Postpartum Preeclampsia: A Silent, But Serious Condition

It should be a wonderful and exciting time in your life. After nine long months of waiting, you can finally meet and bring home your new baby bundle of joy. But for some women, there could be a silent health problem that’s deadly serious: postpartum preeclampsia.

Postpartum preeclampsia happens when a woman’s blood pressure goes above 140/90 after childbirth. It can happen within the first few days or up to six weeks following delivery after giving birth.

We don’t know exactly what causes postpartum preeclampsia, but experts believe there are a few contributing factors. Quick changes in hormonal levels and fluids can affect blood pressure.

Preeclampsia can also have severe features and result in damage to the liver, kidneys, and blood disorders, as well as cause stroke and seizure, so it’s important for everyone to be aware of it.

Initially, preeclampsia may not cause noticeable symptoms, but unexplained headaches, new swelling of the legs, and visual changes should prompt a call to your doctor, says Sonia Tolani, MD, of the ColumbiaDoctors Hypertension Center. She is also the co-director of the Columbia Women’s Heart Center.  

The Risk Factors of Postpartum Preeclampsia

Several factors can contribute to the development of postpartum preeclampsia in older women without a prior history of hypertension. These factors include:

• Gestational hypertension: Women with a history of gestational hypertension also have an increased risk of developing postpartum preeclampsia.
• Hormonal changes: The rapid hormonal shifts after childbirth can affect blood pressure regulation, potentially leading to hypertension.

Understanding the Symptoms of Postpartum Preeclampsia

Postpartum preeclampsia symptoms can vary. Some women may not experience any noticeable signs, which is another reason it can be so dangerous.
“Women at higher risk for development of preeclampsia may want to discuss measuring their BP at home or checking in with their OB within a few days of discharge to be checked. It is very important for women to seek urgent evaluation if they do have symptoms as preeclampsia can proceed very quickly,” advises Dr. Tolani.

Some common symptoms include:

• persistent headaches
• blurred vision
• abdominal pain
• shortness of breath
• swelling in the hands and face
• rapid weight gain

Why Postpartum Preeclampsia is So Serious

Complications from uncontrolled postpartum preeclampsia can be severe and scary. 

“It can be very overwhelming taking care of a new baby, and it is easy for women to not focus on their own health in this setting,” says Dr. Tolani. “It is very important for women to speak to their doctors if they do not feel well in this early postpartum period as ignoring symptoms can lead to very serious consequences.”

Other severe complications include:

• Stroke: High blood pressure can damage the blood vessels in the brain and increase the risk of a stroke.
• Kidney damage: Persistent high blood pressure can damage the blood vessels in the kidneys and lead to kidney disease or failure.
• Eye problems: High blood pressure can damage the retina and other structures, resulting in blurred vision or even vision loss.
• Aneurysms: Although less common than seizures, high blood pressure can weaken the walls of blood vessels, making them more prone to developing bulges or aneurysms. If an aneurysm ruptures, it can cause life-threatening internal bleeding.
• Metabolic syndrome and diabetes: High blood sugar, high cholesterol levels, and obesity are all associated with hypertension.
• Impact on major organs: Persistent hypertension can affect the health of the blood vessels in the heart, lungs, and other vital organs.

What You Can Do

Women should monitor their blood pressure levels after delivery and stay alert to any signs or symptoms of hypertension.

“Studies show that the development of postpartum preeclampsia increases a woman’s risk of having heart disease or stroke later in life, so while it is important for all women to lead a heart-healthy lifestyle, it is even more important for women who experience hypertensive disorders of pregnancy,” cautions Dr. Tolani. 

If you do have postpartum preeclampsia, there are a few things you might have to do next.

• Take blood pressure-lowering medications that can prevent complications such as stroke, organ damage, or seizures.
• Regularly monitor blood pressure at home using a home blood pressure monitor.
• Eat a healthy diet. Avoid foods that are heavy in salt. Fruits, vegetables, whole grains, lean proteins, and low-fat dairy products are healthier.
• Exercise regularly. Physical activity can help lower blood pressure. Activities such as walking, swimming, or gentle yoga can be beneficial.
• Manage your stress. Engage in relaxation techniques like deep breathing exercises, meditation, or gentle stretching.
• Get enough rest. Establish a regular sleep routine and prioritize sleep whenever possible, considering the demands of caring for a newborn.
• Avoid tobacco and limit alcohol. Smoking and excessive alcohol consumption can raise blood pressure levels.
• Follow up with your doctor. Your healthcare team should monitor blood pressure and assess the effectiveness of treatment.
• Seek support. Find support groups or postpartum support networks for guidance, encouragement, and advice. They can provide additional resources and support to help manage hypertension postpartum and relieve stress.

The Bottom Line

The consequences of not treating postpartum preeclampsia can be deadly. Monitoring your blood pressure is an important part of self-care. As you spend this special time with your newborn, make sure you are also taking care of yourself.