Hypertensive Disorders Explained | Preeclampsia & Related Conditions
Preeclampsia is a serious blood pressure disorder that can affect all organs in a pregnant person's body.
When does preeclampsia begin?
It typically starts after the 20-week mark of pregnancy, but in most cases it happens much later, and closer to term. It usually presents with high blood pressure (above 140/90) and one or more other symptoms that signal that your organs are being affected, like protein in your urine, low platelets, high liver enzymes, or other. good person to talk to.
It typically starts after the 20-week mark of pregnancy, but in most cases it happens much later, and closer to term. It usually presents with high blood pressure (above 140/90) and one or more other symptoms that signal that your organs are being affected, like protein in your urine, low platelets, high liver enzymes, or others.
Are there different kinds of preeclampsia?
Are there different kinds of preeclampsia?
Below you will find some definitions for different types of hypertensive disorders of pregnancy. The term "preeclampsia" can be an umbrella term for all of these. It's important to know that the "pre" in "preeclampsia" means "before delivery", but what it really means is "before a seizure".
Why does preeclampsia happen?
When a baby implants into the mother's uterus and starts to grow the placenta, the placenta has to implant into the mother's body and work with her immune system. Her immune system needs to accept the placenta and allow it to dig in and develop its blood supply that will nourish the baby. When the placenta conflicts with the mother's immune system, it implants shallowly. So then, later on in the pregnancy, it cannot draw nutrients across the baby properly, and so it sends out signal proteins into the mother's body, which raise her blood pressure and which mess with her organs and cause the other symptoms of preeclampsia, such as protein in the urine.
Now, the question becomes: what caused that immune conflict? Sometimes it is due to underlying conditions, like pre-existing chronic hypertension. Sometimes it is due to the mother's genes just not playing well with the father's genes and her body not recognizing his DNA well in order to build a good placenta together. Sometimes it is due to a problem with the baby. Sometimes it is a roll of the genetic dice that means the placenta just doesn't work as well as it should. It can be kind of tricky to determine what things might be a factor in any particular case, so if you have questions about what happened to you or your likelihood of recurrence, your OB or MFM would be a good person to talk to.
Now, the question becomes: what caused that immune conflict? Sometimes it is due to underlying conditions, like pre-existing chronic hypertension. Sometimes it is due to the mother's genes just not playing well with the father's genes and her body not recognizing his DNA well in order to build a good placenta together. Sometimes it is due to a problem with the baby. Sometimes it is a roll of the genetic dice that means the placenta just doesn't work as well as it should. It can be kind of tricky to determine what things might be a factor in any particular case, so if you have questions about what happened to you or your likelihood of recurrence, your OB or MFM would be a good person to talk to.
Are there different kinds of preeclampsia?
Are there different kinds of preeclampsia?
Below you will find some definitions for different types of hypertensive disorders of pregnancy. The term "preeclampsia" can be an umbrella term for all of these. It's important to know that the "pre" in "preeclampsia" means "before delivery", but what it really means is "before a seizure".
Umbrella Disorders
Each of these onsets is the same umbrella disorder with different types of presentation. Researchers are looking at this disorder from a molecular level, and no doubt, we will start to learn more about early vs. term onset.
If you want to know more, you can visit this page from the American College of Obstetricians and Gynecologists (ACOG) on preeclampsia high blood pressure during pregnancy.
Module Overview
Understand the spectrum of high blood pressure disorders in pregnancy, from gestational hypertension to preeclampsia,…
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Preeclampsia
New onset of high blood pressure and, at least, one other diagnostic symptom from 20 weeks gestation up through delivery of the baby.
Postpartum Preeclampsia
New onset of high blood pressure and, at least, one other diagnostic criteria after delivery, and occurring up to 6 weeks postpartum. This does not include healing & recovery time from preeclampsia during pregnancy or delivery, which will overlap into the postpartum period. Postpartum preeclampsia is an acute condition. Recovery and resolution of symptoms may take weeks or months, but it does not mean you have postpartum preeclampsia during the entire recovery process.
Eclampsia
New onset of seizures, with or without the high blood pressure requirement of preeclampsia, beginning as early as 20 weeks gestation up to and including during delivery of the baby. Around 5% of cases are not precipitated by high blood pressure. This does not include healing & recovery time from eclampsia that occurred during pregnancy or delivery, which will overlap into the postpartum period.
Postpartum Eclampsia
New onset of seizures, after delivery of the baby, with or without the high blood pressure requirement of preeclampsia, which can occur up to 6 weeks postpartum.
HELLP Syndrome
A variant of preeclampsia that is named after the features that make up the syndrome: Hemolysis, Elevated Liver enzymes & Low Platelets, with or without traditional preeclampsia symptoms, occurring before or during delivery of the baby. It is a fast-moving condition that means delivery very soon.
Postpartum HELLP Syndrome
Hemolysis, Elevated Liver Enzymes & Low Platelets, with or without traditional preeclampsia symptoms, occurring after delivery of the baby and up to 6 weeks postpartum. This does not include healing & recovery time from HELLP that occurred during pregnancy or delivery, which will overlap into the postpartum period. Recovery and resolution of symptoms may take weeks or months, but it does not mean you have postpartum HELLP during the entire recovery process.
Atypical HELLP Syndrome
This term is used a lot by health care professionals who haven’t seen some of the variable onsets outside of the traditional high bp and proteinuria criteria. Atypical preeclampsia is onset that occurs before 20 weeks and is confirmed by kidney biopsy. There are fewer than a dozen confirmed cases. The outcome is never good and requires emergent delivery of a non-viable baby. Women who have chronic hypertension and existing protein spillage may believe they had preeclampsia before 20 weeks due to misunderstanding of preexisting conditions, unmasked chronic hypertension, and kidney damage from hypertension or childhood illness.
Toxemia
A very outdated term used to describe preeclampsia before there was a better understanding of the disorder. You should steer clear of any care providers still using this term.