What is preeclampsia?

Jane Forester, D.O.

Your question
What is pre-eclampsia? - Courtney in Newport Beach, California

The expert answers
Courtney,

Preeclampsia, sometimes improperly called "toxemia," is a term for hypertension (elevated blood pressure) with complications during pregnancy. Often, physicians use the term "pregnancy-induced hypertension" (PIH) to mean the same thing. Preeclampsia occurs primarily in -- although not restricted to - the young woman in her first pregnancy, typically during the last trimester. About 5 percent of first-time mothers and 1 to 2 percent of mothers having subsequent pregnancies develop preeclampsia.

Preeclampsia is diagnosed when a pregnant woman has these three symptoms at the same time:

• the presence of pathologic edema (in hands and face)
• high blood pressure (greater than140/90)
• protein in the urine (proteinuria)

Swelling in the lower legs is common and of little concern; although it can be painful, it's not part of the preeclampsia syndrome. The growing weight of the baby is resting on the veins that help clear fluids out of the lower legs, disrupting the clearance system. The concern arises when edema (swelling) occurs in the hands and face, as the physiologic reasons for this are different.

Your healthcare provider will check for this at every visit, and you will also be asked to give a urine specimen at each exam so it can be checked for the presence of protein (proteinuria). A trace amount is normal, but more can indicate that the kidneys are being overworked during pregnancy; in extreme cases, this can cause the kidneys to shut down.

Likewise, blood pressure readings are taken at each exam so the physician can continually evaluate all three symptoms that constitute preeclampsia and can take immediate action should the syndrome arise.

Jane Forester
Family Physician
Glencoe, Illinois