Postpartum Preeclampsia: Causes, Risks and Treatment

Pregnancy manifests itself in various ways in women apart from its more obvious signs. Women may go through certain complications, changes in blood pressure, aches and much more. However, some complications may appear well after delivery in some women, like the postpartum preeclampsia (PPP). Understanding the reason for this condition and the ways to treat it can be essential to help you deal with it more effectively.

What Is Postpartum Preeclampsia (PPP)?

Postpartum preeclampsia is similar to preeclampsia, but it develops soon after the delivery. The condition is characterised by high blood pressure and an excess amount of protein in the urine (over 300mg). In most cases, this condition develops within 48 to 72 hours of delivery; however, in some cases, it may even appear at about six weeks after delivery.

Being diagnosed with postpartum preeclampsia after pregnancy means that you will need to spend a few extra days in the hospital until your blood pressure is under control. Immediate treatment is required for this condition as a lack of treated may result in seizures or other complications.

What Causes Postpartum Preeclampsia (PPP)?

The causes of postpartum preeclampsia aren’t well-known. It is believed that the condition may have been developing in your body all through pregnancy and only becomes evident after delivery. It is also believed that PPP may be the result of an anomaly in the lining of the blood vessels while you are pregnant, and this may get affected due to certain genetic or environmental factors.

Risk Factors Associated With Postpartum Preeclampsia (PPP)

There are several risk factors that are associated with postpartum preeclampsia. Some of the common ones are:

• Hypertension during pregnancy is the strongest risk factor of postpartum preeclampsia. If your blood pressure is very high around the 20^th week of your pregnancy, you may be more susceptible to developing postpartum preeclampsia.
• Immunity disorders that may obstruct the interaction of the placenta and the immune system may lead to hypertension during pregnancy.
• Obesity is another factor that increases your risk of developing postpartum preeclampsia.
• If you are younger than 20 years or are older than 40, you may be at a higher risk of postpartum preeclampsia.
• Multiple pregnancies or carrying twins may also increase your risk of postpartum preeclampsia.
• Family history may also play a part in causing postpartum preeclampsia. If you have a close woman relative who has suffered from postpartum preeclampsia, you may be at a higher risk.

Symptoms of Post Pregnancy Preeclampsia (PPP)

Many symptoms associated with postpartum preeclampsia are quite similar to the symptoms of preeclampsia.

• High blood pressure is the foremost indicator; if your blood pressure is as high as 140/90 mm Hg as opposed to the normal 120/80 mm Hg.
• Excessive amount of protein in your urine (over 300 mg).
• Severe headaches that go on for a long time after childbirth.
• Sensitivity to light, blurred vision or temporary loss of vision
• Swelling or bloating in the limbs or the face after delivery (typically within 48 hours).
• Sharp pain in your upper abdomen.
• Severe vomiting and nausea within 72 hours of delivery.
• Reduction in urination.
• A sudden increase in weight; almost a kilo in a week.

How Is the Diagnosis Made?

Doctors will run a regular check-up after delivery, and in case they suspect postpartum preeclampsia, they will recommend certain tests. Apart from high blood pressure, a blood test and a urine test are the usual methods used to diagnose postpartum preeclampsia.

1. Blood tests: A blood test is conducted to check the functioning of the kidney as well as the liver. It also indicates the level platelets. Platelets are the cells that regulate blood clot and are vital in cases of excessive bleeding.
2. Urine tests: The amount of protein in the urine is checked to determine if you have postpartum preeclampsia. If there is over 300 mg of protein in your urine, you may have postpartum preeclampsia.

In case your diagnosis is positive, you will need to spend a few more days in the hospitals so that the doctors can monitor your blood pressure and start treatment for the condition.

Treatment and Medication

Postpartum preeclampsia management is usually done through medications. If you have a mild case of PPP, you will be administered with magnesium sulfate for about 24 hours and will be monitored closely (in mild cases an antihypertensive is started, and if the blood pressure increases, then magnesium sulphate is started to prevent seizures). This is an anticonvulsive and prevents seizures. In case your blood pressure is over 150/100, you will be given antihypertensive medications like Labetalol, Nifedipine, Hydralazine, etc. The dosage of these medications is gradually reduced as your blood pressure begins to normalise. These medications may cause side effects like nausea, vomiting, headaches, etc.

Preventive Measures

While there are no definitive ways to prevent PPP, keeping track of your general health and adopting a healthy lifestyle can be the key to prevention. Some of the best ways to prevent the condition are:

• Since obesity increases the risk of postpartum preeclampsia, it is ideal for maintaining your body weight with healthy eating habits. Add a lot of fibre in your diet through fruits and vegetables. Try and get to an ideal weight before planning for pregnancy.
• Exercising regularly can also help to keep your weight in control. Always keep track of your weight and in case you see a sudden increase, ensure to consult your doctor.
• Stay well-hydrated; drink a good amount of water and fresh fruit juices every day, and lower the consumption of sugary juices or artificial fruit juices. Also, avoid alcohol and caffeinated drinks.
• Visit your doctor regularly throughout your pregnancy for regular check-ups and have your blood pressure checked. Regular check-ups will help your doctor detect any early signs of postpartum preeclampsia.

Complications of Postpartum Preeclampsia (PPP)

Postpartum preeclampsia, if left untreated, may often lead to other complications like seizures. Some of the complications of PPP include:

• Pulmonary oedema: In this condition, fluid accumulates in the tissues and the airspace in the lungs, which can be very critical. Pulmonary oedema has symptoms like excessive coughing, trouble breathing, sweating and anxiety.
• Postpartum eclampsia: This is similar to postpartum preeclampsia but is also characterised by seizures. It may cause permanent damage to the brain and the heart, as well as lead to irreversible damage to the vessels. In very serious cases, it can also lead to coma.
• Stroke: Although rare, sometimes there is a lack of oxygen supply to the brain due to PPP, which may lead to a stroke. Immediate medical intervention is required in case of a stroke.
• Thromboembolism: This condition is caused due to a blood clot that may have developed in any part of the body but travels to the blood vessels, causing a blockage. It can lead to organ failure, and in serious cases, may even be fatal. Blood thinners are used to treat Thromboembolism.
• HELLP syndrome: This stands for hemolysis or destruction of red blood cells, enzyme elevated liver enzymes or liver damage, and low platelet count and can be fatal.

Living With Postpartum Preeclampsia

Childbirth will leave you physically and mentally strained. Being diagnosed with postpartum preeclampsia can be even more challenging at this point in time as it means a longer hospital stay. It is important to understand that you will need to cooperative with your doctor to get treated on time and prevent any further complications. Also, try and understand everything you can about the condition to know your options. It is also necessary to reach out to your loved ones for support during this time and focus on being a doting mother to your new baby.

In case you have any questions about the condition, do not hesitate to discuss them with your doctor. Postpartum preeclampsia recovery is a process that will take place gradually with proper care and treatment.

FAQs

1. How Will Postpartum Preeclampsia Affect My Baby?

Unlike preeclampsia, which may lead to premature labour and delivery, postpartum preeclampsia won’t have any direct effects on the baby.

2. Can I Breastfeed My Child If I Have Postpartum Preeclampsia?

You can breastfeed your baby even if you have postpartum preeclampsia. However, the condition may lower your breast milk supply. You can speak to your doctor about this. Also, ensure to tell your doctor that you are breastfeeding when he prescribes medicines for the condition.

3. Are Preeclampsia and Eclampsia the Same?

Preeclampsia is when a woman has high blood pressure during pregnancy with gestation at 20 weeks. It can also increase the amount of protein in the urine.

Eclampsia is a severe type of preeclampsia and has seizures. This is a critical condition and may lead to damage to the heart, brain and even result in coma.

4. Can I Have Preeclampsia Without Having Protein In My Urine?

While the amount of protein in urine is one of the main indicators of postpartum preeclampsia, recent studies have concluded that the condition may even occur without an increased level of protein in the urine.

5. Is There Any Chance of Getting Preeclampsia Again?

If you have had preeclampsia in your previous pregnancy, you are at a high risk of developing postpartum preeclampsia again. But, in case your previous pregnancy was normal, your risks of postpartum preeclampsia are relatively lower, except unless you are obese, have hypertension or have a family history of postpartum preeclampsia.

Post-pregnancy time can be stressful enough, even without having a complicated condition hovering over you. However, in case you are diagnosed with postpartum preeclampsia, you will need to remain calm and understand that your first and foremost task is to tend to your newborn. Breastfeed your baby and enjoy the first few months of your baby’s life. Seek help from your family or friends during this time to ease your burden even after you are discharged. It is important that you regain your health back before engaging in any chores that could strain you. Ensure you consult your doctor for any doubts or changes that you notice in order to facilitate your treatment further.

Also Read: Postpartum Depression