A few months ago, Jessica Simpson posted several photos to Instagram in a self-deprecating take on the “ten year challenge” cycling through social media. The left picture showed her trim ankles rising from trendy platform wedges — the right, that same foot ten years later, ballooned to three times its size in the final trimester of her third pregnancy. Several days previously she had posted a single picture of her swollen foot with the caption, “Help!!!”
The pictures elicited laughs from some and advice and sympathy from others, but to a few, the celebrity’s swelling was more than an issue of vanity or discomfort. It was a possible sign of a dangerous condition that affects 5 to 8% of pregnancies: preeclampsia.
As it turned out, in this case Simpson’s issue was a normal side effect of her pregnancy, often relieved by elevation of the feet and a reduction in salt intake, but her cry for help — humorous as it may have been intended — was indicative of an information disconnect that is pervasive in healthcare today.
The proliferation of information on the internet; advice from our social circles; and our natural tendencies to either downplay or dramatize pregnancy symptoms because of our experiences with our mothers, friends, or previous pregnancies; create a cacophony of conflicting information. It leads us to question when the problems in pregnancy are just the normal side effects of doing the big work of growing a person inside of you, and when they might be symptomatic of bigger problems.
For example, when does swelling mean you simply need to lie down or change your diet, and when does it mean you should call your doctor? Learning about the difference between a normal symptom and a red flag will empower you to feel secure in your pregnancy.
Knowing the following signs and symptoms of preeclampsia can help you identify problems early to ensure the best possible outcome for you and your baby.
High blood pressure (Hypertension)
High blood pressure (BP) is one of the key warning signs of preeclampsia. While it is not always possible to monitor your BP from home, there are a few important symptoms to look out for: shortness of breath or anxiety, racing pulse or mental confusion could all be signs of elevated BP, particularly if these symptoms are new to your pregnancy. Know your normal blood pressure pre-pregnancy, and make sure to communicate this to your provider. Stay informed: ask your provider at every visit what your BP is. If you have a home monitor, track your levels and watch for abnormal readings, always communicating this information to your provider.
Protein in your urine (Proteinuria)
Another important indicator of preeclampsia is protein in the urine — a symptom that is likewise difficult to monitor from home. Again, make sure that your provider is checking these levels at every appointment. This can also be a way of determining whether other symptoms, such as nausea or headaches, are critical or simply the normal side effects of your pregnancy.
Swelling (Edema)
Swelling is fairly typical in pregnancy, especially in the final trimester. We’ve all heard the stories, or maybe experienced it ourselves — first clothes don’t fit, then shoes, as everything in the body begins to feel huge and alien. Because swelling is such a ubiquitous part of the pregnancy journey, it can often be overlooked as a symptom of preeclampsia. Knowing how to distinguish normal from abnormal swelling can be the difference in managing these problems before they become critical. Swelling as an indication of preeclampsia often manifests itself in atypical places — not simply the feet, but around the face, hands, and eyes. This type of swelling is a sign of excess fluid accumulation, or edema, that can be dangerous and should be communicated to your healthcare provider immediately.
Other symptoms of preeclampsia can include
- Constant headaches similar to migraines
- Nausea or vomiting that occurs suddenly and past mid-pregnancy (after the typical period for morning sickness)
- Acute or specific pain in the abdomen, shoulders, and/or lower back
- Sudden weight gain, or weight gain of more than 2 lbs per week
- Changes in vision such as light sensitivity, blurred sight, or auras
- Hyperreflexia; that is, extremely sensitive tendon reflexes best measured by a doctor
- Shortness of breath, racing pulse, mental confusion, and hyper-anxiety.
While many of these symptoms can occur in isolation as normal effects of pregnancy, any combination of them should be a cause for concern. Never be afraid to reach out to your care team with any questions that you have about unusual pains or abnormal feelings — they are there to protect you and empower you through your pregnancy, and your health and security is their priority.