Until the beginning of her third trimester, Jennifer Brymer of Springfield, Missouri, would have classified her pregnancy as pretty normal. This 26-year-old first-time mom was feeling strong and healthy. Then came a sudden weight gain, as well as a case of extremely swollen feet, which prompted a call to her OB-GYN.
"The nurse asked me all kinds of questions: Was my vision blurred? Did my head ache? Were my hands and face swollen? Was there a sharp pain under my ribs? I answered no, my feet are just huge," Brymer says. She was told to stay off her feet as much as possible until her scheduled appointment with the OB the following week. She was informed, however, to call back immediately if she started experiencing problems with her vision or swelling in other parts of her body, particularly her hands.
When she visited her OB, the scale confirmed the weight gain. "I couldn't believe my eyes," she says. "I had gained almost 25 pounds since my last visit three weeks ago." Additionally, her blood pressure was higher than usual and a trace amount of protein was found in her urine. After evaluating the symptoms, her doctor informed her that she was suffering from preeclampsia (pregnancy-induced high blood pressure).
"Concerning symptoms of preeclampsia are persistent headache, blurring of vision, nausea or abdominal pain, swelling of the hands and/or face, and diminished urination," says Dr. Traci Kurtzer of Nova OB group in Chicago. "The signs of preeclampsia that your doctor will screen for during prenatal visits are elevated blood pressure, significant weight gain, protein spilling into the urine, and certain abnormalities in blood tests."
Preeclampsia can be very dangerous to both Mother and Baby so it's vital to take the recommendations of healthcare practitioners seriously, even if you don't feel sick. In fact, it's not unusual for a pregnant woman to be feeling completely fine when preeclampsia is diagnosed.
Jeney Wilkins of Columbus, Ohio, was still exercising four times a week when her obstetrician discovered warning signs of preeclampsia during the 30th week of her first pregnancy. The following week the condition had become so severe that she was admitted to the hospital for treatment. "I was stunned," says Wilkins. "I felt fine. I cried all the way home to pack a bag; my husband was shocked to find out that I was somehow ill."
"The treatment of preeclampsia depends much on the age of the pregnancy and the severity of the condition," says Dr. Kurtzer. Treatment includes varying degrees of bed rest, ideally while lying on your left side, and, in more advanced cases, hospitalization and/or the administering of medication to prevent possible seizures. Additionally, both Mother and Baby will be closely monitored for the duration of the pregnancy. Along with frequent blood tests, ultrasounds, and fetal monitoring, some women will also be asked to check their blood pressure at home several times a day.
The only real "cure" for preeclampsia is delivering the baby, but obviously, the earlier in her pregnancy a woman is, the less desirable that option becomes. In many cases, with careful management, women carry their babies to term. In others, however, depending on the condition of Mother and/or Baby as well as the severity of the preeclampsia, a decision may be made to induce labor and deliver the baby early.
After Brymer was diagnosed, her doctor advised that she could continue to work but she should stay in bed every evening and weekend. As the weeks passed, however, her blood pressure crept higher and her doctor became increasingly concerned with her condition. During the 34th week of her pregnancy she was hospitalized. Over the next several days, Brymer endured medication to manage her preeclampsia, countless blood tests to monitor her liver and kidney function as well as her platelet count, and steroid shots to mature her baby's lungs. She had been in the hospital for six days when her obstetrician decided that it was necessary to induce labor. "My daughter was five weeks early and weighed 4 pounds, 15 ounces when she was born," Brymer says. "She spent an hour in the neonatal intensive care unit and was then placed in the regular nursery. She developed jaundice, but was otherwise in perfect health."
In Wilkins' case, after her initial diagnosis, a regimen of strict bed rest, constant blood pressure and fetal monitoring, and frequent doctor visits was prescribed. And although there were moments when an early induction seemed imminent, she was fortunate enough to carry her son for a full 40 weeks before her obstetrician induced labor. "My son weighed 6 pounds, 6 ounces at birth," Wilkins says. "He was, and still is, healthy and has shown no ill effects from the preeclampsia."
Although the causes of preeclampsia are still unknown, Dr. Kurtzer says, "there are many different risk factors for preeclampsia. Certain medical conditions—such as chronic hypertension, chronic renal disease, autoimmune disorders, and diabetes—are associated with the highest risk of developing preeclampsia." It is also more likely to develop in women who are pregnant with their first child, women who are younger than 20 and older than 40, women who are carrying more than one baby, and women who have had preeclampsia during a previous pregnancy.