Preeclampsia As a Leading Cause of Maternal Death

This deadly condition is highly preventable and treatable. Know what to watch out for and when to get treatment.

  • Preeclampsia is a hypertensive disorder that poses health risks to thousands of pregnant people and babies yearly; it can occur during pregnancy and up to six weeks after delivery.
  • Most preeclampsia deaths are preventable with proper treatment.
  • Work closely with a healthcare provider to monitor your health during and after pregnancy and manage any symptoms.

Preeclampsia is a rare, but serious condition that affects about 3% to 7% of all pregnancies. It is a dangerous form of high blood pressure that can occur both during and after pregnancy.

Preeclampsia has gotten plenty of buzz in popular culture. It's been a plot point on at least two popular television shows—"Downton Abbey" in 2013 and "Black-ish" in 2017. And Beyoncé told Vogue she had an emergency C-section due to "toxemia," another word for preeclampsia.

Despite its brushes with fame, there's still a lot that people get wrong about preeclampsia. Here's a deeper look at what this condition is and what healthcare providers really want you to know.

What Is Preeclampsia?

Preeclampsia is characterized by the elevation of an expectant parent's blood pressure and signs of liver or kidney damage, usually after the 20th week of pregnancy.

We don't know what causes preeclampsia. It was once thought that a toxin called "toxemia" was responsible. Healthcare providers now know this isn't true, but the name has stuck around.

Preeclampsia Risk Factors

Certain risk factors can increase your chances of preeclampsia:

  • Obesity
  • Diabetes
  • Age: being 40 years or older
  • Chronic high blood pressure or kidney disease before pregnancy
  • High blood pressure or preeclampsia in a previous pregnancy
  • African-American ethnicity
  • Family history of preeclampsia
  • First pregnancy
  • Multiple pregnancy (twins or more)
  • History of thyroid disease

Diagnosis of Preeclampsia

At one time, the diagnosis was based on elevated protein levels in the pregnant person's urine. Now, healthcare providers can look for other indicators of the disease instead, such as:

  • Decreased blood platelets (blood fragments that help your blood clot)
  • Fluid in the lungs
  • Seizures
  • Visual disturbances
  • Signs of trouble with the kidneys or liver

Dangers of Preeclampsia

Preeclampsia can be dangerous to the pregnant person and to the fetus. The pregnant person may not even feel sick, so it's important to have health monitored throughout pregnancy.

Preeclampsia can damage the pregnant person's kidneys, liver, brain, and other organs. It can cause complications during pregnancy, including loss of pregnancy. Sometimes preeclampsia can even cause organ failure and stroke. If severe, it can become eclampsia, which can be very dangerous.

The fetus is not isolated from the effects of preeclampsia. This condition can cause several problems with the placenta. The placenta is an organ that connects the fetus to the uterus. Preeclampsia-related problems can cut off the fetus's supply of oxygen and nutrients, which can impair growth. They can also cause preterm birth, stillbirth, and infant death.

Preeclampsia Death Rates

To reiterate, preeclampsia is rare. It occurs in less than 7% of pregnancies.

Nevertheless, preeclampsia is still one of the leading causes of maternal death in the United States. It is also one of the leading causes of maternal, fetal, and infant deaths worldwide.

The rate of preeclampsia in the U.S. has increased by 25% in the last two decades and is a leading cause of maternal and infant illness and death.

Postpartum preeclampsia and eclampsia should be treated right away because they can quickly lead to stroke or death.

What Are the Symptoms of Preeclampsia?

The symptoms of preeclampsia can vary from patient to patient, but here are some things many people experience:

  • Headaches
  • Abdominal pain
  • Shortness of breath
  • Burning in the chest
  • Nausea and vomiting
  • Confusion
  • Visual disturbances like flashing spots or blurred vision

A person can also look and feel swollen in the face or hands and experience sudden weight gain.

If the condition goes untreated, it can be fatal. Preeclampsia increases the risk of fetal growth restriction, preterm birth, C-section (Cesarean) delivery, and long-term maternal cardiovascular disease. It is also a leading cause of maternal and fetal morbidity and mortality.

What Do People (and Health Sites) Get Wrong?

It's important to spread awareness of preeclampsia, and it's also easy for people to be misinformed. Here are some of the most common things people get wrong.

Preeclampsia Does Not Only Occur During Pregnancy

Preeclampsia is often described as a condition that occurs "only during pregnancy," which is incorrect. The risks also extend into the postpartum period (the period after delivery).

Life-threatening conditions can develop and put the person at risk after delivery, even if that person didn't have high blood pressure during pregnancy. Postpartum preeclampsia is a serious, but rare, condition. It requires medical treatment and can be fatal.

People in the postpartum period should continue to have their health, including blood pressure, monitored.

Delivery Is Not the Only Cure

It is true that delivering a baby is the way to stop the process that's causing high blood pressure. However, if the due date is still far away, healthcare providers will want to hold off on delivery until the baby is developed enough. Typically that will be at 37 weeks of pregnancy or later.

Still, it's wrong to think delivery will cure preeclampsia. Even though it's rare, postpartum preeclampsia can occur in people who had high blood pressure during pregnancy and even those who didn't. In fact, it can show up anywhere from 48 hours to six weeks after delivery.

Also, people who had preeclampsia have a higher risk of developing high blood pressure, kidney disease, heart disease, and stroke later in life than people who didn't have preeclampsia.

Racial Disparities

It should be mentioned that Black people are at especially high risk for preeclampsia. Black people who have had one pregnancy with preeclampsia should be extra vigilant if they get pregnant again. They may also be more likely to develop preeclampsia again in a future pregnancy.

Health disparities may be one factor that prevents Black people from getting proper care. They can also increase the risk of illness.

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  2. National Institute of Child Health and Human Development. What causes preeclampsia and eclampsia?

  3. National Institute of Child Health and Human Development. Who is at risk of preeclampsia?

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  5. National Institute of Child Health and Human Development. What are the risks of preeclampsia & eclampsia to the mother?

  6. National Institute of Child Health and Human Development. What are the risks of preeclampsia & eclampsia to the fetus?

  7. Centers for Disease Control and Prevention. Pregnancy Mortality Surveillance System.

  8. The American College of Obstetrics and Gynecology. Preeclampsia and pregnancy.

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  11. Centers for Disease Control and Prevention. High blood pressure during pregnancy.

  12. National Institute of Child Health and Human Development. What are the treatments for preeclampsia, eclampsia, & HELLP syndrome?

  13. The American College of Obstetrics and Gynecology. Preeclampsia and high blood pressure during pregnancy.

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