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What Is Postpartum Preeclampsia?

The monitoring of blood pressure and swelling for six weeks after birth helps diagnose postpartum preeclampsia.
Postpartum preeclampsia can be treated with blood transfusions.
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  • Written By: Amanda R. Bell
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  • Last Modified Date: 01 August 2014
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While preeclampsia occurs primarily during pregnancy, postpartum preeclampsia can occur for up to six weeks after giving birth. Preeclampsia is the most common of the dangerous complications that can occur in expectant or new mothers. It can be caused by preeclampsia during pregnancy that is not resolved with the delivery of the baby or can occur seemingly out of nowhere following delivery.

Postpartum preeclampsia has several symptoms, including the new mother having blood pressure higher than 140/90 and excess protein in her urine. She may also experience issues with her vision, migraines, nausea, dizziness, sudden weight gain or severe abdominal pain. These symptoms can be typical in new mothers, which makes diagnosis of this condition difficult.

Researchers believe that insufficient blood flow to the uterus, issues with the immune system, damage to blood vessels during delivery and a poor diet are possible causes of postpartum preeclampsia. Other possible causes are obesity, excessive stretching of the uterus and even air pollution. When preeclampsia develops during pregnancy both the mother and baby are put at risk. Only the mother is at risk with postpartum preeclampsia, yet this is considered even more dangerous for her because her body is weakened from the trauma of birth.

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Postpartum preeclampsia is most dangerous to the mother within the first 48 hours after giving birth. It can result in multiple organ failure, infections and issues with blood clotting. If left untreated, it can also cause seizures and even send the mother into a coma, when it becomes eclampsia. There is also a risk of developing hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome, which can be life threatening to the mother. Current research also indicates that women who are diagnosed with preeclampsia, either during pregnancy or postpartum, are at greater risk of cardiovascular health issues later in life.

Women at risk for postpartum preeclampsia include those who were diagnosed with preeclampsia during their pregnancy, women who have given birth to multiples, women under the age of 20, women over the age of 40 and first-time moms. While preeclampsia that develops during pregnancy can only be treated by delivering the baby, postpartum preeclampsia can be treated with high blood pressure medication, anti-seizure medication, steroids, blood transfusions or even surgery. If diagnosed in time, the prognosis for the mother is very good.

Today, new mothers usually undergo a standard screening for postpartum preeclampsia before leaving the hospital after giving birth and during their six-week postpartum checkup. Doctors routinely check blood pressure and monitor swelling of the legs and feet, which is a frequent and early symptom of the problem, though swelling of these areas also is common for any new mother. Despite this monitoring, doctors encourage new mothers to report any symptoms of postpartum preeclampsia to their primary doctor the minute they are noticed. If symptoms are severe, women are encouraged to go to the emergency room immediately.

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anon939514
Post 23

This is the first time I have seen anything about postpartum HELLP/ pre-e. My last full term pregnancy I was diagnosed with mild pre-e around 35 weeks. In the middle of 36 weeks I started having blood pressures of 160/110. I finally delivered healthy twins at 37 weeks by c-section.

I complained to my OB from 36 weeks on that I was having chest pain and was told it was "acid reflux" and kept insisting (without doing any kind of check) that it was that even when I told her it didn't feel like heartburn. I also had some mild right sided pain.

At five weeks postpartum I had severe chest pain, so I went to the ER. I had severely elevated liver enzymes. They could never explain what the issue with my liver was, even after I went to a hepatologist. I'm convinced it was HELLP (I was told I likely had HELLP in my first pregnancy that ended at 27 weeks also).

anon938481
Post 22

I was re-admitted ten days after delivery for post partum pre e. My blood pressure was 187/115 and the only symptom I had was a severe headache. I'm glad I listened to my body and went in to get checked. I got magnesium for 22 hours and that brought it down, however, it went back up after being released so I'm taking nine pills a day for my bp and it's still like 130/85 and I'm almost ten weeks postpartum and was wondering if anyone knew how long it could last.

anon928617
Post 21

My oldest daughter is 17, and my youngest is 9. I developed preeclampsia with both pregnancies and both were scheduled premature births. My first time hearing about this condition was after my prenatal visit during my six month check up, when my BP was, as near as I can recall, 186/132. He told me my bp was very high and he was sending me to the hospital to have it checked on further.

Like most people, I attributed my high blood pressure to stress. I told him my husband was a Marine and was on a float and I was worried about him being back in time for the delivery and other little this and that's, thinking I would give him a simple explanation and he would understand.

My visit that day ended up being a frequent inpatient stay. I had no idea how horrible it was. My daughter was taken at 341/2 weeks and was in neonatal ICU, but luckily in the end, I went home with a healthy baby.

At the time I was told it was very uncommon and happened in first pregnancies only, because the body would know not to treat the hormonal changes as unknown. I, however, didn't care. I had such a horrible experience, I said I wasn't having another child. However, eight years later, I unexpectedly got pregnant. To be honest, I didn't even have any thoughts about the first pregnancy issues. However, I could not imagine how much of a journey I was about to take.

I was less than 11/2 weeks along when the blood test confirmed pregnancy. I didn’t know it at the time, but my body reacted immediately to the changes. My pregnancy test was ordered only to rule out pregnancy as most doctors do, because my visit was due to feeling dizzy and nauseated. My urine test was barely pink, hence the blood test, which shows the more accurate conception date.

I had complications from week one. literally. Having been totally healthy and with no medical issues outside of normal since my first pregnancy, I was shocked at what was going on inside my body. However, we still didn't think it was pregnancy related and kept a close eye on things for the next month and without much change in my bp and no other symptoms to add, so I felt there was nothing much to worry about.

I was into my fifth month and had been put on light duty work load because my bp was rising and I had high blood pressure symptoms I hadn't had before and the swelling was causing concern only because of my previous complications. I had only gained 8 pounds. I was still wearing my size 6 jeans, eating healthy and going to gym for walking, thinking I was not going to leave anything to chance. I wasn't expecting to wake up one day and feel so tight all over my body I thought my skin was going burst open.

I was so scared. My fiance looked like he had seen a ghost. I was so swollen. I felt so sick to my stomach and yet I couldn't really grasp what was happening; it was like a state of disorientation. It was January, but I could wear nothing on my feet. They hurt and had swollen so much socks and slippers wouldn't go on.

I was sent to a specialist after two local doctors told me they weren't equipped to manage an extremely high risk pregnancy and that in short, I would be lucky to live through the pregnancy with my life much less the baby. We managed to get me to 36 weeks along and scheduled a c section. I had clotting problems, but she was great, thankfully.

Unlike the first time, my symptoms didn't go away. I am on seizure medicine, hczt for swelling reduction and bp meds which stopped working over the last few years, with no cause to explain.

I have been diagnosed with complicated migraines that happened to cause me to become paralyzed during an EEG test when the ER had to come get me. I have hypothyroidism, had surgery to remove a malformation on the left and have a nodule on the left side which hasn't gotten bigger.

With the doctors running tests, switching my medication strengths, and feeling frustrated because I have all these symptoms of getting swollen and switched to two unsuccessful bp medications to get a normal rate which hasn't happened because it is 163-182/101-113.

I was searching sites and happened upon this one discussing preeclampsia after having a baby and whereas it may seem odd, but for once, I could explain my issues from the ones others shared.

I know it may be a long shot but could it be that maybe even being nearly 10 years later but not without health issues and medications be that this is happening and if so can it go away or should I have tests done that can tell them if it is or isn't?

I appreciate any help or advice anyone has. It has been so long since I have felt normal and perhaps that has me grasping at straws here so please forgive my craziness if so. Thanks.

anon927179
Post 20

I knew all of my symptoms pointed to PE before I delivered and tried to alert my OB. He brushed me off, stating that even though I did have a 40 point increase in my BP, it was still only around 140/80.

When they laid me back on the table for my C-section, I immediately began screaming with pain in my head and my BP was up to 180/98. They gave me pain meds and everything was dismissed. At discharge, I had edema up to my chest, my BP was still elevated, and I was having shortness of breath. Six days after delivery the jerk was finally becoming concerned, along with the persistent headache so I saw my PCP. He did a work up in the office and spoke with my OB, who insisted that my symptoms were not pregnancy related. Everyone made me feel like I was crazy and that my symptoms were in my head. My BP continued to stay around 150/90, which was a a huge increase from my usual 90/50.

Nine days post delivery I went blind. I was first seen in my local hospital and treated like a drug seeker even though my vision began to return when they got my BP lowered in the ER. I was sent home only to wake up three hours later in unimaginable pain and completely blind.

The next morning I was taken by ambulance to a bigger hospital and diagnosed with hypertensive enchephalopathy due to untreated PE. I was admitted to ICU and at one point I had to be administered medications to elevate and stabilize my heart rate. I was kept on a drip to manage my BP and kept sedated. 48 hours later I woke up and my vision had returned. In two days I shed 30 pounds of fluid. I came home on BP meds for a few weeks.

I am happy to report that it's been sis years and the only problem I have is swelling in my legs and my diastolic BP never returned to normal. My advice to anyone is to be your own advocate! You know your body better than anyone. I really wish physicians would pay closer attention to what a patient says. Not every case is out of a textbook.

anon354031
Post 19

It is good to see these posts on here. I had pre-eclampsia with my second child at 37 weeks. My blood pressure was really high and they delivered the baby by c section that same night. When the nurses came in to get me up after the c section, I had extreme pain in the upper right quadrant and I couldn't stand up straight.

The OB came and put it down to a bad reaction to a some pain patch that was put on the c section. Two days later I had blurred vision, bad headache and my heart rate dropped to 30. My BP was high again. I had an enlarged heart, enlarged liver and spleen. I also had a fatty liver and no liver function. I was swollen all over and was transferred to the cardiac ward. The crash cart came in many times as they were just waiting for a cardiac arrest. The doctors never gave me a definite answer. They said they had never seen these symptoms and put it down to pre-eclampsia continuing postpartum.

I was in the hospital for two weeks and it took many medications to get my blood pressure under control. I continued to have checkups for six months after to make sure my liver, spleen and heart were coming back to normal. It took a long time. The specialist told me that they only think my body pulled through because I have never smoked. Very scary and no real understanding for the "specialist" medical staff. This was in New Zealand and the doctors were talking with US specialists to see if they had any ideas. They asked for my permission to write a case study. I think this whole topic needs a lot more attention in medical communities.

anon351400
Post 18

I am 12 weeks pregnant with my third pregnancy. Yesterday I came home from work and lay down. As I closed my eyes I felt my face get numb and felt the bed start to spin (but of course the bed was not spinning). I got up and threw up. I have also been feeling shortness of breath and just having uncomfortable, heavy breathing because the air feels so thick to me. I also have an uncomfortable feeling in my legs, I don't know if it's serious. I haven't gone to the doctor because they say that all the signs are normal or are nothing to worry about, but I just don't feel right.

anon347508
Post 17

I experienced post partum eclampsia nearly two weeks after delivery with my first child. It's the most horrible thing I have ever experienced. I went to the hospital where I delivered, and they thought I had a spinal headache from my epidural so they did a spinal tap, kept me overnight for observation and sent me home the next day.

However, the headache was unbearable and the swelling did not change; it only continued to get worse so therefore, I went to another hospital for a week and they kept sending me home after running test after test. they did not know what was wrong. My blood pressure was at stroke level, but they said it was due to being in pain with my head. All I could do was scream. The only relief I could find was getting in a hot shower because it would bring my blood pressure down to an extent.

During my last and final trip to the emergency room, on my fifth day, I became very disoriented, and everything became very dark. I don't remember getting to the hospital or even being in the hospital until the next day when I woke up in a hospital bed. My organs, like my kidneys, even began shutting down which also led to seizures. Sadly, after the seizures, the doctors were finally able to diagnose me. After a week of receiving treatment. I was able to come home and have had no problems since.

I am currently pregnant with my second child and praying I do not have to experience this again, but if it happens, at least they will know how to treat me.

anon329923
Post 16

Same here. Hospital idiots. The nurse came to the house the next day and I couldn't move. My bp was 175\110.

I wound up in the ER. It is a hands on hospital, not to mention the nurses only cared about breast feeding and not helping me to the bathroom so i wouldn't poo or vomit on myself. It was a terrible experience.

They made me feel as if I were overreacting and I should breast feed my baby with vomit and the runs all over me. Meanwhile, I had a ct scan and signed not to breast feed my child for 24 hours. It's a shame it makes the caring and good caregivers get forgotten in the mix.

anon321314
Post 15

I delivered my son in mid-January 2013. About 10 days later, I woke up with the worst headache I've ever had and seeing black spots. I could feel every heart beat in my head.

After two hours of trying to figure it out, and taking headache meds, I called the on-call doc who suggested to take my BP. At that time it was in the 170/110 range (we took it over and over again to make sure.) The doc said come in. Mind you, I had a perfect pregnancy, with perfect BP, but with some swelling in my ankles and feet which they assumed was from standing and working all day.

We were almost to the hospital and I started to become very disoriented. I had taken my seatbelt off for a second and could not remember how to put it back on, how to use my arms, or where it was. I arrived at the hospital my BP was 210/142 and I then seized twice. They gave me mag sulfate, oxygen and valium to pull me out. I spent one day in ICU and three days in a room. I have been on BP meds ever since that have kept me relatively leveled out. However, I have horrible dizziness, vertigo, memory loss, nausea, loss of appetite, feeling of numbness in my legs, light sensitivity, blurry vision, and easily confused.

My MRI, CT, and EEG came back normal so I have to assume it's the Nifedipine for the BP causing these symptoms. This is the most scared I've ever been in my life. I know that God has a plan and I don't understand it all the time but just have to believe. I am almost 6 weeks postpartum and my doc just took me off the meds. Hopefully, there will be no more spikes and everything will go away. Has anyone experienced these side effects and how long did they last? --Amanda, Richmond, VA.

anon317581
Post 14

I had PP pre-e twice. I get tired of doctors saying that it's rare. Maybe, but I guess I'm the confounding statistic. At least the second time I had an at-home blood pressure cuff to watch my blood pressure going up. The consequences of not diagnosing it properly can be deadly to a new mother.

Doctors and hospital staff should routinely tell patients the warning signs after they give birth. Women should be getting their blood pressure checked at one and two weeks after delivery, even if it's the free screening at a pharmacy. ER staff should be trained to always suspect this if a woman just gave birth. Education is sorely needed.

anon315215
Post 13

At five days post partum, I first noticed that my ankles were getting really edematous and I was really light headed. I took my pulse because I felt like I was going to pass out and it was only 40. I knew something was really wrong. My BP was 185/100 and I was having chest pain. I was rushed to the emergency room and developed the worst headache that I have ever had in my life. I thought that I was going to die. My heart rate went down to 30 and the ER staff brought over the crash cart.

I had the million dollar work up, got lots of fluid and drugs but left the ER without a diagnosis. It was finally at my postpartum appointment with my OB that he diagnosed me with post partum preeclampsia. It was an extremely scary time and I wish that it was more widely known about and discussed at discharge for symptoms to watch for.

anon310093
Post 12

I too had PP PE after my second child. On the day of arriving home, I started to get the upper abdominal pain and my heart rate dropped to below 50. We went to the ER and I was told I was fine. The next day in the afternoon, I developed the most excruciating headache out of nowhere. My pulse was still low and I still had the abdominal pain. I was rushed by ambulance to a different hospital (the largest one in melbourne, Australia), and was tested for every neurological disorder you can think of. I had a CT, MRI, lumbar puncture, x rays and ultrasounds.

Eventually, someone thought maybe its PP PE. My case was so rare in a large city like Melbourne (3 million plus people) I had to meet with the head of obstetric training at the local university to write my case up for med students.

anon294231
Post 11

Thank you to all the women who have posted here. I was discharged from the hospital with swelling in my legs and feet, feeling exhausted, and with a horrible headache. The staff all smiled and said the swelling and exhaustion were all normal parts of giving birth and becoming a new mother. They sent me on my way, making me feel like this was just something I needed to get over. I spent five days at home thinking maybe I was just being dramatic and needed to get my eyes checked and get a little rest. Except for every time I put my feet up to relax, all I could do was look at my cankles and wonder if this really was "normal". It was not normal and I had to go to the emergency room a week after giving birth. They thought I had a stroke but then ruled that out.

My disorientation led them to believe that I needed to be admitted to a psychiatric ward. While there, it took days for the untrained staff to realize I had postpartum pre-eclampsia and not just postpartum depression. I also had a heightened sense of hearing and smell with extreme sensitivity to light. They finally diagnosed me and after 10 days, I was finally released. I didn't even realize that you could get pre-eclampsia when you weren't pregnant, and had my concerns been validated sooner, I would have gotten to spend those precious first days with my new family.

If you think that what you are feeling after having a baby worries you, don't let anyone dismiss your concerns. Keep seeking medical attention until you feel comforted.

anon212840
Post 10

Two weeks after the delivery of my daughter I began to notice swelling in my hands, feet and face. I didn't think much of it until I woke up with a bad headache and looked so swollen in my eyes that they were nearly closed.

I called my doctor and they thought it might be preeclampsia but weren't sure because I was two weeks postpartum. They told me to go the the ER and instead I went to the fire department who confirmed my normally very low BP was 195/98. I then went to the ER. I was treated very quickly and diagnosed with Postpartum Preeclampsia.

I spent three days in the hospital, was given drugs to prevent a seizure and put on magnesium sulfate for 24 hours. I had a horrible migraine that took in excess of thirty hours to break. My liver and cardiac enzymes were elevated and after treatment returned to normal. The preeclampsia caused a minor heart murmur and minor liver damage but nothing major. I am now taking Labetalol to control the high blood pressure but wonder how long it normally takes for preeclampsia to go away when it comes on during the postpartum period.

anon194052
Post 9

I am so thankful I found this site. I was five days post-partum and now I'm nine days. On the fifth day I went to the ER for the worst headache of my life. I also had chest pains. It was very strange and puzzled the doctors, because as soon as I lay down or sat down, the headache worsened but when I stood it would improve.

I ended up standing for almost 24 hours before they found that morphine worked on my headache. My blood pressure was 195/95 which is extremely high for me. I ran a low blood pressure, even during pregnancy. My pulse rate was low (still is) anywhere between 37-44. I was treated for everything, including spinal headache until a doctor saw that my liver enzymes were elevated and said I had postpartum pre-eclampsia. I also started to realize that when I would lie down I felt like I couldn't breathe and I had very swollen feet.

As of now, my blood pressure has been up and down the doctor is hesitant to give me bp medicine because he doesn’t know how long this will last and doesn’t want to drop it too low. This is a very scary time for me since there’s not an exact cure or answer. I'm very curious to hear what ended up happening with all of you and how and when it resolved.

anon193273
Post 8

I am three weeks postpartum. A week after delivery, I was seen in the ER with a blood pressure of 173/111. I was sent home because they thought it was due to a urinary tract infection.

I saw my OB the following Monday and my BP was still high (149/98). He gave me an option to be put on meds and I said no. It's been three weeks now, my BP is still high, I have headaches almost daily, and my vision has been awful. After reading these posts, I sure hope it is not postpartum preeclampsia left untreated.

anon167212
Post 7

My doctor missed the diagnosis, but in 15 years of practice, she had never seen a case. My preeclampsia occurred after my fifth child.

I had never had PE before, never had any complications, never had HBP. I had swelling and HBP seven days postpartum. I was sent home from triage and told it was a result of stress.

After lots of bed rest, two days later I seized and went into a coma. I was in ICU for two days and a monitored floor (at my request so I could see my babies) for two days. I am so grateful that I lived.

The ambulance driver is a family friend, and she thought that they were losing me for sure. God is good.

anon165141
Post 6

I gave birth to twin boys at 33 weeks. A day after they were born, I had a tightness in my chest, then I saw flashes of light in my peripheral vision (almost like little silver fish swimming in my eyes).

I couldn't see properly, everything seemed to be "on top of each other". As I was about to be discharged from hospital, one nurse insisted on checking my BP and it was raised. Within the next 24 hours, it hit 200/110. For the next two weeks, the doctors gave me huge amounts of meds to try to stabilise my BP including anti-seizure meds, steroids, bp meds etc. They caused it to swing from one extreme (80/40) to the other.

At one point, I lost my sight, was unable to speak and became paralysed on one side of my body. Fortunately an MRI indicated that I hadn't had a stroke and the doctors thought that perhaps it was some kind of a cluster migraine. It was one of the most frightening times of my life. I thought I was going to die. My sense of smell and hearing was heightened and this lasted for a few days. Light also hurt my eyes.

It's now 16 months on and I will never ever forget that time. I am exceptionally grateful for my beautiful little boys and the fact that I'm still around for them.

I would encourage any woman who notices swollen ankles, tightness in the chest or vision being a bit funny, to get their BP checked while sitting as well as lying down in case it's postural.

anon154138
Post 5

2.5 days after a c-section, my postpartum preeclampsia was caught by the night nurse during 3 a.m. rounds. I had a sudden spike in blood pressure to 186/106, which had come out of nowhere! (It was so surprising, she checked it more than once to be sure.)

The hospital started Magnesium in my I.V. very shortly thereafter, even though there was no protein in my urine, and my liver enzymes were only slightly elevated. Twelve hours later, my liver enzymes were even more elevated, so I shudder to think how high they would have soared without the 12-hours of magnesium! I had 12 additional hours of magnesium and then was sent home 36 hours later on blood pressure medication which I only needed for six weeks.

I am so thankful that my postpartum preeclampsia was caught, identified and treated so quickly that I never experienced any uncomfortable physical symptoms (such as headache, abdominal pain, nausea, blurry vision, etc)! I don't think I'll ever complain about a 3:00 am night nurse check again! --Elizabeth, Durham Regional Hospital, NC

anon153723
Post 4

I just delivered my son exactly one week ago. I noticed a day after I left the hospital my ankles and feet were swollen. They were four times their regular size.

I'm also a big believer on doing kegels after birth, because I have had a vaginal delivery for six children, but the fluid was so built up in my system I could not feel anything in my lower bottom, not even a Bm. This pretty much scared me. I thought I had nerve damage from delivering and pushing out the baby, but it was fluid build up.

The next thing I noticed I could not breathe. Yes, I have asthma but this was different. When I lay down, it felt like my breath was being cut short and it would wake me out of my sleep, then i got terrible back and chest pains. After these symptoms I went in to the emergency room, and nurses and doctors got to running around like crazy!

This scared the crap out of me. I thought I was going to die, leaving my babies behind. The doctors explained to me that I was being readmitted for postpartum preeclampsia, they put me back in the same room i had left and treated me for two days with magnesium sulfate to control the blood pressure, because it had sky rocketed, causing a slow heart rate. I never had high blood pressure, so this was very scary! Hopefully i will be fine. I was just released yesterday.

anon135762
Post 3

Gwen O. I just saw this post and article. I too had post-partum preeclampsia (that was never truly diagnosed as pre-e).

My symptoms were high BP, low heart rate (33-39 bpm at rest and when moving) and shortness of breath. I also never had a headache, even when my BP hit 210 /115! and no protein in my urine.

I ended up back in the hospital four days after delivery to get treated/observed for the low heart rate but did not get put on BP meds for a week and then my BP still soared and I was changed to a different med and was taking four times the normal dosage.

I then had a D&C as a specialist thought I could have a miniscule amount of retained products of conception. This was three weeks pp. After that my BP finally began to drop without meds. It was a scary and busy month post delivery.

My OB to this day insists it was not post partum preeclampsia. I also hope more doctors pay attention to these symptoms when the present without all of the symptoms. --Angela, Raleigh, NC

anon127914
Post 2

I did have the same problem. In my experience, nobody paid attention to me when I said that I had fluid retention up to my chest. I couldn't even bend my knees at discharge time after delivery, and I couldn't even wear my husband´s shoes, my feet were so swollen. but everyone at hospital said it was normal, but it wasn't. I normally have low blood pressure even during pregnancy.

so please, please listen to your patients. Because I had to stay five days at the hospital because of this, being so worried and nervous about the care of my little one who was not allowed to stay with me.

I had to bottle feed because of all tests that they had to run. And I did not know my baby had an allergy to milk protein, so in that moment she started to feel sick and I spent over a year trying to cure my little girl.

As you can see this problem turned my life upside down.

hope this helps.

anon125917
Post 1

I just got released from the hospital with postpartum preeclampsia. We caught it about a week after delivery. I would like to add to your list of symptoms a low heart rate, which in me caused some chest pain and shortness of breath. The research I have done suggests that preeclampsia will also present weird cardiac symptoms.

What was strange in my case also, is that I never had a headache or protein in my urine. My BP got to 160's/90's, I had lots of swelling in my feet, and a heart rate of 37-42 at rest which caused slight chest pain and shortness of breath.

Thanks for posting this information. I hope more women and doctors pay attention to this issue. --Gwen O., Grand Rapids, Michigan

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