The Warning Signs of Preeclampsia, Before and After Delivery

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Pregnant woman with hands on belly

Sarah Hughes just thought she was tired. Six days earlier, she delivered her second child and was now at home caring for her newborn daughter.

She had blurry vision, was out of breath and had a dull headache that wouldn't go away. Her husband urged her to call her obstetrician at Pennsylvania Hospital, who ordered her to come back to the hospital immediately. Her obstetrician diagnosed her with preeclampsia, a condition marked by elevated blood pressure and excess protein in the urine.

"I didn't think it could be anything serious like preeclampsia; I thought only women who were pregnant could get preeclampsia. I already had my baby," says Sarah.

What is preeclampsia?

While it is true that preeclampsia is most common in pregnant women, in cases like Sarah's is can happen after a woman has given birth.

"Preeclampsia typically develops after the 20th week of pregnancy. However, it can also develop after a woman delivers and is discharged from the hospital," says Sindhu Srinivas, MD, MSCE,, director of Obstetrical Services at the Hospital of the University of Pennsylvania.

The exact cause of preeclampsia is unknown and includes several factors. Components that can play a role in developing preeclampsia include immune system issues, insufficient blood flow to the uterus, damage to the blood vessels and genetic factors.

"Preeclampsia and related disorders are most often characterized by the presence of a sudden rise in blood pressure. This can lead to seizure, stroke, multiple organ failure and death of the mother and/or baby," Dr. Srinivas warns.

Preeclampsia Symptoms

Preeclampsia affects five to eight percent of women and is one of the top causes of maternal mortality. Symptoms can include:

  • High blood pressure during pregnancy
  • Blurred vision
  • Headache
  • Swelling of the face, hands and feet
  • Upper abdominal pain
  • Vomiting
  • Shortness of breath
  • HELLP syndrome (severe form of preeclampsia)

Who is high risk for preeclampsia?

Knowing the symptoms of preeclampsia is vital, especially for women at higher risk for the disorder. Women who have chronic hypertension, have had preeclampsia in previous pregnancies or who have certain medical conditions, such as lupus, are at increased risk for developing preeclampsia.

"Women at risk should consult with a maternal-fetal medicine specialist before conceiving to better understand her risk and how to optimize the pregnancy for the best outcome," says Dr. Srinivas.

"Even if the condition is mild, it can affect the baby's growth and the mother," she says. "If the condition is stable, we may only need to monitor and test during pregnancy. But if a woman's condition worsens or is severe, the only cure for preeclampsia is to deliver the baby."

How can you detect preeclampsia early?

Sarah Donza with her childrenTo support the need for more education and monitoring, Dr. Srinivas and Adi Hirshberg, MD, associate director of Obstetrical Services at the Hospital of the University of Pennsylvania, created Heart Safe Motherhood, a program that sends new moms home with wireless blood pressure cuffs.

"This program helps us monitor women without making them come into the clinic for a blood pressure check," says Dr. Srinivas. "It's our hope that by monitoring their blood pressure in this way, we can address issues before they become serious."

Today, Sarah speaks openly about her experience and advocates for women at risk for preeclampsia.

"I am thankful to have had Penn Medicine doctors who are up to date on the latest research and information and could diagnose me quickly," Sarah said. "After a few days on magnesium sulfate and wearing an oxygen mask, I was on track to recover and get back home to my family."

Explore Penn Medicine's Pregnancy and Heart Disease Program to receive specialized heart care during pregnancy.

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