When Amy Urban gave birth to her first child, like most parents, her biggest focus was her new baby. But in the days following her son's arrival, Amy's blood pressure became dangerously high. After arriving at the emergency room, tests revealed that Amy had postpartum preeclampsia
Preeclampsia is the most common complication of pregnancy – characterized by a rise in blood pressure, large amounts of protein in the urine and swelling of the hands, feet and face. Its cause is unknown. For many women, preeclampsia poses an immediate threat to pregnancy and potential later-life threats to heart health.
Northside Hospital Cardiologist Dr. Lee Padove says preeclampsia is most common during a pregnancy, but five percent of the time the condition occurs after delivery, like in Urban’s case.
Dr. Padove founded the Material Heart Health Clinic at Northside Hospital to address the care gap between maternal and cardiac care.
“When an expectant mother develops high blood pressure or other symptoms related to preeclampsia, it’s important to focus on the safety of the mother as well as address risks associated with future pregnancies,” says Dr. Padove. “That’s why the Maternal Heart Health Clinic was created, to provide these patients with comprehensive cardiovascular care for the rest of their lives.”
Preeclampsia Signs and Symptoms
One of the biggest challenges of preeclampsia during pregnancy is detecting this nuanced disorder. That’s because sometimes preeclampsia can show no obvious symptoms. A prenatal lab examination can detect elevated urine protein levels, an indication of preeclampsia. Other symptoms can include severe headaches, vision changes, swelling, severe breathing issues and even seizures (eclampsia). Early symptom detection is important to improving the odds of a safe pregnancy.
With postpartum preeclampsia, these symptoms are experienced after delivery and are considered just as dangerous to the mother as they are during pregnancy.
“When I was discharged from the hospital after my first child, I was told to follow up with my doctor’s office in six weeks. I had no idea that I needed to keep an eye out for certain symptoms and go back to the hospital if needed,” said Urban. “I thought my upper back and shoulder pain, headaches, and visual disturbances were due to being tired and nursing. I would tell all expectant moms and moms in the postpartum period to report any strange symptoms to their physician and ask to be evaluated and, if needed, go to the emergency room.”
Women may also choose to invest in a blood pressure cuff or check blood pressure at a drug store or grocery store.
Monitoring Preeclampsia and Treatment
When suspicion of preeclampsia exists, a thorough evaluation may include hospitalization, so health care providers can more closely monitoring the mother, baby and placenta.
Treatment for preeclampsia is increased prenatal visits, and more frequent blood tests, ultrasounds and testing than would be expected in an uncomplicated pregnancy. Ideally, after a 37-week gestation period, treatment for preeclampsia would be delivery. If there is a threat to either the baby’s health or mother’s life, delivery is scheduled earlier.
Risks Later in Life
The effects of preeclampsia do not necessarily end after pregnancy. Women who have had preeclampsia during pregnancy have a higher risk post-delivery for developing blood pressure problems, high cholesterol, diabetes, along with stroke and heart disease.
After having preeclampsia in her first pregnancy, Amy Urban scheduled an appointment with her doctor for a records review and advice on any future pregnancies. She was told that she had a 25 percent chance of it occurring again. After delivering her second child at Northside Hospital that’s exactly what happened, and that’s when she met Dr. Padove and the Maternal Heart Health Clinic.
“Although I always exercised, I am now more aware of my cardiac health and the potential of future cardiovascular disease,” Urban said. “It’s important for all women, and especially those who have had preeclampsia, to have annual physicals and to be screened for future cardiovascular issues.”
Additionally, women who experienced preeclampsia during pregnancy are also at nearly double the risk for heart disease or stroke the subsequent five to 15 years. And women who have had severe preeclampsia may have a greater than six-fold risk.
“Women who have had a preeclampsia complication in a first pregnancy, are more at risk of having it again, and it can occur earlier in the next pregnancy,” Dr. Padove said. “However, you may not have it at all in a subsequent pregnancy. There is still so much unknown, which is why it’s important to understand the symptoms and talk to your doctor about anything that feels off.”
It is important that women who have experienced preeclampsia embark on a healthy lifestyle path and follow preventive measures along with continued screening for diabetes, high blood pressure, high cholesterol and premature heart disease.
“Northside’s Maternal Heart Health Clinic educates women about their risk factors and screens them to detect the early development of cardiovascular disease,” says Patricia Tyson, director of heart and vascular physician services. “The clinic augments Northside’s ongoing commitment of providing expert and comprehensive care for patients with preeclampsia.”