For most women with preeclampsia, the condition will develop during pregnancy — but in rarer instances, it can appear after you’ve given birth.
What is postpartum preeclampsia?
While you may have heard of preeclampsia, a condition that develops during pregnancy and typically resolves with baby’s birth, postpartum preeclampsia is a serious health condition that crops up after you've had your baby. It is characterized by high blood pressure and a build-up of protein in the urine.[1]
Left untreated, it can lead to eclampsia (seizures), HELLP syndrome (Hemolysis, Elevated Liver enzymes and Low Platelets, which is a type of preeclampsia), and other problems.
What are the symptoms of postpartum preeclampsia?
The symptoms of postpartum preeclampsia are similar to those that develop during pregnancy. Some can be difficult to detect on your own, especially if you're focused on taking care of your new bundle of joy. But if you have any suspicion that something isn’t right, contact your doctor right away.
Symptoms of postpartum preeclampsia may include:[2]
High blood pressure (140/90 mm Hg or higher)
Too much protein in your urine (proteinuria)
Headaches that can often be severe
Vision changes, including blurry vision, light sensitivity and a temporary loss of sight
Abdominal pain (particularly under the ribs of the upper, right-hand side of the stomach)
Nausea or vomiting
Shortness of breath
Swelling
When does postpartum preeclampsia typically start?
For most women, postpartum preeclampsia appears within 48 hours after giving birth. But if it appears fewer than two days after delivery or up to six weeks postpartum, it’s known as late-onset or delayed onset postpartum preeclampsia.
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When your blood pressure exceeds 140/90 mmHg or higher for the first time in the postpartum period (and/or you experience symptoms such as those noted above), you may have postpartum preeclampsia.
Headaches are the most common reason women report going to their health care provider and in two large studies has been found to be found in 70% of participating women. Shortness of breath was also common.
What causes postpartum preeclampsia?
Experts aren’t sure what causes postpartum preeclampsia, but the American College of Obstetricians and Gynecologists (ACOG) points out that fluid shifts that occur after giving birth can possibly cause a rise in blood pressure levels during the three- to six-day period after labor and delivery.
How common is postpartum preeclampsia?
Some researchers have estimated that between 4 and 6 percent of women with preeclampsia and eclampsia are diagnosed with the disorder during the postpartum period.
If you have preeclampsia during pregnancy (i.e., high blood pressure and signs of liver or kidney damage that occur after week 20), you have a higher risk of developing the condition during the postpartum period than women without preeclampsia, but this disorder can also appear in women who had normal blood pressure levels throughout their pregnancies.
What are the risk factors for postpartum preeclampsia?
Women who have preeclampsia during pregnancy have an increased risk for the disorder after giving birth, but even mothers with healthy blood pressure levels can develop the condition postpartum.
In fact, one study found that about 60% of women who were diagnosed with postpartum preeclampsia (which sometimes also included eclampsia, or seizures) didn’t have either of these disorders when they were pregnant.
While more research is needed to pinpoint what increases a woman’s odds of having postpartum preeclampsia, the following risk factors may play a role in its development:
Having gestational diabetes or preexisting type 1 or type 2 diabetes
High blood pressure that develops after week 20 of pregnancy
Obesity
Carrying multiples
Having heart disease due to high blood pressure
Being 40 years old or older
Autoimmune conditions
Black mothers are also more likely to develop preeclampsia and postpartum preeclampsia
How is postpartum preeclampsia diagnosed?
After you give birth, your doctor will check your blood pressure levels at the hospital, then again at your postpartum doctor's appointments. Keeping a close eye on your blood pressure at home after delivery and being on the lookout for these symptoms can be helpful as most patients are discharged from the hospital one to two days after a vaginal delivery.
If your health care providers suspect that you have postpartum preeclampsia — for example, your blood pressure levels are high — they will give you a blood test and urine test to confirm or rule out the disorder.
If you were diagnosed with preeclampsia earlier in your pregnancy, your providers will keep a close eye on your blood pressure levels for 72 hours after you give birth, either at the hospital or while you’re recovering at home.
Since postpartum preeclampsia can develop up to six weeks after delivery, it’s important to keep tabs on your own symptoms. If you experience problems like headaches, trouble breathing and vision changes, call your doctor right away.
You may need to be readmitted to the hospital, as there’s some evidence that postpartum preeclampsia is linked to a higher risk of complications than preeclampsia that develops during pregnancy.
What are the complications associated with postpartum preeclampsia?
The risk of complications for women with postpartum preeclampsia may be more serious (and escalate more quickly) than those for women whose preeclampsia appeared during pregnancy. Regardless of when the disorder appeared, it’s important to tell your doctor if you’re experiencing any of the above symptoms.
If left untreated, some of the complications include:
Postpartum eclampsia, a serious medical condition that results in seizures and can cause organ damage. (About 1 in 3 cases of eclampsia occur after a woman gives birth; almost half the time, the seizures appear more than 48 hours after delivery.)
Pulmonary edema, or a build-up of fluid in the lungs.
HELLP syndrome, a rare but serious liver and blood-clotting disorder. HELLP stands for hemolysis (a breakdown of red blood cells in the body), elevated liver enzymes (a sign that the liver isn’t processing toxins adequately) and low platelet count (an inability of the blood to clot as well, which can result in more bleeding).
Stroke, which interrupts blood flow to the brain.
How do you treat postpartum preeclampsia?
Postpartum preeclampsia doesn’t go away on its own and can quickly progress to eclampsia, so it’s important to be treated for the condition right away. Your doctor may recommend the following medications:
Blood pressure medications, or antihypertensive medications, which will bring down your blood pressure.
Magnesium sulfate, which can help prevent seizures. Typically, women will take this for 24 hours, and continue to be monitored for other symptoms after they’ve finished the treatment.
Chances are, you’ll be able to breastfeed while taking these medications, but you should always check with your doctor before doing so.
What are the risks of pregnancy-related high blood pressure?
Women with pregnancy-related high blood pressure conditions including preeclampsia and gestational hypertension may have an increased chance of having high blood pressure, cardiovascular disease, or kidney disease later in life.
The risk goes up if two or more pregnancies were affected, or if early-onset preeclampsia makes it necessary to have labor induced before 34 weeks of pregnancy.
What can you do to prevent postpartum preeclampsia?
It’s unclear whether postpartum preeclampsia can be prevented, but your doctor may have the following lifestyle recommendations:
Follow a healthy diet. Moms in their second trimester usually need to up their calorie intake by 300 to 350 calories a day, and then by 500 calories a day in their third trimester. Likewise, if you’re breastfeeding, you may need to eat about 500 more calories per day than you were eating before you got pregnant. Try to include plenty of leafy green vegetables, whole grains and lean sources of protein in your diet.
Stay active. If your pregnancy is normal, you should try to exercise for at least 150 minutes a week (or 30 minutes of moderate-intensity aerobic exercise a day) and do a minimum of two weekly sessions of strength training.
Consider taking baby aspirin. If you have some risk factors for preeclampsia, your doctor may want you to take baby aspirin (aka low-dose aspirin), which may help prevent the condition from occurring or recurring if this is a subsequent pregnancy and you’ve had it in the past.
Thankfully, postpartum preeclampsia is rare. But because it can cause serious complications like eclampsia — and because you may no longer be in the hospital when the symptoms appear — you’ll want to seek medical treatment right away if you notice any of these signs.
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