Postpartum Preeclampsia: Symptoms, Causes, Risks & Treatment

Postpartum preeclampsia is not very common and is characterized by high blood pressure and high protein levels in the urine after delivery. It is more common in women with antenatal hypertensive disorders, but it is not uncommon to experience a new onset of postpartum preeclampsia (1). For most women, the condition develops within the first 48 hours after childbirth, while for others, it may take around six weeks. Some studies also suggest that about 0.3% to 27.5% of all pregnant women in the US experience postpartum preeclampsia (2). Read about the occurrence, causes, symptoms, complications, and treatment options for postpartum preeclampsia.

What Are The Symptoms And Complications Of Postpartum Preeclampsia?

The various symptoms of postpartum preeclampsia are (1) (3) (4):

• Blood pressure more than 140/90 mm Hg (millimeters of mercury)
• Proteinuria (presence of high levels of protein in urine)
• Constant and severe headache
• Disturbances in vision, such as seeing spots, blurred vision, or sensitivity to light
• Swelling in face and limbs
• Nausea and vomiting
• Abdominal pain on the upper right side
• Reduced urination
• Shortness of breath
• Rapid weight gain (a few pounds in a week)

If postpartum preeclampsia is left untreated, it might lead to other complications (1).

1. Postpartum eclampsia: Eclampsia can occur in women after delivery and is characterized by seizures, severe headaches, and visual problems. If the condition is not treated on time, it may lead to intracerebral hemorrhage (bleeding inside the brain) or death (5).

2. Pulmonary edema: Women with postpartum preeclampsia may develop pulmonary edema, where excess fluid accumulates in the lungs, leading to shortness of breath, coughing up blood, anxiety, and speaking problems (6) (7).

3. Stroke: In rare cases, postpartum preeclampsia may cause a stroke. Stroke is a condition where a clot or a bleed in the brain leads to serious outcomes, such as disability, brain damage, or death (8) (9).

4. Thromboembolism: This disorder results from two conditions: deep vein thrombosis (blood clot in the deep vein of thigh, pelvis, and lower leg) and pulmonary embolism (clot breaks and reaches the lungs). Thromboembolism blocks blood vessels in the lungs, kidneys, legs, or brain and may cause stroke or death (10).

5. HELLP syndrome is supposed to be a variant of preeclampsia and is a life-threatening condition. It is characterized by hemolysis (H), elevated liver enzymes (EL), and low platelet count (LP) (11).

6. Others: Postpartum preeclampsia may cause permanent damage to the brain, liver, and kidney. It may even lead to death.

What Are The Causes And Risk Factors Of Postpartum Preeclampsia?

The exact cause of postpartum preeclampsia is unknown; however, some factors increase the risk of the condition (1) (3) (12).

• High blood pressure during pregnancy (after 20th week)
• Obesity
• Pregnant with multiples
• Pregnant before the age of 20 or after 40
• Family history of high blood pressure
• Delivery through C-section
• Diabetes (13)

How Is Postpartum Preeclampsia Diagnosed?

Postpartum preeclampsia may be diagnosed with the following tests (1) (3):

1. Blood pressure check: If the blood pressure is higher than the normal range, you may have to stay in the hospital.
2. Blood test: The test helps determine the platelet count and liver and kidney function.
3. Urinalysis: It is used to check the level of protein in the urine.
4. Brain imaging: The scan helps check the signs of brain damage if you have seizures.

How Is Postpartum Preeclampsia Treated?

Healthcare providers may treat you with the following medications if diagnosed with postpartum preeclampsia (1).

• Blood pressure medicines such as labetalol, hydralazine, and nifedipine can decrease blood pressure (14).

• Anti-seizure medicine such as magnesium sulfate helps control seizures (a sign of severe postpartum preeclampsia). The medication may be given for 24 hours or more depending on the severity (4). If magnesium sulfate is contraindicated, lorazepam or diazepam is suggested (15).

• Anticoagulants (blood thinners) are administered to help prevent blood clots.

How Long Does Postpartum Preeclampsia Last?

With the right medications, postpartum preeclampsia usually resolves within a few days to a few weeks (around 12 weeks). However, if the symptoms last longer than 12 weeks, further diagnosis is made to determine a secondary cause for the condition (3) (16).

What Is The Recommended Diet For Postpartum Preeclampsia?

You should take proper care of your diet if you have postpartum preeclampsia. Some things you may do are (17):

• Take your meals and snacks at regular intervals.
• Include whole grains, fruits, and vegetables in your diet every day.
• Limit the intake of sodium.
• Add sources of protein (peanuts, butter, fish, chicken), calcium (cheese, yogurt, orange juice), vitamin C (broccoli, tomatoes, peppers), and iron (meat, fish, egg, beans) to your diet.
• Drink enough water to maintain your breastmilk supply.
• Reduce the intake of processed foods with high amounts of salt, sugar, and saturated fats.
• In a balanced meal plate, the half plate should have fruits and vegetables, one-fourth with whole grains, and the other one-fourth with healthy protein.

Some other things you can do to keep yourself and your baby in good health are (18):

• Eat enough to maintain your breastmilk supply (a minimum of 1800 calories a day).
• You should avoid alcoholic beverages, as they can pass on to the baby through milk.
• A maximum of two to three cups of caffeinated beverages a day is ideal.
• Do not lose excess weight suddenly. It is recommended to lose half to one pound of weight per week.
• Talk to your healthcare provider before beginning an exercise.

How To Prevent Postpartum Preeclampsia?

You may not be able to prevent postpartum preeclampsia; however, these steps will help reduce the risk of developing complications (3) (12) (18).

• Go for a postpartum checkup even if you don’t have any health issues.
• If you have had hypertension issues during pregnancy, see your doctor three days after discharge to diagnose problems early.
• Be vigilant and identify the early signs of postpartum preeclampsia.
• Monitor your blood pressure regularly at home.
• Contact the healthcare provider immediately if you notice any worrying change in your previous condition.

References

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