Approximately five to eight percent of pregnancies are affected by preeclampsia, a condition characterized by high blood pressure (hypertension) and often changes in the mother's kidney, liver, and blood-clotting systems. Preeclampsia poses health risks for both the mother and the baby during pregnancy. Following delivery, concerns for the mother's health lessen but remain present.
Risk factors for preeclampsia include previous history of preeclampsia; multiple gestation pregnancy (twins or more); history of chronic high blood pressure, diabetes, kidney disease, or organ transplant; obesity; over age 40 or under age 18; polycystic ovarian syndrome (PCOS); rheumatic or autoimmune diseases, such as lupus, multiple sclerosis, or rheumatoid arthritis; in-vitro fertilization (IVF); and sickle cell disease. Women who develop preeclampsia during or after pregnancy face ongoing health challenges, including a life-long increased risk of hypertension, stroke, and heart attack.
At Brigham and Women’s Hospital (BWH), we provide highly specialized care for women who develop preeclampsia during pregnancy or in the postpartum period. Our multidisciplinary team of experts, including maternal-fetal medicine (high-risk pregnancy) specialists, internal medicine physicians, and nutritionists, is dedicated to optimizing the long-term health of these women and facilitating a successful transition to their primary care providers.
Women who develop preeclampsia during pregnancy or in the postpartum period have been found to benefit from more intensive medical follow up in the weeks and months following delivery. Optimal blood pressure and weight control, as well as implementing healthy lifestyle habits related to diet and exercise, are important to reduce the risk of developing cardiovascular disease. Close medical management and important lifestyle modifications during the postpartum period are critical to improving postpartum health, as well as reducing short- and long-term cardiovascular disease risk.
Women with prior history of preeclampsia have a higher risk of developing preeclampsia in subsequent pregnancies. Before conception, these women should consult with an experienced medical team to understand how to best manage existing conditions and risks during pregnancy. Adjustments in medication may be recommended prior to conception. Mothers should not reduce or discontinue medications on their own.
In the Cardiometabolic Clinic, experts in maternal-fetal medicine collaborate closely with an internal medicine specialist with board certification in both adult and pediatric medicine to deliver highly specialized care and health education for women who develop preeclampsia during pregnancy or in the postpartum period. Emphasis is placed on blood pressure stabilization, medication streamlining, nutrition, lactation consultation, appropriate contraceptive choices, sleep quality, mental health, and lifestyle modifications.
Dietary Approaches to Stop Hypertension (DASH) Diet
|Daily Servings (except as noted)||1,600 calories/day||2,000 calories/day|
Grains (choose mainly whole grains)
|6||7 or 8|
|Vegetables||3 or 4||4 or 5|
|4||4 or 5|
|2 or 3||2 or 3|
|Lean meat, poultry and fish||1 or 2||2 or fewer|
|Nuts, seeds and dried beans||3 per week||4 or 5 per week|
|Fats and oils||2||2 or 3|
5 per week
The Dietary Approaches to Stop Hypertension (DASH) diet can help manage hypertension (high blood pressure).
Preconception planning is provided for women who wish to plan future pregnancies. The team works closely with primary care providers in the community to facilitate a successful transition to long-term care, ensuring focus on each patient’s individual needs. Research focusing on health behaviors and provider/patient education are all on-going.
To schedule an appointment or to learn more about our services, please contact us at (617) 732-4840.
Brigham and Women’s Hospital
75 Francis Street
Boston, MA 02115
Louise E. Wilkins-Haug, MD, PhD
Division of Maternal-Fetal Medicine
Ann C. Celi, MD, MPH
Division of General Internal Medicine and Primary Care
For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery.