Dr. Anca Matei is an obstetrician and gynecologist at Almonte General Hospital and assistant professor at the University of Ottawa Department of Obstetrics, Gynecology and Newborn Care.
Preeclampsia affects 4% of pregnancies in Ontario. On this Mother’s Day, let’s talk about it!
Not too long ago a close friend of mine called me in distress. She had given birth just a few days before and now her blood pressure was quite high. She also had a headache. What should she do?
My friend had developed preeclampsia.
Preeclampsia is defined as high blood pressure in pregnancy that causes one or more complications. It’s pretty common: it affects 4% of pregnancies in Ontario.
The reason it is a problem is because high blood pressure can affect any organ of the body, from head to toe. Often, there are no symptoms, but when symptoms occur they can include headaches, changes in vision, pain in your belly, swelling especially where you don’t expect it like your hands or face, nausea or vomiting, among others. If left untreated it can progress to things like seizure and stroke, and it can also affect the pregnancy. This sounds scary. So let’s talk about it! On this Mother’s Day, let’s talk about some ways to help lower your risk of preeclampsia.
- Pre-pregnancy counselling: if you have certain medical conditions like high blood pressure, diabetes, or you had complications with previous pregnancies, it’s a good idea to see an obstetrician for counselling before you get pregnant. Your obstetrician can assess whether your risk of preeclampsia (and other complications) is higher than average and may make recommendations like switching to medications that are safe in pregnancy, starting new medications, or having increased monitoring of the pregnancy once it happens.
- Once pregnant, see a doctor who handles pregnancies early on. Based on your personal characteristics like age, previous pregnancy outcomes, or other medical conditions, they might recommend special tests to identify signs of preeclampsia early, or aspirin to lower the risk of developing it. Low dose aspirin has been shown to lower the risk of preeclampsia in people who are at risk. In these cases it should be started between 12 and 16 weeks of pregnancy and stopped at 36 weeks or when your midwife or doctor recommends it. Make sure you ask your doctor if you should be taking it. Calcium supplementation has also been shown to lower the risk but only in people who don’t have enough calcium in their diets.
- Go to your prenatal care appointments. Every visit your blood pressure is checked. If it’s high, it should be repeated after a brief period of rest. Often if it is persistently high you’ll be asked to go to a hospital that provides care for pregnant people to have a more thorough assessment. This will generally include more blood pressure checks, some questions about symptoms, bloodwork, and monitoring of the baby’s heart beat. You might also have an ultrasound. All this information helps your doctor or midwife to assess whether you need treatment and sometimes early delivery may be recommended.
- Treatment usually includes medications that lower your blood pressure and have good evidence of safety in pregnancy. Sometimes additional medications are needed to prevent seizures, particularly if the blood pressure is very high, and if symptoms or bloodwork changes are severe. But it’s important to know that it’s the placenta that causes the mom’s blood pressure to increase and cause preeclampsia. Therefore, the only way to cure it is delivery. For this reason, when preeclampsia develops in a pregnancy that is already term (over 37 weeks), delivery is usually recommended.
- Postpartum care is also important! Delivery is the cure, but the changes caused by the placenta continue for several weeks after birth. Before you leave the hospital, make sure you have a conversation with your doctor or midwife about how your blood pressure will be monitored, what to look for, and what to do if it’s high or if you have symptoms.
As an obstetrician I see moms with preeclampsia often and I am always amazed by their resilience when faced with a stressful diagnosis like this. On this Mother’s Day I wish all moms and future moms lots of support, good health, and happiness!
Speaking of support, if you’d like to support moms in our community consider joining me for the Almonte General Hospital Run/Walk for Women’s Health on June 8th. You can also support by donating at the link below. All proceeds will help buy much needed equipment for the maternity unit.
https://aghfvmf.givecloud.co/
If you’d like to know more about preeclampsia, The Preeclampsia Foundation has lots of reliable information (www.preeclampsia.org).
