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Preeclampsia is one of the most serious complications that can arise during pregnancy—but with early recognition and the right care, outcomes can improve dramatically.
In this article, we’ll break down what nurses and clinicians need to know:
- How to spot the early warning signs
- What those persistent headaches might really mean
- When preeclampsia typically shows up
- How treatment can make a difference
We’ll also take a closer look at the vital role nurses play in identifying and managing this condition to help protect both mothers and babies.
Let’s dive into the realities of preeclampsia and the power of timely, informed care.
What is preeclampsia?
Preeclampsia is a pregnancy-induced hypertension condition. It is commonly characterized by new hypertension and signs of organ dysfunction, typically proteinuria (protein in the urine). It is one of a spectrum of hypertensive conditions that may complicate pregnancy, together with gestational hypertension and eclampsia.
OB/GYN nurses typically monitor their patients closely for complications like preeclampsia, requiring close attention and the skilled awareness of both maternal and fetal well-being.
Causes and risk factors
While the precise mechanisms behind preeclampsia are still under research, several risk factors can increase the likelihood of developing the condition, such as the following:
- First pregnancy: Preeclampsia is more common in first-time mothers.
- History of preeclampsia: Having preeclampsia in a previous pregnancy increases the risk.
- Chronic hypertension: Women with pre-existing high blood pressure are at greater risk.
- Diabetes mellitus: Both type 1 and type 2 diabetes elevate the risk.
- Kidney disease: Pre-existing renal issues can predispose a mother to preeclampsia.
- Obesity: Higher body mass index correlates with increased risk.
- Multiple gestations: Twins, triplets, or more increase the likelihood.
- Age: Very young (<20) or older mothers (>35) face a higher risk.
- Autoimmune disorders: Conditions like lupus or antiphospholipid syndrome.
How common is preeclampsia?
Preeclampsia affects pregnancies worldwide, making it a significant contributor to maternal and neonatal morbidity and mortality. According to the Centers for Disease Control and Prevention, it occurs in two to eight percent of pregnancies.
The truth about working labor and delivery jobs
When does preeclampsia typically start?
Preeclampsia typically develops closer to the third trimester. However, it can sometimes begin earlier or even postpartum.
- What week does preeclampsia start? Most cases arise after the 20th week of pregnancy.
- What week is preeclampsia most common? It commonly develops between 32 and 37 weeks of gestation.
Early-onset preeclampsia, before 34 weeks, is associated with higher risks and usually requires more intensive monitoring.
Signs and symptoms of preeclampsia
Recognizing the signs of preeclampsia is essential for nurses caring for pregnant mothers. Early symptoms can be subtle but worsen rapidly.
Labor and delivery nurses, especially those certified in labor and delivery (L&D) nursing, are trained to recognize and respond to these warning signs.
Common preeclampsia symptoms include:
- High blood pressure: A blood pressure reading ≥140/90 mm Hg on two occasions at least four hours apart
- Proteinuria: Higher-than-normal levels of protein in the urine, often detected by urine dipstick or 24-hour urine collection
- Swelling: Sudden or excessive swelling (edema), especially in the face, hands, and feet
- Sudden weight gain: Rapid increase of more than 2 pounds per week due to fluid retention
- Headaches: Persistent, severe headaches often resistant to usual pain medication
- Visual disturbances: Blurred vision, flashing lights, or temporary vision loss
- Upper abdominal pain: Typically in the right upper quadrant, under the ribs
- Nausea or vomiting: Common in the second half of pregnancy
- Decreased urine output: Signs of kidney involvement
- Shortness of breath: Indicative of fluid in the lungs
Because these symptoms overlap with normal pregnancy changes, careful assessment and documentation are necessary to distinguish preeclampsia.
Understanding preeclampsia headaches
Headaches are a common and concerning symptom in patients with preeclampsia. Nurses should understand what these headaches feel like and where they are typically located to recognize them as early warning signs.
What does a preeclampsia headache feel like?
Preeclampsia headaches are often described as:
- Persistent and severe
- Throbbing or pulsating in nature
- Resistant to over-the-counter pain relief
- Often accompanied by visual changes
Where is a preeclampsia headache typically located?
- Most frequently in the frontal or occipital regions
- It can be generalized, but often focused behind the eyes or at the back of the head
These headaches differ from typical tension or migraine headaches in intensity and associated symptoms. When a patient reports such headaches, it should prompt immediate evaluation.
Postpartum preeclampsia
Preeclampsia can also develop after the birth of the baby, a condition known as postpartum preeclampsia.
What is postpartum preeclampsia?
Postpartum preeclampsia refers to new-onset high blood pressure and signs of preeclampsia occurring within 48 hours to six weeks after childbirth. This condition can be just as dangerous as prenatal preeclampsia, making postpartum monitoring essential.
Symptoms to monitor after delivery include:
- Elevated blood pressure
- Headaches
- Visual changes
- Upper abdominal pain
- Swelling and sudden weight gain
Postpartum preeclampsia requires immediate medical attention and careful management to prevent complications.
Preeclampsia treatment options
Currently, the only definitive cure for preeclampsia is delivery of the baby and placenta. Treatment focuses on managing symptoms and preventing complications until delivery can be safely performed.
- Blood pressure control: Antihypertensive medications such as labetalol, nifedipine, or methyldopa may be used to maintain safe blood pressure levels.
- Seizure prophylaxis: Magnesium sulfate may be administered to prevent eclampsia (seizures).
- Frequent monitoring: Includes blood pressure checks, fetal heart rate monitoring, urine tests, and blood tests to assess organ function.
Delivery as the ultimate solution
If preeclampsia is severe or the pregnancy is near term (usually ≥37 weeks), induced delivery is usually recommended. In early-onset preeclampsia, careful balancing of maternal and fetal risks may delay delivery under close supervision.
One of the benefits of labor and delivery nursing is the opportunity to provide critical care for patients with preeclampsia and improve their outcomes.
Hospitalization and nursing care protocols
Rapid recognition of deterioration is critical for timely intervention. Therefore, patients with severe preeclampsia require hospitalization. Nurses provide continuous monitoring, medication administration, patient education, and emotional support.
How nurses can help identify and manage preeclampsia
Nurses in obstetrics and L&D play an important role in the early identification and management of preeclampsia.
Role of bedside nurses in early detection
- Regularly monitor blood pressure and observe for symptoms.
- Perform urine protein testing as ordered.
- Assess for headache, visual disturbances, and edema.
- Document findings clearly and communicate concerns promptly to the healthcare team.
Documentation and communication with OB teams
Strong nursing skills in documentation and team communication are essential.
- Accurate and timely charting supports clinical decision-making.
- Nurses advocate for patients by reporting worsening symptoms or abnormal labs.
- Collaborate with obstetricians and midwives to adjust care plans.
Supporting patient education and awareness
Education is another core responsibility in a nurse’s scope of practice.
- Educate patients about the warning signs of preeclampsia and when to seek help.
- Encourage adherence to prenatal visits and monitoring.
- Provide emotional support and reassurance.
Learn more about nursing roles in the mother-baby specialty.
Preeclampsia symptoms and treatment explained
Preeclampsia is a serious concern in maternal healthcare, but with vigilant nursing care, early recognition, and appropriate management, outcomes can be improved. Nurses in obstetrics and labor & delivery are indispensable.
Already have experience working with pregnant mothers or delivering babies? Browse PRN shifts near you, maybe your skills are needed to fill a schedule gap.
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