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  • Postpartum Preeclampsia: The Complication to Watch Out for After Childbirth

    If you didn’t have high blood pressure during pregnancy, you could still develop it postpartum.
    by Rachel Perez .
Postpartum Preeclampsia: The Complication to Watch Out for After Childbirth
PHOTO BY iStock
  • If you’re pregnant, you’ve probably had your blood pressure taken every time you go to a prenatal checkup. Any slight increase in your blood pressure alerts doctors to check if you may be at risk for developing preeclampsia. It’s a pregnancy complication in women whose blood pressure had been normal but has since increased during pregnancy, which typically starts at 20 weeks.

    Most women who had preeclampsia will deliver healthy babies and get their blood pressure back to normal, but childbirth is not a cure for it. During and after giving birth, doctors will continue to monitor your blood pressure to check for postpartum preeclampsia.

    What is postpartum preeclampsia

    Postpartum preeclampsia is an after-birth complication where a woman experiences high blood pressure and high levels of protein in the urine. It can develop soon after birth, usually within the first 48 to 72 hours after delivery. In rare cases, symptoms of postpartum preeclampsia show up late, up to about one month postpartum.

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    High blood pressure affects your body’s blood volume and circulation. It can prevent organs from getting enough blood and oxygen. Like preeclampsia, postpartum preeclampsia can damage a woman’s kidneys, liver, brain, heart, and other organs if it’s not managed early. Left unchecked, it can develop into eclampsia, a much more severe condition characterized by seizures and followed by a coma.

    The Preeclampsia Foundation, a nonprofit organization devoted to education and supporting research on preeclampsia, estimates that 15% of women who get postpartum preeclampsia go on to experiences more severe effects.

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    What causes postpartum preeclampsia?

    Similar to preeclampsia in pregnancy, the exact cause of postpartum preeclampsia is still unknown. The American College of Obstetricians and Gynecologists (ACOG) suggests that a shift in fluid volume levels in the body after childbirth may be a reason for a woman’s blood pressure levels to rise three to six days after labor and delivery.

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    “It takes time for the uterus to shed its lining after birth, so this process may be behind the delay that’s sometimes seen in late-onset preeclampsia after delivery,” explains Dr. James N. Martin, M.D., former president of the ACOG and member of the Preeclampsia Foundation Medical Advisory Board.

    Women who had just given birth shed excess blood, as well as mucus and tissue, from the uterus via postpartum vaginal discharge, or lochia, which can last from at least six to eight weeks postpartum.

    Another theory doctors have is some women may already have preeclampsia during pregnancy but only showed signs or symptoms until after she had given birth.

    Are you at risk of having postpartum preeclampsia?

    The statistics aren’t that reliable due to underreporting. Most women who already have high blood pressure during pregnancy and childbirth are more likely to develop postpartum preeclampsia. According to The Mayo Clinic and What to Expect, a woman is more at risk for developing postpartum preeclampsia when:

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    • You have preeclampsia or high blood pressure during pregnancy.
    • You are 40 years old or older.
    • You are obese.
    • You are expecting multiples (twins, triplets, etc.).
    • You have a history of chronic or uncontrolled high blood pressure.
    • You have type 1 or type 2 diabetes.
    • You have a heart condition caused by high blood pressure.

    Albeit unusual, many women who had normal blood pressure all throughout their pregnancy can still have postpartum preeclampsia. In fact, new moms who did not have preeclampsia during pregnancy may be at an even higher risk of having postpartum preeclampsia.

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    The signs and symptoms of postpartum preeclampsia

    Many moms lack of awareness about postpartum preeclampsia and its symptoms, especially when they show up later than 72 hours after childbirth. A delay in getting diagnosed and immediate medical treatement makes postpartum preeclampsia potentially fatal, according to professor of obstetrics and gynecology Dr. Ira Bernstein, M.D.

    High blood pressure, or even an unstable one, is one of the reasons doctors will keep you in the hospital after delivering your baby until your blood pressure stabilizes or returns to normal.

    Learning to recognize the symptoms of postpartum preeclampsia, even if you’ve been home from the hospital after childbirth, is crucial as postpartum preeclampsia requires immediate treatment. The symptoms of postpartum preeclampsia are similar to signs of preeclampsia. These include:

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    • High blood pressure at or exceeding 140/90
    • Proteinuria, or too much protein in your urine
    • Headaches, severe or otherwise, that won’t go away
    • Vision changes such as blurry vision, light sensitivity, and a temporary loss of sight
    • Pain in the abdomen or stomach, particularly under the ribs of the upper-right-hand side of the stomach
    • Nausea or vomiting
    • Swelling in the arms and face

    According to the Preeclampsia Foundation, head to the hospital as soon as possible if:

    • Your blood pressure is at 160/11o.
    • You see spots in your vision.
    • You have shortness of breath.
    • You have seizures.

    Postpartum eclampsia is a reason not to miss your postpartum checkup, It’s perfectly okay to come earlier than your six-week post-birth checkup.

    How is postpartum preeclampsia diagnosed and treated?

    Postpartum preeclampsia is confirmed through a blood test and urinalysis. The blood test will determine how well your liver and kidneys are functioning or if your blood’s platelet count is within the normal range. Urinalysis can detect if your pee contains unusually high levels of protein.

    If you’ve been diagnosed with postpartum preeclampsia, your doctor will likely recommend hospital admittance to monitor your blood pressure closely. Your doctor may also prescribe antihypertensive medication to manage and lower your blood pressure. In severe cases, doctors will also prescribe magnesium sulfate to prevent seizures.

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    The possible complications of postpartum preeclampsia

    Women who did not have preeclampsia during pregnancy may present symptoms that escalate more quickly and develop complications more than women who had high blood pressure during pregnancy. These complications may include

    • Thromboembolism or when a blood clot that travels from another part of the body causes a blockage in the veins.
    • Pulmonary edema or buildup of fluid in the lungs.
    • Stroke, which interrupts blood and oxygen flow to the brain.
    • HELLP syndrome, a rare but severe liver and blood-clotting disorder. HELLP is an acronym: Hemolysisor (breakdown of red blood cells in the body), Elevated Liver enzymes (which means the liver isn’t functioning properly), and Low Platelet count (which impairs your blood’s ability to clot and may cause you to bleed more profusely.

    Can postpartum preeclampsia be prevented?

    Since doctors do not know what causes it, it is hard to know how to prevent postpartum preeclampsia except to apply what we know of how to reduce the risk of high blood pressure. Doctors sometimes prescribe baby aspirin to women who are prone to developing preeclampsia.

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    Typically, doctors advise pregnant women to be mindful of their diet so as not to gain too much weight. Similarly, after childbirth, new moms are encouraged to add just about 500 calories to be able to sustain breastfeeding.

    Working and keeping active also helps prevent high blood pressure at bay. Women who have low-risk pregnancies should engage in low-impact exercises for about 30 minutes every day. Women who have just given birth, however, should wait at least six weeks before starting any workout regimen. Remember to always consult your doctor first before doing any exercise while pregnant or after giving birth.

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