By now you know you may as well have collected mail at your OB’s office when you were preggers, but why were all those visits necessary? One reason is the deadly threat of preeclampsia that becomes even more of a concern with each progressive pregnancy. A favorite Go-To expert, Dr. Gafori of IGO Medical Group points out it’s on the rise and especially a threat to MO35’s (Moms Over 35… I just liked that better than “geriatric” and “advanced maternal age”… ahem). From signs to look out for to treatment and the fact that you can get it postpartum, too (yikes! Who knew…), Dr. Gafori answers Breezy Mama’s questions.
Are you seeing more cases of preeclampsia?
Preeclampsia is seen in 5 to 10% of pregnancies world wide, but in 5 to 8% of pregnancies in the United States. Some of the risk factors for preeclampsia include advanced maternal age and pregnancies involving more than one baby (twins, triplets, etc..) With assisted technologies and infertility treatment, we are seeing more older mothers and more “multiple” pregnancies, so we may be seeing more patients with preeclampsia.
What is preeclampsia?
Preeclampsia is a syndrome in which patients develop high blood pressure and protein in their urine. The disease is typically diagnosed after 20 weeks of pregnancy, but most patients develop the disease in the third trimester.
What symptoms do pregnant moms need to be aware of that might indicate they have it?
One of the main reasons that you see your doctor more frequently in the third trimester is that we are trying to screen for any changes that might lead to preeclampsia. We check your blood pressure each week and we check for protein in your urine sample. Additionally, we ask questions to see if you are developing any symptoms of the disease and examine you for any signs of the disease (these are changes in your physical exam or labwork).
Symptoms include severe or persistent headache (not all headaches indicate preeclampsia…if your headache resolves in a short period of time or after a dose of Tylenol, it may just be a normal headache) , visual disturbances, persistent nausea or vomiting, pain in your upper central abdomen or under your right lower ribs (this is where the liver is located), swelling in the hands and face, and rapid weight gain.
Is there anything a pregnant woman can do to avoid getting it?
There are many studies looking into preventative measures for preeclampsia. Unfortunately, we have not come up with anything certain at this time. In women who have had severe preeclampsia in prior pregnancies or are at high risk for preeclampsia, studies have shown that low-dose aspirin has had an effect in decreasing the rate of developing preeclampsia. However, this treatment should be discussed with your doctor and is only used in specific situations.
Who is most at risk?
There are many risk factors for preeclampsia. This is a list of some of the more common ones:
- Nulliparity (Women’s first pregnancy)
- History of Preeclampsia in a previous pregnancy
- Age > 40 years or < 18 years (many women over 40 years old have medical problems that put them at higher risk for preeclampsia)
- Chronic Hypertension (this means that the mother was diagnosed with hypertension before the pregnancy or before 20 weeks gestation)
- Kidney disease
- Diabetes (diagnosed before or during pregnancy)
- Multiple gestation (twins, triplets, etc)
- Antiphospholipid syndrome or any inherited thrombophilia (These are both related to abnormal clotting, some people have genetic mutations that put them at higher risk)
What is the treatment?
The treatment is delivery to prevent complications for both the mother and the baby. Sometimes, this leads to preterm or early delivery. We need to consider the risks to both of our patients (mother and baby) when planning for delivery. Women can still suffer from preeclampsia after delivery.
What can happen if it goes untreated?
Complications can include eclampsia (maternal seizures), hypertensive crisis (extremely high blood pressures that can lead to stroke), placental abruption (separation of the placenta from the wall of the uterus), hemorrhage, and fetal or maternal death.
Does it only occur in pregnant women?
Yes, preeclampsia only occurs in pregnancy.
But can it occur postpartum?
Yes, it can occur postpartum. It can occur before labor, during labor, immediately after labor, or within the following 6 postpartum weeks though it is rarer the further you get from delivery.
Anything else women should know?
This disease affects mothers and babies. The only way that we will be able to prevent the many complications of preeclampsia is through scientific research and education. As most of us have at least heard of someone who has suffered from this disease, we can help by joining our local preeclampsia foundation and helping to raise money for research studies that will get us closer to understanding and preventing this disease.
Join walkers in your hometown and thousands nationwide to help The Preeclampsia Foundation, which provides hope, support and valuable information to millions of mothers and babies every year who will be impacted by preeclampsia and related disorders of pregnancy. To register for the walk in your area, click here!
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About Dr. Gafori:
Valerie Gafori MD, FACOG is a board certified obstetrician/gynecologist. She completed her undergraduate degree in Physics at MIT, her masters degree in Biology at Stanford University, and medical degree at UMDNJ: New Jersey Medical School. She completed her residency in OB/GYN at George Washington University and joined a private practice in Washington DC for one year before she moved to La Jolla. She is now in private practice in La Jolla, California with IGO Medical Group. She has special interests in minimally invasive surgery and gynecology.