For some women, preeclampsia during pregnancy is silent. They don’t even realize they have preeclampsia until they go to a routine appointment and discover they have elevated blood pressure or protein in their urine. While doctors may tell women to pay attention to symptoms like headaches, blurry vision or swollen hands, feet or face, preeclampsia can come on seemingly out of the blue and with no symptoms at all.
Name: Alicia
Children: One
Condition: Preeclampsia
Diagnosed: Week 36
This is exactly what happened to Alicia, a teacher from Missouri who developed preeclampsia with her second pregnancy. Just shy of 37 weeks pregnant, Alicia went to a regularly scheduled appointment and found out she needed to be induced due to high blood pressure.
“I wasn’t planning on this,” Alicia says. “I felt like my birthing plan was just being thrown out the window. I know it was for safety reasons, but I felt like I was spiraling out of control. I was just scared.”
Already considered high risk due to a blood clotting disorder, Alicia had a little extra time to prepare because she needed to be off the blood thinner medication she was taking for 24 hours before being induced. However, things got worse during labor. She hemorrhaged, resulting in surgery and a blood transfusion. She fainted while visiting her son in the neonatal ICU. Then Alicia had breathing problems, which prompted more tests due to concern about possible blood clotting in her lungs.
Risk Factors and Prevention
Today, Alicia has a healthy and active little boy. She remained on blood pressure medication for several weeks following delivery of her son. Looking back, she wishes she’d been more aware of her risk for and the severity of preeclampsia and had been more in tune with potential symptoms.
“I didn't think I had a risk,” Alicia says. “I know there's always a risk of anything because pregnancy is different for everybody, and it's different with each one. But I didn't feel any different than I did with my first pregnancy. That's what was crazy.”
Preventing traumatic experiences like Alicia’s is one reason Mirvie is developing an RNA platform to understand the underlying biology of each unique pregnancy. Using a simple blood test, the platform can predict pregnancy complications months before they occur, giving moms and doctors time to prepare and intervene before complications like preeclampsia become a crisis.
According to the Preeclampsia Foundation, the rate of preeclampsia in the United States has increased 25 percent in the last two decades. Preeclampsia and related hypertensive disorders of pregnancy impact 16% of all births in the United States. These disorders are among the leading causes of maternal mortality in the United States, and they are also independent risk factors for future cardiovascular disease.
Alicia remembers her doctor giving her an informational brochure about preeclampsia but wishes she’d had a conversation about it.
“They give you pamphlets, but they didn't really talk about it because that wasn't my issue,” Alicia says. “Because I already was considered high risk, they were more concerned about my blood clotting disorder than anything.”
In hindsight, Alicia wonders if she had a symptom of preeclampsia but never mentioned it to her doctor.
“Everything swelled so bad, but that's also a symptom of my blood clotting disorder,” she says. “It shows you have to pay attention to your body and talk to your doctor about it. Speak up and speak out. It’s for your health and your baby. There's nothing wrong with asking questions.”
Alicia also wonders if she would have asked different questions had she known she was at risk. Having certain blood clotting disorders can increase the risk, as can certain other preexisting conditions. But many women like Alicia who may be at increased risk of preeclampsia don’t realize it, especially as there is not yet a widely available test to effectively predict who is at risk - something Mirvie works every day to change.
Need for Education
Mirvie’s Future of Pregnancy Health Report, based on a survey of more than 1,000 new and expecting moms, revealed education about preeclampsia is falling short. Only one in 10 women surveyed were able to identify all of the common preeclampsia symptoms. The survey also revealed:
“More than 90% said they would want a personalized plan for their care, would like to sit down with their care provider to make sure they knew when to call with concerns, and were interested in options for home blood pressure monitoring,” says Dr. Alison Cowan, head of Medical Affairs at Mirvie. “Women tend to prioritize their health during pregnancy because it’s a time of high motivation to do everything possible to protect their growing babies.”
Alicia says if she’d known she was at risk for preeclampsia, she would have been more proactive during her pregnancy. “Even though you might have heard the terminology before or read about it before, until it's actually a part of your life, you don't make a big deal about it,” she says. “It’s important to make sure that a woman is as involved in her own care as possible.”
Encouraging and empowering proactive, preventive care is one of Mirvie’s primary goals.
“We know there is so much vital work to be done to improve pregnancy health,” Cowan says. “The work Mirvie is doing is going to help fill the unmet need that moms are telling us they have today: they want more information, they need more information, and they’re ready and willing to act on it.”
