ST. LOUIS - Fourth grade teacher Chelsea Horn, pregnant with her first baby, told her students she was going for a routine doctor’s appointment and would be back the next day. Little did she know, she would be welcoming her daughter later that day – at just 26 weeks gestation.
Horn had high blood pressure going into pregnancy and received extra monitoring. Even so, she began developing persistent headaches and swelling in her legs and feet.
“I had a classroom helper so I taught with my feet elevated and still nothing seemed to reduce the swelling,” Horn recalled.
At this point, doctors knew it was preeclampsia and wanted to prevent it from escalating.
“Pregnancy can cause dangerous high blood pressure,” explained Dr. Dan Jackson, a high-risk OB with Mercy Clinic Maternal and Fetal Medicine. “When that high blood pressure is accompanied by urine protein and other abnormal labs, it turns into preeclampsia.”
Preeclampsia increases the risk of stillbirth, delayed fetal growth and significant maternal complications, including heart attack, stroke, fluid in the lungs, liver failure, kidney failure and death. According to Dr. Jackson, hypertension in pregnancy contributes to many of the maternal deaths in the United States.
Once Horn was diagnosed with preeclampsia it quickly became severe. At just 26 weeks and weighing barely more than one pound, her baby girl, Charlie, was born and rushed to the neonatal intensive care unit. After the emergency c-section, Horn had a very rare complication from preeclampsia known as hyponatraemia. Her sodium levels plummeted and she was rushed to the intensive care unit (ICU).
“When I heard I needed a central line, that’s when I realized it was pretty serious,” Horn said. “They needed to stabilize my sodium levels, which had to be done gradually or it could cause more complications. The whole time I was in the ICU, I kept thinking of getting down to Charlie.”
Horn spent four days in the ICU and was able to see Charlie on the second day. Nurses wheeled her down anytime day or night. After 11 days in the hospital and many most tests, Horn was cleared to go home.
“While I was happy to be ok, I was also sad because now I would have to leave Charlie and not get to see her as often,” Horn commented. “It’s not natural to leave your baby. I try to spend as much time holding her as I can. It’s so strange to think she would still be inside me now.”
Can preeclampsia be prevented?
In some cases, yes. A daily low dose aspirin has been shown in several studies to reduce the risk of preeclampsia in women at risk. The American College of Obstetrics and Gynecology (ACOG) and the US Preventative Services Task Force (USPSTF) have a set of joint recommendations regarding who should be offered this treatment. Some of the more common indications are obesity, first pregnancy, maternal age at delivery over 35, history of preeclampsia in a prior pregnancy, multiple gestation pregnancy, and preexisting hypertension or diabetes.
Is it genetic?
While a family history of preeclampsia may increase the risk of preeclampsia, no definitive genetic link has been identified.
What are the symptoms?
Concerning signs and symptoms include increased blood pressure, headache, vision changes, chest pain or shortness of breath, severe heartburn, or pain under the ribs on the right side (right upper quadrant pain).
Tips to managing the symptoms?
If a pregnant or postpartum patient has any of these symptoms, she should be evaluated immediately by her physician or midwife.