With increased awareness in the news, we at UofL Health believe it is important for women in pregnancy to understand the details and signs of preeclampsia.

Preeclampsia is a disorder occurring in pregnancy that usually develops after 20 weeks and most often in the third trimester. There are certain women who have high risk of developing preeclampsia including those who have had the disorder in a past pregnancy, those carrying multiples (twin, triplets, etc.) and those with additional medical disorders such as high blood pressure, diabetes or kidney disease. Other additional factors can also increase risk of the disorder when combined, such as first pregnancy, Black race, 35 years or older, maternal obesity and in vitro fertilization (IVF).

Preeclampsia can affect multiple organs and systems of the body including the liver, kidneys, blood cells and the brain. In severe cases, it can lead to eclampsia and cause seizures.

While many of the symptoms of preeclampsia may be similar to those seen in normal pregnancies, such as nausea, vomiting or swelling, other symptoms may be more distinguishable. Your doctor may ask you about these symptoms including headaches that don’t go away with attempted treatment, visual changes, swelling of your hands or face, upper abdominal pain (usually on the right) or sudden rapid weight gain.

The first requirement for diagnosis of preeclampsia is elevated blood pressure. While many things can cause high blood pressure in one single check, it is important that additional evaluation is performed if high blood pressure is found during your doctor visits.

You may additionally be asked to collect a urine sample looking for increased protein in the urine that may be a sign of kidney problems caused by preeclampsia. Your doctor may also order blood work to look for changes in blood counts and liver and kidney enzymes. At times, patients may also be asked to be monitored in the hospital while these labs are collected to allow proper evaluation and treatment of elevated blood pressure.

If you are diagnosed with preeclampsia, you may be treated in a hospital or outpatient setting depending on the severity. In mild cases, patients may be seen regularly by their obstetrician to monitor blood pressure, labs and the baby. In severe cases, you may be monitored in the hospital until delivery, which often occurs several weeks before your due date.

While there is no sure way to prevent preeclampsia, there are ways to decrease your risk of developing it.

Before getting pregnant, your doctor may recommend treatment of other medical problems that increase the risk of preeclampsia. During pregnancy, your doctor may also recommend the use of low-dose aspirin. Ultimately, recommendations may vary based on individual risks.

Recently, the FDA approved a test to be used in pregnancy for those being evaluated for preeclampsia to predict patients who will ultimately develop the severe form of this disorder within a few weeks. Currently this test is approved for use between 23 to 35 weeks gestation and looks at changes in certain molecules that may be found in the blood.

Unfortunately, there is not a test to predict development of preeclampsia before becoming pregnant or early in pregnancy. Ultimately, it is important for all patients who are pregnant to be aware of their individual risks. Always ask your doctor if you have any new symptoms or concerns.

If you are in need of prenatal care or have a condition that puts your pregnancy at high risk, call UofL Physicians – OB/GYN & Women’s Health at 502-588-4400.

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Article by: Tiffany Tonismae, M.D., FACOG

Tiffany Tonismae, M.D., FACOG, is a maternal-fetal medicine and high-risk obstetrician with UofL Physicians – OB/GYN & Women’s Health. Dr. Tonismae specializes in high-risk pregnancies that include diabetes and hypertension in pregnancy, multiple gestations and fetal anomalies. She has researched extensively involved management of extremely preterm pregnancies as well as mental health disorders and substance use disorders in pregnancy. Dr. Tonismae is also certified in perinatal mental health, and she is an assistant professor in the Department of Obstetrics, Gynecology and Women’s Health with University of Louisville School of Medicine.

All posts by Tiffany Tonismae, M.D., FACOG
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