What are the risks of preeclampsia & eclampsia to the mother?

Preeclampsia during pregnancy is mild in the majority of cases.1 However, a woman can progress from mild to severe preeclampsia or to full eclampsia very quickly―even in a matter of days. Both preeclampsia and eclampsia can cause serious health problems for the mother and infant.

Women with preeclampsia are at increased risk for damage to the kidneys, liver, brain, and other organ and blood systems. Preeclampsia may also affect the placenta. The condition could lead to a separation of the placenta from the uterus (referred to as placental abruption), preterm birth, and pregnancy loss or stillbirth. In some cases, preeclampsia can lead to organ failure or stroke.

In severe cases, preeclampsia can develop into eclampsia, which includes seizures. Seizures in eclampsia may cause a woman to lose consciousness and twitch uncontrollably.2 If the fetus is not delivered, these conditions can cause the death of the mother and/or the fetus.

Although most pregnant women in developed countries survive preeclampsia, it is still a major cause of illness and death globally.3 According to the World Health Organization, preeclampsia and eclampsia cause 14% of maternal deaths each year, or about 50,000 to 75,000 women worldwide.4

In "uncomplicated preeclampsia," the mother's high blood pressure and other symptoms usually go back to normal within 6 weeks of the infant's birth. However, studies have shown that women who had preeclampsia are four times more likely to later develop hypertension (high blood pressure) and are twice as likely to later develop ischemic heart disease (reduced blood supply to the heart muscle, which can cause heart attacks), a blood clot in a vein, and stroke as are women who did not have preeclampsia.5

Less commonly, mothers who had preeclampsia can experience permanent damage to their organs, such as their kidneys and liver. They can also experience fluid in the lungs. In the days following birth, women with preeclampsia remain at increased risk for developing eclampsia and seizures.3,6

In some women, preeclampsia develops between 48 hours and 6 weeks after they deliver their baby—a condition called postpartum preeclampsia.7,8 Postpartum preeclampsia can occur in women who had preeclampsia during pregnancy and among those who did not. One study found that slightly more than one-half of women who had postpartum preeclampsia did not have preeclampsia during pregnancy.9 If a woman has seizures within 72 hours of delivery, she may have postpartum eclampsia. It is important to recognize and treat postpartum preeclampsia and eclampsia because the risk of complications may be higher than if the conditions had occurred during pregnancy.10 Postpartum preeclampsia and eclampsia can progress very quickly if not treated and may lead to stroke or death. Visit the Preeclampsia Foundation website for more information: https://www.preeclampsia.org/stillatrisk .

Citations

  1. Sibai, B. M. (2004). Magnesium sulfate prophylaxis in preeclampsia: Lessons learned from recent trials. American Journal of Obstetrics & Gynecology, 190(6), 1520–1526. Retrieved November 14, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/15284724
  2. National Institute of Neurological Disorders and Stroke. (2016). The epilepsies and seizures: Hope through research. Retrieved January 4, 2017, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Epilepsies-and-Seizures-Hope-Through
  3. Preeclampsia Foundation. (2018). FAQs. Retrieved November 14, 2018, from https://www.preeclampsia.org/health-information/faqs 
  4. Lim, K.-H., Steinberg, G., & Ramus, R. M. (2018). Preeclampsia. Retrieved November 14, 2018, from http://emedicine.medscape.com/article/1476919-overview 
  5. Bellamy, L., Casas, J. P., Hingorani, A. D., & Williams, D. J. (2007). Pre-eclampsia and risk of cardiovascular disease and cancer in later life: Systematic review and meta-analysis. British Medical Journal, 335(7627), 974. Retrieved November 14, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/17975258
  6. Smith, M., Waugh, J., & Nelson-Piercy, C. (2013). Management of postpartum hypertension. The Obstetrician & Gynaecologist, 15(1), 45–50. Retrieved December 28, 2016, from http://onlinelibrary.wiley.com/doi/10.1111/j.1744-4667.2012.00144.x/pdf  (PDF 561 KB)
  7. ACOG Committee on Practice Bulletins, Obstetrics. (2020). Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Number 222 https://pubmed.ncbi.nlm.nih.gov/32443079/
  8. ACOG Committee on Practice Bulletins, Obstetrics. (2019). Chronic Hypertension in Pregnancy: ACOG Practice Bulletin Number 203 https://pubmed.ncbi.nlm.nih.gov/30575676/
  9. Yancey, L. M., Withers, E., Bakes, K., & Abbott, J. (2011). Postpartum preeclampsia: Emergency department presentation and management. Journal of Emergency Medicine, 40(4), 380–384. Retrieved November 14, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/18814997
  10. Andrus, S. S., & Wolfson, A. B. (2010). Postpartum preeclampsia occurring after resolution of antepartum preeclampsia. Journal of Emergency Medicine, 38(2), 168–170. Retrieved November 14, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/18547773