Scary Shit Series – Preeclampsia

If preeclampsia was a person, it would be that unassuming guy at a party that farts then walks away from a conversation to go piss in the punch when no one is looking.

It seems quiet and harmless, but it’s sneaky and mean.

Approximately 6-8% of women develop preeclampsia and it usually develops after 20 weeks of pregnancy and can occur up to six weeks after you’ve had the baby. Although, 37 weeks pregnant to 48 hours post delivery tends to be the sweet spot for rearing its ugly head.

What happens is your blood vessels constrict for no apparent reason (there are many theories but I won’t get into that here) causing your blood pressure to rise.

A few things tend to happen because of this “squeezing” caused by the high blood pressure, your kidneys leak extra protein into your urine, and your capillaries leak fluid into your tissue cells which can often make your face, hands and eyes swell up (called edema). If you don’t address it, this pressure can also damage your kidneys, liver and brain, and it can restrict the blood flow to the placenta, often leading to smaller or prematurely born babies. After that, you can get into seizures, then it is eclampsia and it can be life threatening to both mom and baby.

That’s the scary part. If left unchecked, it can go from nothing to something fairly quickly and the only real cure for preeclampsia is having your baby. That is why medical professionals are very twitchy about it, and it’s one of the reasons you are constantly having your blood pressure taken and having to pee in a cup at your pre-natal appointments.

The good news is that it rarely gets that ugly. More than likely you will be put on bed rest and you’ll be monitored. If the preeclampsia doesn’t cooperate, then you’ll be admitted to the hospital and more than likely given magnesium sulfate intravenously to prevent seizures, and medication to lower your blood pressure. If you’re past 34 weeks, then your doctor or midwife may suggest that you be induced or have a c-section.

Preeclampsia symptoms to watch out for:

Swelling:

Swelling of the hands, face, and eyes in particular. Your feet often swell when you’re pregnant but it’s when you’re getting puffy in the face, or if it comes on suddenly, that it’s a bit of a flag. Now, let’s be honest, I got ‘puffy’ all over when I was pregnant and could have been cast as Violet Beauregarde in Charlie and the Chocolate Factory so I’m not sure I would have noticed this one. Still, it’s a good symptom to watch for. If you notice when you press on your skin you still have a dent where your finger was, then hustle to the hospital to get checked out – that’s not a “wait and see” sign.

Sudden Weight Gain:

If your body is leaking fluid into your tissue, then your body isn’t getting rid of it so that often translates into a rapid gaining of weight. Anything over two pounds a week is something to make note of. (Again, this is from the woman who gained 5 pounds in a week although, I think I was retaining Dairy Queen and not fluid.)

Nausea or vomiting:

You *should* be over any morning sickness at this point so nausea and vomiting that kinda comes out of left field should be brought to your doctor or midwife’s attention.

Severe pain below your ribs and/or shoulder pain:

Don’t ignore pain that’s just below your right ribs or your right shoulder. (I guess it’s sound advice not to ignore any kind of severe pain). Shoulder pain can feel like someone is deeply pinching you along the bra strap or on your neck, or it can be painful to lie on your right side. Again, toddle on down to the hospital if you think you’re experiencing this one because your body may be telling you, “hey lady, something is wrong with your liver”, and you need your liver.

Headaches and/or changes in vision:

A persistent and/or severe headache is another one to watch out for, along with vision changes, including temporary blindness, seeing flashing lights or spots, sensitivity to light, and blurry vision. Again, your body may be telling you that your blood flow is being seriously restricted and to seek some medical attention. STAT.

“Why thank you! I’m pregnant so I’m completely unfamiliar with swelling and weight gain” you say sarcastically. This is one of the many reasons preeclampsia is such a dick. Not only does it often present similar symptoms to a normal pregnancy, but you may also have no symptoms at all and be completely floored by the news that you have this potentially dangerous condition. This is why it’s important to pee in a cup all the time and it’s why your blood pressure is seemingly taken every ten seconds after you’ve had a baby.

The following may also put you at higher risk for preeclampsia:

Pregnant for the first time.
A family history of preeclampsia
A 10-year or longer gap between pregnancies.
Had pre-eclampsia in a previous pregnancy.
Over the age of 40, or under 20
Obese before becoming pregnant, with a body mass index (BMI) of 30 or more.
Multiple fetuses
An existing medical problem, such as kidney disease or high blood pressure.
Diabetes

So, basically everyone at some point. Good times.

There’s a fine line here. I don’t want to scare you because even if this develops, it usually doesn’t escalate into anything severe, but I do want to impress the importance of keeping an eye out for these things and taking this condition seriously.

When my friend was pregnant with her first child, she was told to take it easy because she was showing some signs of preeclampsia and her doctor wanted to run a few tests. She went home to lie down for the day and failed to mention her blurry vision and swollen legs because she didn’t want to come off as being whiney.

The next day she went to the IKEA summer sale, driving range, dinner and late night dessert trying to squeeze the most out of her last weeks of freedom so she was pretty surprised when her doctor finally got a hold of her and tossed her in the hospital. She ended up being pumped full of magnesium sulfate, stuck in a dark room with the lights off, then induced. After she had the baby, she was monitored for a few more days (in the dark) then finally released.

Thankfully both she and her daughter escaped unharmed but it just goes to show that you don’t have to feel really sick to be really sick.

So keep your prenatal appointments and stay alert for any sneaky symptoms and don’t let that party farter piss in your punch.

If you have been diagnosed with preeclampsia and want to get more information about it, I found preeclampsia.org was a really helpful resource.