What Is Postpartum Preeclampsia: Symptoms and Treatment

Postpartum preeclampsia is a rare but life-threatening condition that occurs after childbirth. It is indicated by high blood pressure and certain proteins in the urine. Women at risk of postpartum preeclampsia may develop the condition within 48 hours and even up to six weeks after delivery. Learn more about what postpartum preeclampsia is all about and how to spot it. 

Postpartum Preeclampsia Symptoms

Preeclampsia during pregnancy and after birth have similar symptoms. Postpartum preeclampsia can induce the following symptoms:

• severe headaches
• blurred vision
• nausea and vomiting
• sore ribs
• shortness of breath
• sudden weight gain 
• swelling around the eyes, hands, and feet

High blood pressure⁽¹⁾, a hallmark of preeclampsia, happens, but it does not pose any physical indication. Hence, keeping track of your blood pressure readings is crucial. If your blood pressure reading frequently exceeds 140/90 mmHg and other signs of postpartum preeclampsia are present, let your doctor know immediately. 

In addition to the spike in your blood pressure, preeclampsia after childbirth can also trigger proteinuria⁽²⁾ or excess protein residue in the urine. This condition results from an abnormality in the blood flow, causing a kidney strain. Consistent proteinuria can be a sign of kidney damage. 

Causes of Postpartum Preeclampsia

The exact cause and physiological pathway of postpartum preeclampsia is yet to be discovered. Nonetheless, several factors have been identified that contribute to the development of postpartum preeclampsia, specifically the following:

• Blood vessel problems: Some abnormalities in the blood vessel lining and formation⁽³⁾ during pregnancy can lead to increased blood pressure, leading to preeclampsia during and even after childbirth.
• Placental issues: The placenta forms new blood vessels to channel oxygen and nutrients to the fetus. These newly formed blood vessels may contain physiological damage⁽⁴⁾ that sparks preeclampsia.  
• Preexisting conditions: Your risk of postpartum preeclampsia increases if you have kidney disease, diabetes, obesity, chronic inflammation, and autoimmune disorders. 
• Family history: If someone in your family has experienced preeclampsia, your likelihood of carrying the genes that inhibit proper placenta development⁽⁵⁾ increases. Hence, you are relatively inclined to have preeclampsia after child delivery.   

Also Read: 11 Preeclampsia Risk Factors Every Pregnant Woman Should Know 

Treatment for Postpartum Preeclampsia

At the potential onset of postpartum preeclampsia, your doctor may prescribe you antihypertensive medications to lower your blood pressure. If this is not addressed, let alone diagnosed, preeclampsia can lead to seizures and other life-threatening complications. Hence, part of the treatment is managing and preventing these consequences.

For example, magnesium sulfate⁽⁶⁾ might be administered to prevent seizures. Your physiological capacity will also likely be monitored closely to screen for organ damage. This will include kidney function tests and liver blood tests. Specifically, it is crucial to prevent HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome, as this is a possible effect of postpartum preeclampsia.   

The postpartum preeclampsia survival rate is high with early diagnosis and a proper treatment course. However, since the condition is rare, as preeclampsia is commonly associated with pregnancy instead of afterbirth, it is easy to overlook. 

Frequently Asked Questions

What causes high blood pressure after childbirth?

Postpartum hypertension can be due to preeclampsia after childbirth. It can also be caused by the removal of extra fluids, as pregnancy tends to promote fluid retention. Likewise, high blood pressure can be triggered by physical and emotional stress after child delivery, certain medications, and underlying medical conditions like thyroid and kidney diseases. 

Does postpartum preeclampsia go away?

Postpartum preeclampsia has to be addressed medically to prevent any further complications. It is not advisable to wait for the condition to go away on its own. Close monitoring is crucial, especially concerning symptoms and spikes in high blood pressure within and after six weeks of delivery. 

Is postpartum preeclampsia life-threatening?

Yes, undetected and untreated postpartum preeclampsia can result in death. It can also lead to serious conditions like seizures, stroke, and permanent organ damage. Postpartum preeclampsia also increases a woman’s risk of developing heart disease long after childbirth. 

The Bottom Line

Postpartum preeclampsia is rare. However, given the limited understanding of the true cause of the condition and the severity of its complications, it’s imperative to learn how to spot its symptoms. Many women tend to ignore post-natal care. But this life-threatening condition is a testament to its significance. Make sure to schedule checkups with your obstetrician after childbirth to ensure you’re recovering well.

Sources

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² Unverdi S, Ceri M, Unverdi H, Yilmaz R, Akcay A, Duranay M. Postpartum persistent proteinuria after preeclampsia: a single-center experience. Wien Klin Wochenschr. 2013 Feb;125(3-4):91-5. doi: 10.1007/s00508-013-0320-8. Epub 2013 Jan 19. PMID: 23334478.

³ Opichka MA, Rappelt MW, Gutterman DD, Grobe JL, McIntosh JJ. Vascular Dysfunction in Preeclampsia. Cells. 2021 Nov 6;10(11):3055. doi: 10.3390/cells10113055. PMID: 34831277; PMCID: PMC8616535.

⁴ Magee LA, Brown MA, Hall DR, Gupte S, Hennessy A, Karumanchi SA, Kenny LC, McCarthy F, Myers J, Poon LC, Rana S, Saito S, Staff AC, Tsigas E, von Dadelszen P. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022 Mar;27:148-169. doi: 10.1016/j.preghy.2021.09.008. Epub 2021 Oct 9. PMID: 35066406.

⁵ Kim SK, Vishweswaraiah S, Macknis J, Yilmaz A, Lalwani A, Mishra NK, Guda C, Ogunyemi D, Radhakrishna U, Bahado-Singh RO. New-onset postpartum preeclampsia: epigenetic mechanism and prediction. J Matern Fetal Neonatal Med. 2022 Dec;35(25):7179-7187. doi: 10.1080/14767058.2021.1946504. Epub 2021 Aug 10. PMID: 34374309.

⁶ Sullivan M, Cunningham K, Angras K, Mackeen AD. Duration of postpartum magnesium sulfate for seizure prophylaxis in women with preeclampsia: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2022 Dec;35(25):7188-7193. doi: 10.1080/14767058.2021.1946505. Epub 2021 Jun 30. PMID: 34187284.