Can you have postpartum preeclampsia without high blood pressure

You’ve probably heard of preeclampsia, a condition that happens during pregnancy. A pregnant mom’s blood pressure may get high enough that it poses health risks for her and her unborn baby. But how common is postpartum preeclampsia, and what causes it?

What Is Preeclampsia?

A pregnant woman with preeclampsia has the following symptoms:

• High blood pressure
• Protein in urine
• Swelling in the legs, hands, face, and sometimes entire body
• Headaches
• Changes in vision
• Nausea and abdominal pain
• Trouble breathing

Preeclampsia is dangerous because if it goes untreated, it can lead to eclampsia, a condition when you have seizures. High blood pressure levels also put you at a higher risk for having a stroke. 

Preeclampsia may begin as soon as 20 weeks into your pregnancy, although the symptoms may not be bad at first. As your pregnancy progresses, you may notice that your blood pressure continues to increase, and you have more swelling.

Who is at risk for developing preeclampsia? There are several factors that increase your risk of developing preeclampsia:

• Obesity
• Diabetes
• Kidney disease
• Pregnancy when younger than 15 or older than 35
• First pregnancy
• Preeclampsia in a previous pregnancy
• Pregnant with twins or triplets 
• Autoimmune conditions
• African-American or Hispanic ethnicity
• Family members had preeclampsia or high blood pressure during a pregnancy

Why Does Postpartum Preeclampsia Happen?

In rare cases, preeclampsia is either not detected during pregnancy, or it extends beyond pregnancy instead of resolving itself after birth. Postpartum preeclampsia is not common and happens when you have high blood pressure and too much protein in your urine following birth. 

In most cases, postpartum preeclampsia develops within the first 48 hours following birth, but it can happen up to six weeks later. Postpartum preeclampsia must be treated quickly. Otherwise, postpartum preeclampsia can cause seizures and leave you at a higher risk for having a stroke. This is why postnatal care is critical for new moms. 

Are there any complications? Left untreated, preeclampsia can cause other life-threatening health conditions:

• Pulmonary edema – Fluid buildup in your lungs
• Stroke – Interruption to blood flow to the brain can cause a stroke
• Thromboembolism – Blood clots that stop blood vessels from traveling throughout the body

Is postpartum preeclampsia different from preeclampsia? Postpartum preeclampsia is the same as preeclampsia that occurs during pregnancy. The only difference is that it appears after the birth of your baby. Usually, preeclampsia symptoms resolve following birth, so postpartum preeclampsia is very rare.

How Is Postpartum Preeclampsia Treated?

During your hospital stay following birth, your blood pressure and other vital signs are closely monitored. If your doctor suspects preeclampsia, they may ask you to come in for a checkup sooner than usual.

Your doctor will determine the severity of your condition before prescribing a treatment plan. If your case isn’t severe, your blood pressure is lower than 160/110. Your doctor may prescribe an oral medication to lower your blood pressure.

If your blood pressure is any higher, your doctor will need to examine you for HELLP syndrome: 

• Hemolysis – damaged red blood cells
• Elevated liver enzymes – damage to your liver
• Low platelets – your blood doesn’t clot as easily 

Your doctor will ask for blood work tests that provide total blood count and levels of creatinine and liver enzymes. They will also do a urinalysis to check for protein levels in your urine. For more severe conditions, you may be hospitalized for closer monitoring.

If you’re at risk for having seizures, you may be prescribed magnesium sulfate, which helps to prevent seizures. 

Can I prevent preeclampsia? Doctors don’t know exactly what causes preeclampsia. Unfortunately, there is no way to completely prevent preeclampsia in future pregnancies. You can exercise and maintain a healthy diet as a means of managing your blood pressure and improving your overall health. 

Questions to ask your doctor. Some useful questions to ask your doctor about your condition are:

• How serious is my diagnosis?
• What treatment options do I have?
• What types of tests do I need?
• Can I breastfeed with this condition?
• How can I manage other health conditions I had before this?
• What signs should I watch for that indicate my condition is worsening?

Your hormones change rapidly after giving birth, and your emotions may be all over the place. Postpartum preeclampsia can make these feelings worse. Be sure to talk to your doctor if you think you are depressed or need help coping.