A potentially serious complication of childbirth, postpartum preeclampsia is marked by high blood pressure and increased levels of protein in the urine. It can come on promptly after birth or take weeks to gradually develop. While it's a relatively rare condition, postpartum preeclampsia can be life-threatening if not quickly diagnosed and treated. Postpartum preeclampsia can develop within two days of giving birth -- or weeks later.
As with preeclampsia that is diagnosed during pregnancy, postpartum preeclampsia is typically asymptomatic at first and can develop anywhere from 48 hours to four to six weeks following delivery, says Dr. Lindsay Nordwald, an obstetrician and gynecologist with the Hutchison Clinic in Hutchinson, Kansas. High blood pressure – a reading of 140/90 or higher – is the most common symptom, as is high levels of protein in your urine, the Mayo Clinic notes. As the condition worsens, symptoms can include: severe headaches, nausea and vomiting, blurred vision or sensitivity to light, anxiety, and shortness of breath, swelling of the face and limbs, sudden weight gain, pain in the upper right abdomen or chest. After leaving the hospital, most women do not have their blood pressure checked again until their first postpartum checkup, which usually follows about six weeks after giving birth. Therefore, if you experience any of these symptoms following the birth of your child, it is critical that you immediately contact your health care provider.
As with preeclampsia during pregnancy, the exact causes of postpartum preeclampsia are not clear. "Your risk is increased if you had hypertension in the pregnancy. However, it can also be new onset," Nordwald observes.
While most cases of preeclampsia resolve after childbirth, you have an increased risk of developing the condition after birth if you're obese; if you have a first-degree relative who has had preeclampsia; if you've delivered multiples; or if you're younger than 20 or older than 35 when you deliver. The use of pain relievers such as ibuprofen can aggravate previously diagnosed gestational hypertension, as can large volumes of intravenous fluids given to mothers during the birth process, according to findings published in the American Journal of Obstetrics and Gynecology. Chronic health conditions such as diabetes, rheumatoid arthritis, Graves disease or lupus also can increase your risk of developing preeclampsia.
Postpartum preeclampsia can be mild with a slightly increased elevated blood pressure to severe, putting the mother at risk of stroke, vital organ damage, congestive heart failure, pulmonary edema, coma or even death. It also can lead to HELLP syndrome, a condition that results in hemolysis, or the destruction of red blood cells, elevated liver enzymes and low platelet count.
Although these complications can sound scary, it's important to note that the outcome is good for the majority of women who experience isolated cases of postpartum preeclampsia, who have effectively manage their chronic hypertension, and who seek prompt treatment, according to the AJOG study.
How It's Treated
The treatments for postpartum preeclampsia are similar to those used for preeclampsia during pregnancy, Nordwald says. If a mother's blood pressure is dangerously high, she likely will be given medication to lower it, and magnesium sulfate may also be given to prevent seizures, Nordwald explains.
While these drugs are typically considered safe to use during breastfeeding, confirm this with your physician. Women who are having shortness of breath, heart palpitations or chest pain following childbirth may need a chest X-ray or an echocardiogram to rule out and prevent serious complications. Once properly diagnosed and treatment, the condition can take anywhere one or more weeks to resolve, requiring mothers to stay in the hospital longer than planned or to be readmitted soon after going home.
Again, prompt treatment is critical: if you're experiencing severe headaches, blurred vision or gripping chest pain, go to the nearest emergency room.