Preeclampsia and Gestational Hypertension

What is preeclampsia?

Preeclampsia is a condition in pregnancy in which the mother develops sudden high blood pressure and releases protein in the urine. There can also be dysfunction of the kidneys, liver, or brain. It can happen after 20 weeks of pregnancy and also right after birth. About four to five percent of pregnancies are complicated by preeclampsia.

Women with preeclampsia are at high risk for heart complications, bleeding, stroke, and blood clots. It is estimated that 10 to 15 percent of maternal deaths in the world are due to preeclampsia. Preeclampsia can also lead to reduced birth weight in the fetus and cause premature birth.

What is gestational hypertension?

Gestational hypertension is high blood pressure without protein in the urine or other organ damage during pregnancy. A percentage of women (10 to 25 percent) with gestational hypertension can progress to having preeclampsia.

What are the symptoms of preeclampsia and gestational hypertension?

Sometimes there are no symptoms, and one or the other is diagnosed when your blood pressure is high, greater than 140/90 mmHg.

  • Preeclampsia symptoms include:
  • New light sensitivity
  • Severe headache that doesn’t get better
  • Confusion
  • Chortness of breath
  • New swelling of the legs
  • Pain in the upper right stomach

Blood work and urine test are done when there is a concern for preeclampsia.

What puts me at risk for preeclampsia and gestational hypertension?

The major risk factors for development of preeclampsia or gestational hypertension are:

  • Previous preeclampsia or gestational hypertension
  • High blood pressure or diabetes prior to pregnancy
  • Multiples (i.e. twins)
  • Underlying kidney disease
  • Lupus
  • Antiphospholid syndrome

Other risks are older age, placental abnormalities in previous pregnancies, and family history of preeclampsia.

What can I do to reduce my risk for preeclampsia and gestational hypertension?

A baby aspirin has been showed to reduce the risk of development of preeclampsia and low birthweight/preterm birth by 10 to 20 percent. It is safe for mother and baby but should be prescribed by a maternal-fetal medicine physician for those at high risk of developing preeclampsia. For certain women increased calcium may reduce risk.  For overweight or obese women, pre-pregnancy weight loss can lower risk as well.

How do preeclampsia and gestational hypertension affect my heart health?

Having preeclampsia or gestational hypertension doubles the risk of developing coronary heart disease and stroke in the future. That doesn’t mean heart disease is inevitable, but women who have these complications of pregnancy need to be followed closely by their physicians to make sure their other risk factors for heart disease—like blood pressure, cholesterol, and blood sugar—are well controlled. Also, women with preeclampsia or high blood pressure in pregnancy must maintain a heart-healthy lifestyle with regular exercise and a Mediterranean or similar diet.