Understanding Postpartum Preeclampsia with IU Health

Disclosure: This post is sponsored by IU Health.

A week after giving birth via c-section, Megan Miller started hemorrhaging due to uterine fibroids. With her husband away from home picking up their older daughter from a family member, she called her sister, a nurse. She urged Megan to check her blood pressure and when she saw how dangerously high it was, she strapped her newborn into the carseat and called for an ambulance. After spending five days at IU Health West, Megan’s blood pressure was finally under control.

Megan suffered from postpartum preeclampsia. Rare but severe and life-threatening, postpartum preeclampsia is a condition that women can suffer from after giving birth. We recently spoke with Dr. Micah Mathai, an Obstetrician Gynecologist who practices at both the IU Health North and IU Health Saxony, soon to be IU Health Fishers, locations. He talked to us about the signs and symptoms, treatment, and how you can prevent getting postpartum preeclampsia.

IU Health postpartum preeclampsia

What are the signs and symptoms of postpartum preeclampsia? How common is this condition?

Dr. Mathai says there is non-severe and severe postpartum preeclampsia, with signs and symptoms varying greatly.

Common symptoms of postpartum preeclampsia include:

  • Worsening headaches or headaches that don’t improve with conservative treatment or medications
  • Blurry vision
  • Abdominal pain in your RUQ (right upper quadrant)
  • Abrupt onset increased generalized swelling

Dr. Mathai says the most common sign – when consulting your doctor – of general or non-severe postpartum preeclampsia is elevated blood pressure with associated protein in your urine. Non-severe preeclampsia is an elevated blood pressure greater than or equal to (or the symbol ≥) 140 systolic, greater than or equal to 90 diastolic, with associated protein in urine.

Your doctor may diagnose you with severe postpartum preeclampsia if you have:

  • Blood pressures ≥ 160 systolic or ≥ 110 diastolic
  • Kidney dysfunction (elevated serum creatinine) >1.1 or >2x the baseline
  • Liver dysfunction: serum AST or ALT levels ≥ 2x the upper limit of normal — or patient has new onset RUQ abdominal pain or epigastric pain
  • Platelet count less than 100,000
  • Evidence of pulmonary edema (or fluid in the lungs)
  • Neurologic signs: New onset headache or visual disturbances

Dr. Mathai says postpartum preeclampsia “is rare and less common than preeclampsia that occurs during pregnancy, and with exact numbers not well studied, it’s likely around 0.5% of all pregnancies.”

Can I get postpartum preeclampsia if I did not get preeclampsia before giving birth? Are the two conditions related in any way?

Yes, postpartum preeclampsia can occur even if you didn’t get it before giving birth,” says Dr. Mathai. “Both entities are related and generally treated the same, but postpartum preeclampsia occurs after delivery of the baby while preeclampsia in general occurs during pregnancy, typically after the 20th week of gestation.”

How soon after giving birth can you start to show symptoms?

You can start to show symptoms of postpartum preeclampsia within 24 to 72 hours after delivery, says Dr. Mathai. Most women come in for diagnosis within the same week after delivery, but it is possible to show symptoms up to sevens weeks postpartum.

How long can it last and how is it treated?

The duration of postpartum preeclampsia can vary and it depends on the severity and how quickly it is diagnosed and treated,” says Dr. Mathai. “Generally, with swift diagnosis and treatment, blood pressures will improve within a few days. However, it may take weeks for it to fully return back to pre-pregnancy levels.”

With non-severe postpartum preeclampsia, Dr. Mathai says that after discharge, your doctor will monitor your elevated blood pressure closely with a follow-up appointment. “A blood pressure check should be performed by a trained professional, approximately one week postpartum or one week after discharge, to make sure BPs are not spiking.” He highly recommends you get a blood pressure cuff to monitor your levels at home. If you do not have one, ask your doctor for a prescription.

With severe postpartum preeclampsia, Dr. Mathai says you would need immediate attention and treatment with intravenous Magnesium Sulfate (or IV Magnesium). IV Magnesium is used to prevent seizures (eclampsia is the medical term for seizures) and worsening of symptoms. With that, your doctor may also give you anti-hypertensive medications to help bring down the blood pressure and further prevent seizures. They would also monitor how much you’re urinating and how much fluid you are getting by utilizing diuretics, or water pills. When you have postpartum preeclampsia, monitoring fluid is very important because you’re dehydrated while also being “volume overloaded” with disproportionate amounts of fluid in the body, a.k.a. swelling. 

Can you breastfeed while having postpartum preeclampsia?

Like everything with postpartum preeclampsia, this is a loaded question because again, it depends on the severity of the condition. Dr. Mathai says in general, yes. It is usually safe to breastfeed while recovering from postpartum preeclampsia, as long as you are being careful with the medications given to you. Most medications are safe during lactation, but certain medications will not be safe to use. Your doctor will monitor you closely and will work with you. Dr. Mathai says, “Being asked to stop breastfeeding almost never happens and we usually just make sure any medication given to you are appropriate and acceptable for breastfeeding and lactation.”

How can I prevent getting postpartum preeclampsia?

Before getting pregnant, Dr. Mathai suggests treating or managing any underlying modifiable risk factors for preeclampsia, including pre-gestational diabetes, chronic hypertension, a pre-pregnancy Body Mass Index (BMI) of 30 or greater, and obstructive sleep apnea. Consult your doctor with any concerns prior to getting pregnant.

While pregnant, Dr. Mathai says taking low-dose aspirin (81 mg) daily between 12 weeks and 28 weeks (preferably before 16 weeks) daily until delivery can reduce the risk of postpartum preeclampsia, depending on your risk factors. Again, it is important to consult your doctor on this, and prior to beginning the low-dose aspirin.

Looking back, Megan is thankful to the staff at IU Health for acting quickly while she was suffering from postpartum preeclampsia. She was able to recover with her newborn baby by her side. After going through that scary experience, she wants to help spread more awareness for expecting mothers to understand what could happen after giving birth. To learn more about IU Health’s Maternity Care as well as finding an OB/GYN near you, visit iuhealth.org/bookobygn.

About Micah Mathai, MD

Micah Mathai, MD specializes in Obstetrics & Gynecology for IU Health Physicians Obstetrics & Gynecology. After earning his undergraduate through New York University and University at Albany, Dr. Mathai received his masters degree through Walden University, and his medical degree through the University of Medicine and Health Sciences in Basseterre, St. Kitts. He then completed a residency at Aultman Hospital in Canton, OH. He is here to advocate in your journey of building the kind of healthy family you’re hoping for. When he is not catching up on sleep, he enjoys spending time with his wife, daughter, and their labradoodle Rocky.


IU Health Hospital

Named among the “Best Hospitals in America” by U.S. News & World Report for 22 consecutive years, Indiana University Health is dedicated to providing a unified standard of preeminent, patient-centered care. A unique partnership with Indiana University School of Medicine – one of the nation’s leading medical schools – gives our highly skilled physicians access to innovative treatments using the latest research and technology. Learn more at iuhealth.org.

iu health postpartum preeclampsia