Pregnancy is an exciting time that brings plenty of changes to an expecting mother’s health. This excitement also can come with its share of stressors. Soon-to-be mothers and parents need to pay close attention to changes to the health of the mother or the baby.

One condition many expecting parents have questions about is preeclampsia. Preeclampsia is either new high blood pressure or worsening of existing high blood pressure that develops after the 20th week of pregnancy and is accompanied by excess protein in the urine.

Preeclampsia can cause the placenta to detach and/or the baby to be born too early, increasing the risk that the baby will have problems soon after birth. In some cases, preeclampsia can suddenly cause seizures (eclampsia). If not treated promptly, eclampsia is usually fatal. It’s important for patients to be prepared to discuss preeclampsia with their physicians and know the signs of preeclampsia. Here are answers to some of patients’ most common questions about preeclampsia.

1. What’s the difference between preeclampsia and high blood pressure?

The difference between preeclampsia and chronic hypertension (high blood pressure) ultimately comes down to timing. After the 20th week of pregnancy, new-onset high blood pressure accompanied by protein in the urine is defined as preeclampsia. Before 20 weeks, a woman with high blood pressure readings would be diagnosed with chronic hypertension (high blood pressure not related to pregnancy). 

Women with chronic hypertension, whether diagnosed before or during pregnancy are at a higher risk of developing preeclampsia. Women with chronic hypertension before pregnancy who develop worsening high blood pressure are diagnosed with what’s known as preeclampsia superimposed on chronic hypertension.

2. Who’s at risk of preeclampsia?

Preeclampsia can occur in any pregnant woman. Even expecting mothers who have no prior health problems can be at risk. That said, preeclampsia is more common among women with certain disorders or characteristics, including high blood pressure before pregnancy.

Other risk factors include preeclampsia in a previous pregnancy, diabetes before pregnancy (type 1 or 2 diabetes) or developed during pregnancy (gestational diabetes), obesity, advanced maternal age (over 35 years) or young maternal age (under 18 years), and relatives who have had preeclampsia.  Women who became pregnant through in vitro fertilization or with autoimmune disorders may also be at increased risk. 

3. What are the signs and symptoms of preeclampsia?

Watching for common signs of preeclampsia is vital to a healthy pregnancy, delivery, and the postpartum period. The classic symptom to watch for after 20 weeks is headaches that do not go away. Changes in vision like blurriness, flashing lights, spots or increased sensitivity to light can also be a sign. Some expecting mothers experience nausea throughout their pregnancy. But new nausea or vomiting that develops after 20 weeks could be a sign of preeclampsia. Other things to watch for include pain in the upper-right quadrant of the midsection and swelling of the face, hands, fingers, neck, and/or feet.

A pregnant woman should call her doctor if she has a new headache that does not resolve or lessen with acetaminophen or if she has sudden swelling of her hands or face. When in doubt, contact the doctor—it’s important to make sure whether there is a health problem.

4. Can preeclampsia ever be caused by white coat hypertension?

“White coat hypertension” is a common term for individuals who experience high blood pressure in clinical settings but not during their everyday lives. Women who typically experience anxiety during blood pressure readings during medical appointments should discuss this with their doctor. However, if a blood pressure reading is high, it is usually repeated. If it is still high, this usually means that there could be a problem that needs to be monitored and investigated to see if treatment is needed. All consistent high blood pressure readings need to be addressed and taken seriously, especially during pregnancy.

5. How is preeclampsia treated?

Treating preeclampsia isn’t like treating chronic high blood pressure. Women with severe preeclampsia or eclampsia are often admitted to a special care unit or in some cases, an intensive care unit (ICU). At 37 weeks and beyond, delivery is most often the “treatment” for preeclampsia.

6. Can preeclampsia be prevented?

When it comes to preventing and treating preeclampsia, there are a few common myths that should be cleared up. A salt-restricted diet and bed rest will not prevent or treat preeclampsia. Nor will reducing physical and mental stress (though those are good pursuits at any time and especially during pregnancy).

For some women at high risk, doctors may prescribe a low dose of aspirin be taken daily during the first trimester. Studies have shown this reduces the risk that preeclampsia will occur. Additionally, it is important to take steps to be as healthy as possible and get any chronic conditions under control before pregnancy.  

7. Do women with preeclampsia have to have a C-section?

Many women with preeclampsia can have a normal vaginal delivery. Having preeclampsia does not mean a woman has to deliver via Cesarean section. Doctors will weigh a wide range of factors in deciding the recommended birthing process. Ultimately, it depends on the severity of the preeclampsia, the stability of the mother, and the baby’s status.

8. What is the follow-up for preeclampsia after childbirth?

After delivery, women who had preeclampsia should see their health care professional for blood pressure measurement at least every 1 to 2 weeks after delivery. It’s also important to note that preeclampsia can occur post-delivery. If a woman has symptoms of preeclampsia during the postpartum period, she should call her doctor.