watched closely.

What are the long-term effects of the condition?

Preeclampsia may cause pregnancy complications, including the following:

Preeclampsia can also cause the following health problems that affect both mother and baby:

What are the risks to others?

Preeclampsia is not contagious. Both mother and baby are at risk for complications of preeclampsia.

What are the treatments for the condition?

Giving birth is the only cure for preeclampsia. Preeclampsia limits blood flow to the placenta and the fetus. If a woman has symptoms, flow may already be reduced by 50%. The healthcare provider may decide to induce labor or to wait for labor to occur naturally. The following factors will determine the decision:

If the symptoms are mild, outpatient treatment is common. This includes bed rest at home and biweekly exams in the provider's office. If symptoms do not improve, hospitalization may be needed. Fetal testing will be done to decide if early delivery is possible.

In severe cases, the provider may decide to induce labor with medications. Delivery may be induced if any of the following conditions occur:

Treating severe preeclampsia means controlling the woman's blood pressure. A C-section may be needed. Medications to prevent eclampsia include magnesium sulfate and hydralazine. Anticonvulsants may be used to prevent seizures.

What are the side effects of the treatments?

Magnesium sulfate may cause nausea, vomiting, and breathing problems. These can often be avoided with careful monitoring of serum magnesium levels. Other medications may cause allergic reactions and stomach upset.

What happens after treatment for the condition?

A woman may be at risk for developing eclampsia up to 6 weeks after delivery. She will have regular visits to the healthcare provider, as well as regular blood and urine tests.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Author:Eva Martin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:05/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:05/08/01