Accesibilidad
Animación
Accesibilidad

When preeclampsia doesn’t end after delivery: A mother’s experience with postpartum preeclampsia

10 June 2024

When preeclampsia doesn’t end after delivery: A mother’s experience with postpartum preeclampsia

For Erin Kirk, preeclampsia developed quickly toward the end of her first pregnancy. She’d never heard of the condition—a pregnancy complication characterized by dangerously high blood pressure—outside of television and movies, and her care team hadn’t discussed the topic with her.

“I felt blindsided,” she says. “I was about 34 weeks pregnant, and my blood pressure reading was high at a check-up on a Friday, so we kept an eye on it over the weekend.” High blood pressure is typically defined as a blood pressure reading of at least 140/90 mm Hg, and Erin recalls her numbers being even higher. But without any of the other “classic” symptoms of preeclampsia—such as headaches or blurred vision—her healthcare team didn’t immediately suspect it might be preeclampsia.

However, by Sunday, Erin’s numbers still hadn’t stabilized, so she admitted herself to the hospital.

Image
erin_hospital_bloodpressure.jpg

"I was put on bed rest, and I was in the hospital until delivery at 37 weeks,” she says. “I also had an anterior placenta (i.e., when the placenta grows in the front of the uterine wall). Because of the placement of my placenta and my high blood pressure, they told me I needed a C-section, which I was not happy about.”

Erin also remembers being told that once her placenta was removed during delivery, “everything would be fine.” But soon she would discover that would not be the case for her experience.

Facing the whiplash of postpartum preeclampsia

According to the Preeclampsia Foundation, most people with the condition will deliver healthy babies and fully recover. However, postpartum preeclampsia remains a possibility even after delivery.

Image
erin_bloodpressure.jpg

Erin’s case, she was assured that everything would return to normal once her placenta was removed. Instead, her experience was far from over.

“We had our little boy, Dixon, who had to go to the NICU because of some fluid in his lungs, but he was only there for about 36 hours,” explains Erin. “I was held for three days, and everything seemed fine at first. We went home, and I was told to keep an eye on my blood pressure, which we did.”

However, five days later, Erin was back in her obstetrician’s office with high blood pressure. “After a visit to triage, I was admitted again,” she says.

This time, the hospital stay was much more difficult. “I had a newborn I was trying to breastfeed, which made things harder because he wasn’t the hospital’s patient, but I was, and I needed a bassinet and a pump to care for him,” she explains.

Fortunately, the hospital accommodated Erin’s needs for her newborn. Still, she describes the hospital stay as “miserable,” largely due to the side effects of her preeclampsia treatment.

“They gave me a 24-hour magnesium drip,” she says. Magnesium sulfate is a common treatment for preeclampsia to help lower blood pressure and prevent complications like seizures. While effective, the side effects can be intense.

“I started to feel bad within an hour or two of starting the magnesium drip,” says Erin. “It made me feel incredibly weak. It was physically impossible to get out of bed. I was trying to breastfeed, but I couldn’t even hold myself up, so my husband had to hold me up every three hours or so to help me pump. You’re also not allowed to eat while receiving the medication, so I was starving. I felt nauseous and sleepy; it felt like the worst case of the flu I’ve ever had. It is hands-down the worst I’ve ever felt.”

Between the debilitating side effects of her treatment and the whiplash of being told delivery and removal of her placenta would “fix everything”—only to be back in the hospital within one week—Erin struggled significantly through the postpartum period of her first pregnancy.

“Also, being a new mom and not being able to hold your baby for 24 hours is a miserable feeling,” she adds.

Once Erin completed the 24-hour magnesium drip, she was discharged within about one day. “They sent me home with some blood pressure medication, which I took for about six weeks before I was able to stop,” she says.

But little did she know, this wouldn’t be the last time she’d experience postpartum preeclampsia.

Déjà vu: A recurrence of postpartum preeclampsia

Because of the trauma experienced during her first pregnancy, Erin says she and her husband took a while to even decide whether they wanted to have another baby.

Once they chose to try again, Erin remembers discussing the potential risks with her healthcare provider. “He told me that the risk of having preeclampsia in your subsequent pregnancies definitely increases after you’ve already had it once,” she says.

To help mitigate her risks, Erin was prescribed low-dose baby aspirin as soon as she found out she was pregnant again. “I was much more aware of potential symptoms to look out for this time,” she says. “Truthfully, I thought I was in the clear.”

Everything was smooth sailing until approximately 35 weeks into Erin’s pregnancy. That’s when she discovered her baby had a dangerous heart arrhythmia.

“I was admitted to the hospital, completely unprepared, again,” she says. This time, she was put on bed rest for nine full days, bringing her to Christmas Eve.

“I begged and pleaded to go home for Christmas, and they did let me,” says Erin. “But starting the day after, I had to go to my healthcare provider’s office daily for check-ups.”

By 37 weeks—which happened to mark New Year’s Eve—Erin’s healthcare team needed to deliver the baby. “Technically, they delivered the baby at 37 weeks and one day, because no one wanted to do that on New Year’s Eve,” she jokes.

While her first son, Dixon, stayed in the NICU for fewer than two days, Erin’s newborn son, Levi, stayed for over three weeks. After being discharged herself after only a few days, Erin was at the NICU every day with Levi.

On day 11 of accompanying Levi’s NICU stay, Erin noticed her vision was growing blurry. “Even though I hadn’t really been monitoring my blood pressure at this time, I was still swollen, and I knew what it was,” she says.

With memories of the miserable magnesium drip flashing back into her mind, Erin called her mom to help her get some food first. “I knew it would be my last meal for 24 hours,” she says.

Within a couple of hours, Erin was hospitalized again for postpartum preeclampsia. Though she only had to stay for about a day, she faced the dreaded 24-hour magnesium drip for a second time, “which was just as miserable” as the first time, she says.

“The only blessing was that our little man was being cared for in the NICU,” she adds. “But I still pumped every three hours as I had been beforehand.”

Looking ahead: Raising awareness about postpartum preeclampsia

Today, Erin and her family are healthy, though she is still discovering how preeclampsia may be affecting her long-term health.

“I have had some heart concerns, specifically arrhythmia and sporadic blood pressure issues,” she explains. “I know there are higher chances of heart-related issues down the road after preeclampsia, so I’m staying on top of everything as best as I can.”

Erin also chose to have a tubal ligation (a surgery that closes a woman’s fallopian tubes to prevent pregnancy) during her C-section with her second pregnancy. “My husband and I were very concerned about going through all of that again,” she says. “We knew we were done, and my body isn’t meant to handle any more pregnancies.”

For other mothers who may be concerned about preeclampsia, Erin says it’s important to pay attention to your body and educate yourself on the subject as much as possible.

“With my first pregnancy, I had no idea what was going on. I felt confused about preeclampsia and what it all meant,” she explains. “At least with my second pregnancy, I knew what to expect. Plus, my OBGYN’s office had started hosting these new monthly meetings with everyone in the practice who was due to deliver that month, so we had a community of other moms going through similar experiences. I loved this! I spoke about my experience with preeclampsia with the group, hoping to not scare them, but to help them know about the possibilities and what to look for. The OBGYNs at these meetings encouraged me to share my experience.”

Erin also stresses the importance of raising awareness about postpartum preeclampsia. “It’s a myth that preeclampsia is ‘fixed’ with delivery,” she says. “The fact that I was told that, then had postpartum preeclampsia with both pregnancies, proves that it’s not true. I wish I had known how common it is.”

While postpartum preeclampsia is considered rare, it’s not an impossibility, and it can still happen regardless of an individual’s history, or lack thereof, with the condition.

“I think there should be some conversations with your healthcare team before delivery about what can happen,” says Erin. “Everyone makes a ‘birth plan,’ and the reality is that I can only name two or three friends who’ve had everything go smoothly. It seems that, more often than not, there are some complications.”

Increasing early preeclampsia detection through comprehensive screening

One way to stay ahead of these pregnancy complications is through comprehensive preeclampsia screening.

To help determine the risk of developing the condition early in pregnancy (i.e., prior to symptom onset, which typically happens at approximately 20 weeks’ gestation), Labcorp offers a first-trimester preeclampsia screening. Given between 11 and 14 weeks’ gestation, the first-trimester screening test looks at a combination of maternal factors and biomarkers associated with blood pressure, fetal development and placental health. Using a proprietary algorithm of these factors to assess the risk of developing preeclampsia later in pregnancy, this screening test can be given to any pregnant patient.

Labcorp also offers an FDA-cleared second/third trimester preeclampsia test, which can provide prognostic confirmation of the condition in hospitalized pregnant patients. Using biomarkers associated with blood vessel and fetal health, the test is given between 23 and 35 weeks’ gestation to assess the risk of preeclampsia progressing to severe complications within the following two weeks.

Whether you’re curious about these types of screening tests or potential preeclampsia risk factors, Erin encourages you to ask questions and have an open dialogue with your healthcare team.

“Find out the possibilities before you think they may be an issue,” she says. “Be your best advocate, be patient and educate yourself as much as you can. Pay attention to your body, and report anything that seems ‘off,’ even if you think it’s nothing. It can be traumatic and upsetting, but there is help out there to deal with the trauma of it all.”

Preeclampsia is a serious pregnancy complication that affects 5% to 7% of pregnancies globally and is a leading cause of maternal illness and death. In the U.S., the risk is significantly higher for Black patients, who are three times more likely to die from pregnancy-related complications compared to white patients. 

Learn more about preeclampsia and Labcorp’s comprehensive preeclampsia testing solutions, and start a conversation with your healthcare provider.