Cheryl Martin (Host): Welcome to This is LIFE Cast. I'm Cheryl Martin. And with me is Sarah Mallonee. She's a registered nurse and a childbirth educator here at Infirmary Health. Our topic this episode, is a pregnancy condition that has serious health ramifications. It's preeclampsia, a leading cause of illness for mothers and newborns. So Sarah, what is preeclampsia?

Sarah Mallonee: Great question. So, preeclampsia is a serious blood pressure disorder that typically occurs after 20 weeks of pregnancy or in the postpartum phase as well. So, you're not out of the woods as soon as you've had the baby. It's characterized by high blood pressure. There'll be signs of organ damage, protein in the urine. And it stems from improper placental development. It's a high-risk condition and can lead to eclampsia. So, we call it preeclampsia because preeclampsia is before the seizure. If you did have a seizure, they call it eclampsia. So, it's a very serious condition that is caused by pregnancy hormones. And the resolution to that is to not be pregnant anymore, so we don't have those pregnancy hormones around.

Host: So after the pregnancy, the mother is okay?

Sarah Mallonee: Yes. Preeclampsia is generally a condition—it can cause long-term health implications, but the bulk of what is causing you trouble during preeclampsia goes away once you've delivered the baby. So, you're not quite out of the woods in that initial postpartum period about the first three weeks or so, because the pregnancy hormones in your body still have to go away, and that doesn't happen immediately. But preeclampsia, part of the management is controlling that blood pressure, preventing seizures sometimes with medications like magnesium sulfate, monitoring until it's safe you to deliver. And then, because it's caused by pregnancy hormones, this will typically cause your doctor to recommend an earlier delivery for your health and the baby's health.

Host: So once a mother has a seizure, does it then be called eclampsia?

Sarah Mallonee: That's correct. So, it's called preeclampsia, because eclampsia means that the condition was bad enough to cause a seizure. So, they call it preeclampsia because that's the period before the seizure.

Host: And how often would a mother have a seizure?

Sarah Mallonee: We don't like it to get to that point. Eclampsia is a little bit more rare, whereas preeclampsia can be diagnosed in about 3-8% of pregnancies worldwide and, in the United States, between 5% and 8% of pregnancies. It's a leading cause of maternal and fetal mortality in our country. So, it's a very serious problem. But our doctors with the right prenatal care and monitoring you throughout your pregnancy appropriately, we can catch these cases early. So, developing into eclampsia is a little more rare.

Host: I find it interesting with the numbers you shared, it's actually higher here in the United States, 5% to 8% versus 3% to 8%. So, who's at a higher risk for preeclampsia and why those numbers for us?

Sarah Mallonee: Good question. It probably has to do with the general overall health of people in the United States. So, there are higher risk factors that a person could develop preeclampsia. So if you have a history of the condition, so if you had preeclampsia in any of your other pregnancies, you're at a higher risk of developing it again.

A person with chronic hypertension, they've already got something going on with their cardiovascular system, and that person is more likely to develop preeclampsia. People diagnosed with kidney diseases, diabetes, autoimmune diseases like lupus, pregnancies that are multiple gestations, like twins and triplets. And then, some other key risk factors, african American women are at a higher risk of developing preeclampsia. And also, among those women who had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy. Also, obesity is a risk factor and being pregnant over the age of 35 or using in vitro fertilization to get pregnant.

Host: So, is there a cure for preeclampsia?

Sarah Mallonee: There is no true cure for preeclampsia. There is management, and there are things that can be done to hopefully prevent or lessen symptoms. So, some doctors will typically recommend taking low-dose aspirin for our high-risk individuals. They'll sometimes prescribe them low-dose aspirin, starting at around like 12 to 16 weeks of pregnancy. But truly, there's no absolute cure for preeclampsia.

Host: So, It doesn't really make a difference, let's say, if a mother is bedridden from the time she is diagnosed with it?

Sarah Mallonee: Some women will be put on bedrest as a management strategy for preeclampsia. So, one thing that we pay close attention to with preeclampsia, because it causes an elevated blood pressure, is things to reduce stress in any way. So, sometimes bedrest is something that would be utilized to reduce your blood pressure. Because if you're not up doing as much work, you're not going to have as high of a blood pressure. So, that's sometimes a management strategy for preeclampsia. But be all and end all, women that develop preeclampsia, it's not necessarily something that they could have helped.

Host: Okay. So, there is nothing they can do to prevent it. But I'm also wondering, when you mentioned diabetes or obesity or high blood pressure, I'm assuming that if a woman is in relatively good health without these symptoms, she's less likely to develop it.

Sarah Mallonee: Absolutely. Anytime we do anything to take care of any of our long-term health goals. So if we're doing things like weight management strategies, we're dieting, we're exercising, all these things can go a long way into helping prevent the symptoms from being worse or have a less severe case of preeclampsia. But some women develop it regardless of whether they're healthy or not.

Host: Wow. Sarah, how important is it to keep regular OB appointments and communicate any issues you're having with your healthcare team so they can thoroughly monitor you?

Sarah Mallonee: That's the thing. Sometimes preeclampsia can sneak up on you kind of silently. It's not necessarily something that you would catch right away. So, keeping your obstetricians appointments is extremely important because they're checking in with you regularly throughout your pregnancy to make sure that your pregnancy is going well, that your health is good throughout the course of your pregnancy, and that you're not developing any issues. And that's part of the reason we check in with you so frequently during pregnancy.

So. in communicating to your healthcare team, the signs and symptoms that you're experiencing throughout your pregnancy or the different things that you're experiencing throughout your pregnancy is important so that your communication's good and they can keep a good eye on you. You may be thinking whenever you get to the OB office, like, "Hey, golly, I just got here and they're taking my blood pressure. Let me sit down for a second." No, they want to see what your blood pressure's doing, because they want to know whether or not you've got controlled blood pressure, whether you're moving and grooving or not.

So, some things that they're going to ask you to look out for and some things that you should be looking out for throughout your pregnancy if you're experiencing any of these things would be to look out for severe headaches. It tends to be when a person has a higher blood pressure, they'll have a headache that just didn't really get touched by anything. Maybe you did some headache recovery measures, like you took a nap, maybe got a shower, got a little water, took a little Tylenol and it just didn't really touch it. It may not be a headache. It may be your blood pressure that's elevated. Vision changes, so you may see spots or blurring of your vision. Sometimes with preeclampsia, patient's will experience upper right abdominal pain. They will experience swelling in their face, in their hands. If you notice a rapid weight gain as well. And then, a person with a worst case will occasionally experience shortness of breath from fluid on their lungs. So if they're having a hard time catching their breath, that'd be extremely important to alert their doctor about.

Host: Is it possible that when a woman experiences these symptoms, it can be misdiagnosed or she thinks it's something else?

Sarah Mallonee: Generally, with this condition, it's such a common thing that we are looking out for throughout your pregnancy. So, we're always on the move trying to make sure that this isn't happening to you throughout your pregnancy. But a lot of times, it'll be people that are experiencing something at the house and they just don't think to tell anybody is the bigger problem. It's like, "Okay, yeah, they said I was going to be more tired during my pregnancy," or "Maybe I'm not sleeping so good and I've got this headache. And it's probably just because I'm not sleeping so good. They brush symptoms off. And that's what I would discourage you from doing. Anytime you think something's wrong, your intuition is actually really good and there probably is something wrong, and I would get yourself checked out.

Worst case scenario is that they tell you you're fine. And that's the best case scenario to me. So if you call and you say, "Hey, I'm experiencing this thing," and they go, "You know what? It's okay, that's fine," then yay, good for you, then you're doing so good. But if you're brushing your symptoms under the rug because you're worried about bothering somebody, you may be getting yourself into a worse hole.

Host: Sarah, where can we learn more about preeclampsia?

Sarah Mallonee: Good question. So, anytime I speak on conditions, I always want you to understand that I'm speaking as a nurse and there is going to be more wealth of knowledge coming from your doctor as well. So, anytime you're having any concerns regarding your health of your pregnancy, I want you talking to your doctor about any concerns that you're having so that you can learn more about these things, or any of your concerns in general about your pregnancy.

But you can also read more. I did write a blog post about preeclampsia on the Bump and Beyond blog. And you can find that blog on the Infirmary Health website under the News and Education section.

Host: Sarah Mallonee, thank you for educating us on preeclampsia and eclampsia. Extremely important information for pregnant women. Thank you.

Sarah Mallonee: You're welcome.

Host: As the first choice for healthcare for the Gulf Coast region, Infirmary Health is here for you, here for life. Visit us at infirmaryhealth.org to get more information. And if you found this podcast helpful, please share it on your social media. You can also check out the entire podcast library for other topics of interest to you. This is LIFE Cast, a podcast from Infirmary Health. Thanks for listening.