Overview

Postpartum preeclampsia is a rare condition that occurs when you have high blood pressure and excess protein in your urine soon after childbirth. Preeclampsia is a similar condition that develops during pregnancy and typically resolves with the birth of the baby.

Most cases of postpartum preeclampsia develop within 48 hours of childbirth. But, postpartum preeclampsia sometimes develops up to six weeks or later after childbirth. This is known as late postpartum preeclampsia.

Postpartum preeclampsia requires prompt treatment. Left untreated, postpartum preeclampsia can cause seizures and other serious complications.

Symptoms

Postpartum preeclampsia can be difficult to detect on your own. Many women who experience postpartum preeclampsia show no signs or symptoms during pregnancy. Also, you might not suspect that anything is wrong when you're focused on recovering after childbirth and caring for a newborn.

Signs and symptoms of postpartum preeclampsia — which are typically the same as symptoms of preeclampsia prior to delivery — might include:

  • High blood pressure (hypertension) — 140/90 millimeters of mercury (mm Hg) or greater
  • Excess protein in your urine (proteinuria)
  • Severe headaches
  • Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
  • Pain in your upper belly, usually under the ribs on the right side
  • Nausea and vomiting
  • Shortness of breath
  • Decreased urination

When to see a doctor

If you have signs or symptoms of postpartum preeclampsia shortly after childbirth, contact your health care provider right away. Depending on the circumstances, you might need immediate medical care.

Contact your health care provider if you have questions or concerns about your health as you recover from childbirth.

Causes

The causes of postpartum preeclampsia and preeclampsia that occurs during pregnancy aren't well understood.

Risk factors

Limited research suggests that risk factors for postpartum preeclampsia might include:

  • High blood pressure during your most recent pregnancy. You're at increased risk of postpartum preeclampsia if you developed high blood pressure after 20 weeks of pregnancy (gestational hypertension).
  • Obesity. The risk of postpartum preeclampsia is higher if you're obese.
  • Having multiples. Having twins, triplets or more increases your risk of preeclampsia.
  • Chronic high blood pressure. Having uncontrolled high blood pressure before pregnancy increases your risk of preeclampsia and postpartum preeclampsia.
  • Diabetes. Having type 1 or type 2 diabetes or gestational diabetes increases your risk of preeclampsia and postpartum preeclampsia.

Complications

Complications of postpartum preeclampsia include:

  • Postpartum eclampsia. Postpartum eclampsia is essentially postpartum preeclampsia plus seizures. Postpartum eclampsia can permanently damage vital organs, including your brain, eyes, liver and kidneys.
  • Pulmonary edema. This life-threatening lung condition occurs when excess fluid develops in the lungs.
  • Stroke. A stroke occurs when the blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. A stroke is a medical emergency.
  • Thromboembolism. Thromboembolism is the blockage of a blood vessel by a blood clot that travels from another part of the body. This condition is also a medical emergency.
  • HELLP syndrome. HELLP syndrome — which stands for hemolysis (destruction of red blood cells), elevated liver enzymes and low platelet count — can rapidly become life-threatening. Symptoms of HELLP syndrome include nausea and vomiting, headache, and upper right abdominal pain. HELLP syndrome is particularly dangerous because it represents damage to several organ systems. On occasion, it may develop suddenly, even before high blood pressure is detected, or it may develop without any symptoms at all.

Prevention

Your doctor may:

  • Discuss the signs and symptoms of preeclampsia with you
  • Recommend taking baby aspirin (81 milligrams) to prevent preeclampsia during your next pregnancy
  • Encourage you to have an active lifestyle and to eat a healthy diet

Aug. 17, 2021
  1. Papadakis MA, et al., eds. Preeclampsia-eclampsia. In: Current Medical Diagnosis and Treatment 2021. 60th ed. McGraw-Hill Education; 2021. http://accessmedicine.mhmedical.com. Accessed March 12, 2021.
  2. Walls RM, et al., eds. Acute complications of pregnancy. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed March 12, 2021.
  3. Sharma KJ, et al. Postpartum hypertension: Etiology, diagnosis, and management. Obstetrical and Gynecological Survey. 2017; doi:10.1097/OGX.0000000000000424.
  4. Redman EK, et al. Clinical course, associated factors, and blood pressure profile of delayed-onset postpartum preeclampsia. Obstetrics & Gynecology. 2019: doi:10.1097/AOG.0000000000003508.
  5. American College of Obstetricians and Gynecologists. Committee Opinion No. 692: Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstetrics & Gynecology. 2017; doi:10.1097/AOG.0000000000002019.
  6. Dipierto L, et al. Benefits of physical activity during pregnancy and postpartum: An umbrella review. Medicine and Science in Sports and Exercise. 2019; doi:10.1249/MSS.0000000000001941.
  7. Katsi V, et al. Postpartum hypertension. Current Hypertension Reports. 2020; doi:10.1007/s11906-020-01058-w.
  8. Powles K, et al. Postpartum hypertension. CMAJ. 2017; doi:10.1503/cmaj.160785.
  9. Giwa A, et al. Late onset postpartum preeclampsia 3 months after delivery. American Journal of Emergency Medicine. 2017; doi:10.1016/j.ajem.2017.07.024.
  10. American College of Obstetricians and Gynecologists. Practice Bulletin No. 222: Gestational hypertension and preeclampsia. Obstetrics & Gynecology. 2020; doi:10.1097/AOG.0000000000003891.
  11. Wick MJ (expert opinion). Mayo Clinic. May 14, 2021.

Related

Associated Procedures