Preeclampsia is a dangerous combination of high blood pressure, fluid retention, and high levels of protein in the urine of women after their 20th week of pregnancy. Sometimes called toxemia or pregnancy-induced hypertension, it affects about one in 20 pregnant women and their unborn children, and is the leading cause of maternal mortality worldwide. If not treated, preeclampsia can worsen into eclampsia, a potentially fatal condition that involves seizures and coma. The cure for preeclampsia is delivery of the baby by induced labor or cesarean section. Treatments seek to control the condition until the baby can be delivered safely.

Preeclampsia:

• High blood pressure (above 140/90)
• Large increase in the systolic (top number) or diastolic (bottom number) blood pressure
• Headaches
• Excessive weight gain (more than 5 pounds in a week)
• Sudden weight gain over 1 or 2 days
• Retention of fluids, which causes the hands and face to swell (pregnancy naturally causes the ankles to swell slightly, which is not necessarily a sign of preeclampsia)
• Decrease in the amount of urine produced

Eclampsia:

• Pain in the upper right side of the abdomen
• Vision disturbances, such as seeing flashing lights

Nobody knows what causes preeclampsia. However, certain women have a higher risk of developing it in pregnancy, including women in their first pregnancy, teenagers, and women over 40 who are pregnant. Others at high risk are women carrying multiple fetuses, women who had preeclampsia with a previous pregnancy, who are obese, or who have had high blood pressure, diabetes, or kidney disease.

You may or may not experience any symptoms of preeclampsia. See your doctor immediately if you do. Women often discover they have preeclampsia during a routine pre-natal checkup that includes a urine test and blood pressure check. As you get closer to your delivery date, your doctor may do a non-stress test that checks your baby's heart rate to make sure your baby is getting enough oxygen.

If you have a mild case of preeclampsia, your health care provider may recommend that you rest in bed. You should lie on your left side, to prevent the weight of your uterus from pressing against important blood vessels. You should drink a lot of water to help you urinate and get rid of excess fluids. Your health care provider may want to monitor your blood pressure and urine every couple of days. The goal is to manage the condition to reach at least 36 weeks in your pregnancy, when the baby may be safely delivered.

If you have severe preeclampsia, it may not be possible to wait that long, and your health care provider may admit you to the hospital, where you will receive drugs to induce labor, or have a cesarean section.

Your practitioner may prescribe the following drugs intravenously:

• Magnesium sulfate or hydralazine, to reduce your blood pressure
• Calcium gluconate, if your blood pressure falls too low
• Furosemide, to encourage you to urinate more

In severe cases, your doctor may prescribe medications to lower your blood pressure. Your doctor may also give you corticosteroids to help the baby's lungs develop faster in advance of an early delivery.

Complementary and Alternative Therapies

If you have preeclampsia, you should be under the care of an obstetrician. You may use complementary and alternative therapies with medical treatment. Some of the more common therapies are described below.

Nutrition and Supplements

Some supplements appear to help prevent preeclampsia but do not help once you have the condition. Others, intended to lessen the severity once you have the condition, show mixed results in scientific studies. Note: You should not take any of these supplements during pregnancy without a doctor's supervision.

Preventing preeclampsia: If you are deficient in calcium or at risk for hypertension, some studies show 2,000 mg per day to lower the risk of developing preeclampsia. Taking calcium does not seem to reduce risk of developing the condition in healthy women, and not all studies show the same result.

• For women with a history of preeclampsia and high homocysteine levels, folic acid (5 mg per day) and vitamin B6 (250 mg per day).
• Vitamin C (1,000 mg per day) and vitamin E (400 IU per day) for those at risk of preeclampsia. Neither seems to help once you have the condition.
• Lycopene (2 mg two times per day). Further studies are needed to confirm results.
• Magnesium (200 mg two to three times per day) was shown to help reduce risk in one study, but another study showed no effect.

Treatments for preeclampsia: These treatments require close medical supervision:

• Studies show mixed results for l-arginine, an amino acid, given either intravenously or orally, with a dose determined by your doctor. Some studies indicate that it can be helpful when given long-term throughout pregnancy. Further studies are underway.
• Magnesium sulfate, given by injection, can help lower blood pressure.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to determine a diagnosis before pursuing treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink two to four cups per day. You may use tinctures alone or in combination as noted.

Note: These herbs should be used during pregnancy only under a doctor's supervision. Do not self-treat.

Herbs that can be used to treat mild hypertension in pregnancy include the following:

• Hawthorn berries (Crataegus laevigata)
• C ramp bark (Viburnum opulus)
• Milk thistle (Silybum marianum)

Use equal parts of each in a tincture, 20 drops three to four times a day.

Acupuncture

May be helpful in lowering blood pressure and increasing circulation.

Your health care provider will monitor you carefully for the first few days after you have delivered your child. Your health care provider may keep you in the hospital for several days to weeks after you have delivered your baby, depending on the severity of the preeclampsia. You should have checkups at least every 2 weeks for the first several months after leaving the hospital.

If you wear rings, remove them as soon as you start having symptoms. Swollen fingers can make it difficult (or even impossible) to remove rings, and they may begin to cut off circulation in your fingers.

The symptoms of preeclampsia can appear gradually and suddenly get worse. See your health care provider regularly for checkups during your pregnancy, which you should do regardless of your risk of preeclampsia. Your health care provider can recognize early signs of preeclampsia and get treatment for you immediately.

Early onset and severe preeclampsia may indicate increased cardiovascular mortality. Your health care provider may recommend more frequent screening examinations for cardiovascular risk factors.

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