You've probably heard of preeclampsia, a condition that can sometimes happen during pregnancy. Your blood pressure may get high enough to pose health risks for you and your unborn baby. But how common is postpartum preeclampsia, and what causes it?
What Is Postpartum Preeclampsia?
It's a rare and serious condition that can happen soon after giving birth. Your blood pressure rises, and there's extra protein in your pee. If you get this condition, it'll usually happen within 48 hours of giving birth. But it's possible to get it six weeks or later after your baby is born. When that happens, it's called late postpartum preeclampsia.
Like preeclampsia, postpartum preeclampsia can be dangerous. If not treated, it can lead to eclampsia — a condition where you have seizures. And high blood pressure puts you at a higher risk of a stroke.
Preeclampsia is a similar condition with similar symptoms, but it develops during your pregnancy and usually goes away when you give birth. In postpartum preeclampsia, the symptoms happen after you've delivered your baby.
Why Does Postpartum Preeclampsia Happen?
"Many people think it's either a preclinical preeclampsia happening before birth that's just not recognized or that it's preeclampsia that's just starting at the time of birth, but it's presenting later," says Sonia Tolani, MD, a cardiologist at Columbia University's Irving Medical Center in New York City. "There may be some circulating factors that lead to it."
You're more likely to have postpartum preeclampsia if you didn't get diagnosed and treated for preeclampsia before giving birth.
Who is at risk for developing postpartum preeclampsia?
Anyone who has recently given birth can get postpartum preeclampsia. It hasn't been studied as much as preeclampsia. But the conditions are thought to have similar risk factors, including:
- High blood pressure during pregnancy
- Obesity
- Diabetes
- Kidney disease
- Being younger than 15 or older than 35 during pregnancy
- First pregnancy
- Preeclampsia in a previous pregnancy
- Being pregnant with twins or triplets
- Autoimmune conditions
- African-American or Hispanic ethnicity
- Family history of preeclampsia
Postpartum preeclampsia should be treated quickly. Otherwise, it may cause seizures and raise your chances of having a stroke. This is why postnatal care is critical for new moms.
Is postpartum preeclampsia different from preeclampsia?
For the most part, postpartum preeclampsia and preeclampsia are the same. The main difference is that postpartum preeclampsia happens after you've given birth, while preeclampsia happens before delivery. So, it doesn't go away with delivery the way preeclampsia typically does.
"The truth of it is that postpartum preeclampsia isn't terribly different from preeclampsia, except for when it presents," Tolani says. "We think of it as having the same risk factors. We don't necessarily distinguish between the two as doctors in the way that we treat and think about them."
Common Symptoms of Postpartum Preeclampsia
This condition can be hard to detect on your own. Many women who have it show no signs or symptoms during pregnancy. It's important to know the warning signs of postpartum preeclampsia, so you can get help. They may include:
- High blood pressure
- Protein in your pee (proteinuria)
- Swelling in your legs, hands, face, and sometimes your entire body
- Headaches that may be severe
- Changes in your vision, including blurry vision, temporary vision loss, seeing spots, or sensitivity to light
- Belly or rib pain
- Nausea and vomiting
- Trouble breathing
- Peeing less
How quickly does postpartum preeclampsia progress?
It can advance quickly and may require immediate medical attention. Contact your doctor right away if you have symptoms. Go to the emergency room or call 911 if your blood pressure is 160/110 or higher.
How Is Postpartum Preeclampsia Diagnosed and Treated?
During your hospital stay after giving birth, your blood pressure and other vital signs are closely monitored. If your doctor thinks you're at risk for postpartum preeclampsia, they may ask you to monitor your blood pressure at home and come in for a postpartum checkup sooner than usual.
"If it's a woman who is older, diabetic, obese, or maybe had some mildly borderline blood pressures, that might be somebody who we send home with a blood pressure monitor to monitor in the postpartum period for a couple of weeks," Tolani says.
"There's also been a big push from the OB/GYN community to see these women earlier. Traditionally, your first visit with your OB would be six weeks after you deliver, but we're starting to understand is that what we call the fourth trimester, which is that period of post-delivery, can be a very vulnerable time for women, particularly for women from communities where there's not a lot of recognition of risk factors for preeclampsia, and where the rates of preeclampsia are quite high. So, seeing women within that first week, either with a video visit or in-person visit, is another thing that's being instituted."
If you have postpartum preeclampsia, your doctor will check the severity of your condition before creating a treatment plan. If your case isn't severe and your blood pressure is lower than 160/110, your doctor may prescribe an oral medication to lower your blood pressure.
If your blood pressure is higher, your doctor may examine you for HELLP syndrome, which involves:
- Hemolysis — damaged red blood cells
- Elevated liver enzymes — damage to your liver
- Low platelets — your blood doesn't clot as easily
Your doctor will ask for blood tests that show your total blood count and levels of creatinine and liver enzymes. They'll do a urinalysis to check for protein levels in your pee.
Medicines for postpartum preeclampsia may include:
- Blood pressure medicines
- Medicines to prevent seizures, such as magnesium sulfate
- Blood thinners to reduce your risk for clots
Do you have to be hospitalized for postpartum preeclampsia?
It depends on your symptoms and how severe they are. You may need to spend more time in the hospital after giving birth, or go into the hospital when symptoms develop later. This allows your care team to monitor you.
Questions to ask your doctor
Some useful questions to ask your doctor about your condition are:
- How serious is my diagnosis?
- What treatment options do I have?
- What types of tests do I need?
- Can I breastfeed?
- How can I manage other health conditions I had before this?
- What signs should I watch for that indicate my condition is worsening?
Postpartum Preeclampsia Complications
Left untreated, postpartum preeclampsia can cause other life-threatening health conditions, including:
- Postpartum eclampsia, including seizures
- Damage to organs, including the brain, eyes, liver, and kidneys
- Fluid in your lungs (pulmonary edema)
- Stroke
- Blood clots that block your blood vessels (thromboembolism)'
Postpartum preeclampsia may also come with a higher risk of chronic or mental health conditions.
"The natural history of preeclampsia is that the blood pressure over the next six weeks should improve back to normal," Tolani says. "But there will be a significant percentage, maybe about 25% of women who develop preeclampsia, who will then go on to develop chronic hypertension."
Your hormones change rapidly after giving birth, and caring for a newborn is exhausting for anyone. Your emotions may be all over the place. Postpartum preeclampsia can make these feelings worse. Be sure to talk to someone if you think you are depressed or need help dealing with it.
Can It Be Prevented?
Doctors don't know exactly what causes preeclampsia, whether it's before birth or after. Unfortunately, there is no way to completely prevent postpartum preeclampsia in future pregnancies. But your doctor may:
- Discuss symptoms of preeclampsia with you
- Recommend taking baby aspirin (81 milligrams) to prevent preeclampsia during your next pregnancy
- Encourage you to have an active lifestyle and to eat a healthy diet
"I think the key is also getting the information out there because there have been some studies that show, particularly in Black and Latino populations, some women haven't even heard the term preeclampsia," Tolani says. "So I think that knowledge — really getting that out for women to understand and advocate for themselves — is really important."
If you think you're at risk of developing postpartum preeclampsia, talk to your doctor about ways to lower your risk for complications and how to catch it quickly.
Takeaways
Postpartum preeclampsia is a rare but serious condition. Its symptoms are similar to preeclampsia, except they happen after you give birth, not before. It's important to know the warning signs and see a doctor immediately if needed. You can't prevent it, but things that may lower your risk include an active lifestyle and a healthy diet.
Postpartum Preeclampsia FAQs
How serious is postpartum preeclampsia?
Very. It can be life-threatening if you don't get help.
Can postpartum preeclampsia affect breastfeeding?
It shouldn't. Medicines used to lower your blood pressure are generally considered safe enough to take while breastfeeding. But ask your doctor if you have concerns.
Does postpartum preeclampsia go away?
Not on its own. Early treatment is key. It typically goes away several weeks after you give birth, if you get proper care. But if untreated, it can be life-threatening.
How long does postpartum preeclampsia last?
If treated, it can last days or several weeks.
