So I get asked a lot about what preeclampsia is and the short answer is that it is a condition of the placenta that occurs after 20 weeks gestation and causes high blood pressure and one other symptom (most commonly protein in the urine). The tricky part about this illness is that though doctors know a lot about it, no one yet knows what CAUSES preeclampsia. And without a known cause, there is not a known solution. I am part of a group on Facebook that is for preeclampsia survivors and they are a strictly evidenced based group. This has been a huge help to me in my journey after preeclampsia, preparing for what life may entail (most like blood pressure issues later in life) and what a future pregnancy might look like for us. It is also extremely helpful in knowing just what we are dealing with, the things to look for, and ways to advocate for myself. This knowledge has been a huge help since it seems time and time again I was told things that were not true in the hospital. So I thought it might be interesting to share a somewhat brief explanation that was presented in the group I am a part of:
"The evidence is clear that preeclampsia is not a lifestyle issue. There is nothing we do wrong, or fail to do right that causes it. That’s the good news, but of course the flip side is there is nothing we can change that would then prevent it. Weight loss, exercise, calorie restriction, Brewer’s (**this is a very specific diet that some people claim prevents preeclampsia--many women in the group followed it to a T and still developed the disorder**), none of that will help.
Scientists actually know quite a bit about how preeclampsia develops. It is a placenta issue. The placenta starts developing soon after implantation and digs into the mother’s blood supply so it can get oxygen and nutrients for the baby. This process is usually finished around 20 weeks gestation.
Early on, the placenta takes in much more than the tiny baby needs and saves up the extra for later. Then during labor, when contractions start to cut off the blood supply, no problem. The placenta just dips into its reserves and baby still gets plenty of oxygen. As this saved oxygen gets used up, the placenta releases a chemical-protein that prevents blood vessels from getting repaired. Usually, the chemical stays in the area where the placenta is connected to the uterus, only damaging the blood vessels between the two. This happens in all pregnancies, and scientists think this is what allows the placenta to separate after birth.
In a preeclamptic pregnancy, the placenta does not dig in deeply enough to take in enough oxygen. As the baby grows, it eventually needs more than the placenta can provide, and it starts dipping into its reserves early. The chemical is produced in much larger quantities and has time to move beyond the placenta into the mother’s blood stream. It damages all of our blood vessels, which is what triggers all the symptoms we know as preeclampsia.
So, why doesn’t the placenta dig in deeply enough? That is where the research is focused now. They think it is a combination of how well your genes and your partner’s genes work together to build a placenta, and then how well that placenta negotiates with your immune system. None of this is lifestyle.
So far, the only thing proven to lower the risk of preeclampsia is low dose aspirin, and it only seems to work in a small number (think 5%) of cases. Really, the best thing you can do is be closely monitored. You might not get preeclampsia again at all. New pregnancy, new combination of genes, new placenta. But close monitoring will make sure that if it does happen, it will be caught right away so you can make the best decisions about what care you need."
In addition, this video was shared to the group, that is an interesting look at why women have periods, but also what the act of menstruation is supposed to do and how sometimes things go wrong and cause issues in pregnancy (diabetes, high blood pressure, preeclampsia, etc). Don't worry, it is a cartoon, so nothing super graphic!
Now for some interesting information:
1. The only known treatment is a baby aspirin started before the 12th week of pregnancy and even that is only shown to be effective in 5% of women.
2. Preeclampsia is most commonly a condition of a first pregnancy (occurring just 4% of the time in all women) and only 2% of the time in subsequent pregnancies for all women.
3. If you have had preeclampsia before, you are at an increased risk of developing it again, women who had it in their first pregnancy, have a 20% change of developing it in a second pregnancy (this is 10 times higher than the risk for all women).
4. There is some scientists that say the rate is higher for those women who have a new partner for a subsequent pregnancy, thus supporting some research that the male sperm may play a role in preeclampsia. The theory is that if you have the same partner, you are less likely to develop it because your body recognizes the sperm as familiar rather than unfamilar and attempts to "attack" it.
5. Preclampsia has a heredity link, if your mother had it, you are at an increased risk of having it. But new studies also show that if your father's birth was precclamptic, it can also increase your risk too.
Though preeclampsia is relatively well known disorder, there are still many many things hospitals and nurses are ill-advised about when dealing with a patient with preeclampsia. Here are a few of the un-truths I or others were told while in the hospital:
* You need to relax so your blood pressure will go down. FALSE: My placenta just fed my body with a bunch of protein that is restricting my blood supply and increasing my blood pressure. Relaxing (even though relatively impossible when thinking about delivering a baby 12 weeks early will not cure that.)
* I have never seen a case this severe, pregnancy should have 'cured' you (my blood pressure did not normalize after birth, it took a few days to get into a high range and then 4 weeks to ween off medicine after birth). FALSE: After delivery, it can take sometimes up to 6 weeks for your body to get back to regulating correctly and even then you may need medicine to help.
* After you deliver the baby, you will have no long term effects. FALSE: preeclampsia is often indicative of elevated blood pressure issues later in life
* You should never have another baby or you will get it again. TRUE and FALSE: some women are advised a future pregnancy would likely end the same way because of underlying conditions. But for most woman a future pregnancy (though scary) is feasible with good monitoring.
* Preeclampsia can only occur before baby is born. FALSE: there is such a thing as post-partum preeclampsia and ecclampsia (which is seizure activity after birth) and it is equally as serious.
Here is the Preeclampsia website for tons of additional information if anyone is interested. But I am also happy to seek out answers for anyone interested!
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