The known and unknown of preeclampsia in pregnant women

St. Joseph’s/Candler OB/GYN Dr. Andres Montes explains what we do know about this condition and how we take care of both mom and baby

It’s a common complication of pregnancy, and yet there’s little known about the cause or a possible cure.

Gestational hypertension, also known as preeclampsia, is a condition that can develop in pregnant women usually brought on by high blood pressure and protein in the urine. It occurs in about one out of every 25 pregnancies and is frequently seen in pregnant women who deliver at the Mary Telfair Women’s Hospital.

While common, untreated preeclampsia can lead to serious or even fatal complications for both mother and baby. This is why routine pre-natal care is so important.

“We have the testing ability and the criteria to diagnose gestational hypertension, and we know how to help pregnant women manage it,” says Dr. Andres Montes with St. Joseph’s/Candler Physician Network – OB/GYN. “But what we don’t know yet is the exact cause. Similarly, we don’t know for certain why it appears to be more prevalent in younger generations.”

Preeclampsia usually occurs late in pregnancy, normally after 20 weeks. It can happen to any expecting mother, even if there’s no history of high blood pressure; however, it is most often seen in first-time pregnancies. Pregnant teens and women over 40 also may be at higher risk of developing the condition.

The cause of preeclampsia is unknown. Many believe the placenta plays a role because once it is delivered, mom tends to get better. Other underlying causes also may contribute to the condition, such as obesity, diabetes and chronic high blood pressure before pregnancy.

“We know from a molecular standpoint that the placenta is sending out factors into the vascular system that remodel it and put the patient at risk for high blood pressure in pregnancy,” Dr. Montes says. “We also know there is an obesity epidemic in this country, including among younger folks. We do know that obesity and co-morbidities such as diabetes will put you at an increased risk for gestational  hypertension.”

Signs and symptoms

There are known symptoms of preeclampsia. However, they may not always be easily detected without the help of a doctor. Symptoms of preeclampsia may include:

• High blood pressure
• High amounts of protein in the urine
• Swelling, particularly in the face and hands
• Abdominal pain
• Seeing spots in your vision

Caring for a mom with preeclampsia

It’s important to routinely see your obstetrician throughout your pregnancy to monitor for gestational hypertension. Because while we may not know the exact cause of preeclampsia, doctors do know how to keep both mom and baby safe throughout the rest of the pregnancy and delivery.

“If I see that your blood pressure rises in the 20^th week or later, the first thing I have to look for is gestational hypertension,” says Dr. Montes. “With a gestational hypertension diagnosis, I will see you every week starting at 32 weeks. We will complete ultrasounds to make sure the baby is neurologically doing well. We will make sure the placenta is working properly and that the blood flow between the baby and the placenta is going well.“

Besides close monitoring, there’s no active cure for preeclampsia. Dr. Montes also adds that moms diagnosed with the condition will not go on blood pressure medication because that could lead to more severe preeclampsia. However, if preeclampsia becomes severe, there are medical interventions that may require a hospital stay.

While it all may sound frightening, Dr. Montes likes to assure his patients that your healthcare team is doing everything it can to keep you and your baby safe.

“I don’t want all these new moms to feel afraid. We are very adept at managing gestational hypertension so that you will have the safest pregnancy possible,” Dr. Montes says. “As physicians, we have national guidelines for helping moms have a safe pregnancy, and we will do what’s best for you and your baby.”