Eclampsia vs. preeclampsia: What you need to know for your pregnancy journey

Your body undergoes many changes during pregnancy, and there are several specific conditions that women can experience, including preeclampsia and eclampsia. But what are these conditions, how are they related and what are the differences between the two?

From lowering the risk of preeclampsia to when to seek care, here’s what you should know about caring for yourself or someone you love.  

Eclampsia vs. preeclampsia: What's the difference?

Preeclampsia is a condition that sometimes happens in the second half of pregnancy or after you deliver your baby. It’s often detected based on high blood pressure and protein in the urine, but preeclampsia can cause a range of other symptoms, too.

Known as a condition of vasospasm, preeclampsia causes the blood vessels to constrict or “squeeze.” When this happens, it causes high blood pressure, affecting multiple systems in your body—from your brain and heart to your liver and kidneys. Rarely, preeclampsia can progress to eclampsia, a medical emergency that includes seizures. 

Maternity care providers and researchers don’t know the exact cause of preeclampsia. But it’s thought that the condition might start with an imbalance of chemicals from the placenta. If the placenta doesn’t develop correctly during early pregnancy, it can cause a problem with the blood vessels deep in the uterine wall, creating an imbalance that might lead to the condition.

While preeclampsia and eclampsia are serious conditions, with the right education, support and healthcare team by your side, you can recognize the signs and get the care you need.

Signs and symptoms of preeclampsia

One of the best things you can do when it comes to preeclampsia is to educate yourself and your family about the signs and symptoms. It takes an educated and supportive team outside of the medical environment to make sure that mom and baby stay healthy. Some resources to educate yourself and your family include the Preeclampsia Foundation, the CDC’s HEAR HER campaign and DSHS’s HEAR HER Texas campaign.

The CDC also provides education regarding several urgent maternal warning signs during pregnancy. While checkups are essential, often, it’s the pregnant mom or someone close to her who notices something is off first.

Watch for signs such as:

• Headaches
• Blurry vision, seeing spots or vision loss
• Severe abdominal pain, especially in the middle of the stomach or under the right rib
• Decreased urination
• Difficulty breathing
• Persistent nausea or vomiting that’s not morning sickness
• Feeling like you have the flu

If you or your loved one has any symptoms of preeclampsia, listen to your body and follow your OBGYN’s guidance to get care right away.

Signs and symptoms of eclampsia

If you develop eclampsia, you may have any of the symptoms of preeclampsia—including high blood pressure, vision changes or headaches—along with seizures. A seizure causes uncontrolled shaking, loss of awareness or confusion. If you or a loved one has a seizure during pregnancy, you need immediate emergency medical care.

How do you diagnose eclampsia vs. preeclampsia?

Doctors primarily detect preeclampsia by measuring high blood pressure and the presence of protein in the urine. But it can also be confirmed using blood tests if you have other symptoms or just don’t feel well. Your doctor diagnoses eclampsia if you have preeclampsia with seizures.

Your treatment options

If you’re diagnosed with preeclampsia, your OBGYN may consult with a maternal-fetal medicine (MFM) doctor who specializes in high-risk pregnancies to monitor your condition and decide on your next steps. If you don’t have severe symptoms and it’s too early to deliver, you may stay in the hospital, where your care team can monitor you closely.

If you have preeclampsia with severe features, your OBGYN will discuss delivery plans with you. This choice depends on many factors, including your risk factors, symptoms and how far along you are in your pregnancy. In some cases, you may require antihypertensive medications to control your blood pressure and antenatal steroids to help accelerate your baby’s development before you deliver.

How can you prevent eclampsia or preeclampsia?

Whether you’re planning to have a baby or you’re already expecting, it’s important to educate yourself on preeclampsia and how you can reduce your risk. Ask your doctor, “What are my risk factors for preeclampsia? Am I a candidate for low-dose aspirin?” This helps start the conversation about the preventive steps you can take.

Lifestyle changes

Lifestyle choices like eating healthy, exercising and maintaining a healthy weight can help reduce your risk of preeclampsia. The best time to make these changes is during preconception—but changes during pregnancy make a difference, too.

You should also talk to your doctor about any other medical conditions you have. For example, you can work together to create a plan to better control conditions like diabetes.

Medications

If you have certain risk factors, your doctor may have you take a low-dose aspirin every day to help reduce your risk of preeclampsia. The U.S. Preventive Services Task Force provides a list of high risk factors and moderate risk factors for preeclampsia to help guide this decision.

If you have one high risk factor or two moderate risk factors, you’ll receive a recommendation to start a low-dose aspirin daily. It is best to start low-dose aspirin between 12 to 16 weeks of pregnancy. However, it can be started up to 28 weeks. Sometimes, your doctor might recommend aspirin even if you only have one moderate risk factor.  

Potential complications

When it goes undetected and untreated, preeclampsia can be life-threatening for both you and your baby. While preeclampsia is most common during pregnancy, it’s also important to know that preeclampsia and eclampsia complications can happen in the days or weeks after labor and delivery as well.

Complications for the mother

Because preeclampsia affects your whole body, it can damage organs like your brain, liver, kidneys, eyes or heart. Severe range blood pressures put you at risk for stroke in pregnancy, and those who have preeclampsia have a higher risk of heart disease in the future.

One serious complication is HELLP syndrome. This life-threatening form of preeclampsia causes the red blood cells to hemolyze (burst open), which affects liver function and lowers platelets (important for blood clotting).

The tricky thing about HELLP syndrome is that not all women who have it will have high blood pressure or protein in the urine. But immediate medical attention is essential to the health of both mom and baby. You can learn more about HELLP syndrome at the Preeclampsia Foundation website.

Complications for the baby

The earlier in the pregnancy that preeclampsia happens, the higher the risk of complications from preterm delivery for the baby. For example, if you need to deliver at 22 weeks, the risk is much more than a baby delivered at 38 weeks.

Your OBGYN may seek consultation with a maternal-fetal medicine specialist and neonatologist as part of a multidisciplinary team to monitor your condition and guide decisions about the timing of delivery. 

Eclampsia: A medical emergency for expectant moms

If you develop eclampsia, it’s a medical emergency. You will be given anticonvulsant medications for seizure control and antihypertensive medications for blood pressure control. Eclampsia is an indication that your baby needs to be delivered.   

During pregnancy and after delivery, be sure to monitor your blood pressure ranges. If the top number—the systolic blood pressure—is 140 or higher or the bottom number—diastolic blood pressure—is 90 or higher, you need to call your doctor.

If the top number is 160 or more or the bottom number is 110 or more, you need immediate treatment at the hospital. You should go to a hospital with maternal care if you’re experiencing very high blood pressure or any of the urgent maternal warning signs, like severe headaches, severe abdominal pain, vision changes, trouble breathing or seizures.

When it comes to symptoms during or right after pregnancy, the most important thing to remember is to trust yourself. You know your body best, so speak up for yourself. Ask questions. Get your partner or family members involved. The right knowledge, a supportive team around you, and early intervention and treatment all play a critical role in eliminating preventable harm to you and your baby.

Questions about your pregnancy journey? Find comprehensive support from an OBGYN today.