Preeclampsia in a Second Pregnancy: Causes, Symptoms, and Prevention

Have you experienced preeclampsia during your first pregnancy? If so, you may be at a higher risk of developing it again in your second.

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and potential damage to organs—particularly the liver and kidneys. It typically occurs after the 20th week of pregnancy, most often in the third trimester, and several factors can increase a woman’s risk of developing it.

If left untreated, preeclampsia can lead to seizures (eclampsia) and serious complications such as kidney or liver failure, stroke, or even maternal death.

For the baby, reduced blood flow can result in restricted growth, low birth weight, premature delivery, or, in rare cases, stillbirth. According to Health.com, here are the main causes, symptoms, and prevention methods for preeclampsia during a second pregnancy.

Causes of Preeclampsia in a Second Pregnancy

Recurrent Preeclampsia: Women who developed preeclampsia during their first pregnancy have a higher chance of recurrence the second time. The earlier it appeared previously, the more severe it tends to be and the more likely it is to return.

HELLP Syndrome: This condition, which involves the destruction of red blood cells, elevated liver enzymes, and low platelet count, is closely linked to preeclampsia. About 4–12% of women diagnosed with preeclampsia also develop HELLP syndrome. Those who have experienced it in a previous pregnancy are more susceptible to it again.

Additional Risk Factors:

• High blood pressure or kidney disease prior to pregnancy

• Family history of hypertension or preeclampsia

• Maternal age over 40

• Multiple pregnancy (twins or more)

• A gap of more than 10 years between pregnancies

• Obesity (BMI over 30)

Common Symptoms to Watch For

• Severe headaches

• Vision problems (blurred vision or temporary loss of sight)

• Nausea or vomiting

• Pain in the upper abdomen

• Shortness of breath

• Decreased urination

• Swelling of the face or hands

Diagnosis is confirmed through blood pressure measurements and lab tests of blood and urine to check for protein.

Prevention and Early Management

If preeclampsia is detected early, both the mother and baby can be treated and closely monitored to achieve the best possible outcome. The following steps can help reduce the risk of recurrence:

• Comprehensive Check-Up: After your first pregnancy, request a full assessment of your blood pressure and kidney function before conceiving again.

• Blood Clotting Disorders: If you or a close relative have a history of blood clots, ask your doctor to screen for thrombophilia, a hereditary condition that may increase preeclampsia risk.

• Maintain a Healthy Weight: Losing excess weight before pregnancy helps lower the chances of developing preeclampsia.

• Manage Blood Sugar: If you have insulin-dependent diabetes, ensure your glucose levels are well-controlled before and during early pregnancy.

• Control Blood Pressure: For women with chronic hypertension, medical supervision before conception is crucial.

Protecting Yourself from Preeclampsia

To help prevent recurrence in a second pregnancy, your doctor may recommend a low-dose aspirin (60–81 mg daily) starting at the end of the first trimester.

Regular prenatal checkups are the best way to detect and manage preeclampsia early. Your doctor will likely order basic blood and urine tests during your first visit and repeat them throughout pregnancy to monitor for early warning signs. Additional ultrasounds or tests may also be needed to ensure your and your baby’s well-being.