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Toxemia; Pregnancy-induced hypertension (PIH); Gestational hypertension; High blood pressure - preeclampsia
The exact cause of preeclampsia is unknown. It occurs in about 3% to 7% of all pregnancies.
Risk factors include:
Often, women who have preeclampsia do not feel sick.
Symptoms of preeclampsia can include:
Note: Some swelling of the feet and ankles is considered normal during pregnancy.
Symptoms of severe preeclampsia include:
The health care provider will do a physical exam. This may show:
Blood and urine tests will be done. This may show:
Tests will also be done to:
The results of a pregnancy ultrasound, non-stress test, and other tests will help your provider decide whether your baby needs to be delivered right away.
Women who had low blood pressure at the start of their pregnancy, followed by a significant rise in blood pressure need to be watched closely for other signs of preeclampsia.
The only way to cure preeclampsia is to deliver the baby.
Most often, at 37 weeks, your baby is developed enough to be healthy outside of the womb
As a result, your provider may want your baby to be delivered so the preeclampsia does not get worse. You may get medicines to help trigger labor, or you may need a C-section.
If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has matured. The provider will recommend:
Sometimes, a pregnant woman with preeclampsia is admitted to the hospital. This allows the health care team to watch the baby and mother more closely.
Treatment in the hospital may include:
You and your provider will continue to discuss the safest time to deliver your baby, considering:
The baby must be delivered if there are signs of severe preeclampsia. These include:
Sign and symptoms of preeclampsia most often go away within 6 weeks after delivery. However, the high blood pressure sometimes gets worse the first few days after delivery.
If you have had preeclampsia, you are more likely to develop it again during another pregnancy. In most cases, it is not as severe as the first time.
If you have high blood pressure during more than one pregnancy, you are more likely to have high blood pressure when you get older.
Rare but severe immediate complications for the mother can include:
Having a history of preeclampsia makes a woman a higher risk for future problems such as:
Call your provider if you have symptoms of preeclampsia during your pregnancy.
There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy.
Markham KB, Funai EF. Pregnancy-related hypertension. In: Creasy R. ed. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 48.
Rosene-Montella K. Common medical problems in pregnancy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 239.
Sibai BM. Preeclampsia and hypertensive disorders. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 31.
Reviewed By: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.