For most women, bed rest is not recommended. There is no scientific evidence that bed rest prevents preterm labor or reduces preeclampsia risk. Being completely inactive can increase the risk of other problems, including blood clots. If your ob-gyn suggests bed rest because you have a specific medical condition, ask if you can do some activity.
Published: November 2020 Last reviewed: November 2020
Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information. This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer. August 25th, 2010 Pre-Eclampsia is a medical condition that only affects women during pregnancy and post partum. It is characterized by high blood pressure and protein in the urine, subsequently creating a toxic physical environment for both mother and baby. It is frequently the reason a pregnant woman is prescribed bed rest. While it can occur anytime during pregnancy, it typically occurs after 20 weeks of pregnancy, in the late second or third trimester. Pre-Eclampsia occurs in 5-8% of all pregnancies globally and is the cause of some 76,000 maternal deaths and 500,000 infants annually. Pre-Eclampsia can rapidly become a serious or even fatal medical condition. Women should know the signs and symptoms of pre-eclampsia and report any signs or symptoms they have to their health care provider immediately. Major Signs and Symptoms of Pre-EclampsiaNone – The problem with Pre-Eclampsia, much like other hypertensive disorders, is that it often has no symptoms. Hypertension – Hypertension or high blood pressure is defined as two blood pressure readings over 140/90 at two different times at least six hours apart. However, pregnant women with normally low blood pressure, such as 110/65, may be diagnosed with pre-eclampsia prenatally or in the post partum period when their blood pressure rises to 135/80 and/or they develop signs and symptoms of pre-eclampsia. In 1990 the National Institutes of Health, National High Blood Pressure Education Program: Working Group Report on High Blood Pressure in Pregnancy issued the following research guidelines: In the past it has been recommended that an increase of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure be used as a diagnostic criterion, even when absolute values are below 140/90 mm Hg. This definition has not been included in our criteria because the only available evidence shows that women in this group are not likely to suffer increased adverse outcomes. Nonetheless, it is the collective clinical opinion of this panel that women who have a rise of 30 mm Hg systolic or 15 mm Hg diastolic blood pressure warrant close observation, especially if proteinuria and hyperuricemia (uric acid [UA] greater than or equal to 6 mg/dL) are also present. For this reason, it is extremely important that women know what their baseline blood pressure readings are and at each prenatal visit they ask their providers what their blood pressure is. In this way, both health care provider and patient can be on the look out for blood pressure abnormalities and address them as soon as possible. Swelling (Edema) – Swelling can be an insidious symptom of pre-eclampsia because so many women experience swelling of their hands and/or feet or even their faces when they are pregnant. However, when the swelling is significant enough to change your facial features, you should notify your health care provider immediately, advising them that you believe the swelling has become excessive. You may need to show them a photo of you prior to pregnancy, your driver’s license for example, to prove your point. In any event, if swelling concerns you, make sure it becomes a concern of your health care providers and that it is addressed. Proteinuria – Proteinuria occurs when proteins, usually filtered by the kidneys and retained in the blood stream, leak into the urine because the small blood vessels in the kidneys have become damaged allowing the proteins to pass through. (This is usually due to your elevated blood pressure. Remember, pre-eclampsia creates a toxic physical environment to both mother and baby!) Other Common Signs and Symptoms of Pre-EclampsiaSudden Weight Gain – Since weight gain is a hallmark of pregnancy, it’s often hard to discern between regular pregnancy weight gain and weight gain associated with Pre-Eclampsia. The rule of thumb is that if you start gaining more than 2 lbs per week or more than 6 lbs in a month, you should consult with your health care provider as this could be an indication of pre-eclampsia. Headache – Severe, migraine-like headaches which are often one sided and dull and throbbing could be a warning that your blood pressure is dangerously high. Contact your health care provider immediately for evaluation. Nausea or Vomiting – While nausea and/or vomiting is common in the first trimester, it usually abates during the second and third trimesters. If you have sudden onset of nausea and/or vomiting in the second or third trimester, contact your health care provider immediately for evaluation. Changes in Vision – If you experience any sudden blurred vision, double vision, flashing spots, or sudden light sensitivity, this is another warning that your blood pressure may be dangerously high. Contact your health care provider immediately for evaluation. Racing pulse, mental confusion, heightened anxiety, trouble catching your breath – While all of these symptoms can occur in pregnant women, when they suddenly occur from out of the blue and especially if they occur together, this is cause for concern. Contact your health care provider immediately. Lower back pain – Low back pain is so common in pregnancy that it is difficult to distinguish between the typical low back pain of pregnancy and low back pain associated with pre-eclampsia. If you are unsure, certainly consult your health care provider. But consult with your health care provider immediately if the low back pain is present with right upper quadrant abdominal pain as this may be another sign of pre-eclampsia. This is a cursory overview of Pre-Eclampsia and we will delve into the subject with more depth in coming blog posts. Just remember that pre-eclampsia can have serious medical consequences for both you and your baby including death, so if you are concerned about symptoms, consult with your health care provider and have an immediate evaluation. This list of signs and symptoms is edited and reprinted from the list presented on The Pre-Eclampsia Foundation website. This website is a holds a wealth of information on pre-eclampsia; current research and resources for more information and to get more help and/or support. Did you have pre-eclampsia during your pregnancy? Are you a Mama on Bedrest now for pre-eclampsia? Share your story in our comments section below.
When a celebrity like Kim Kardashian, Mariah Carey, or Adriana Lima (or even Lady Sybil from Downton Abbey) experience preeclampsia during their pregnancies, the media often fills up with facts about preeclampsia that are misleading or even downright false. The myths are everywhere, and we have heard them all. Most of these myths persist because it is human nature to seek control over the unknown. People may think this information is helpful or reassuring, but it can cause confusion and even emotional distress in patients who have experienced a hypertensive disorder of pregnancy. Here's the Top 10 Preeclampsia Myths that our team can help to dispel for the next time you hear about preeclampsia in the news: 1) Bedrest can delay the onset of preeclampsia, or at least make your case progress more slowly. False: trials have shown no strong evidence that bedrest benefits preeclampsia patients. Bedrest can have some difficult side effects too: it is known to raise your risk of depression, bone loss, and blood clots. Follow your doctor’s advice to reduce activity if you've been diagnosed, and ask for clarification, since strict bedrest may do more harm than good. According to the American College of Obstetrics and Gynecologists, "For women with gestational hypertension or preeclampsia without severe features, it is suggested that strict bedrest *not* be prescribed." 2) Only overweight women get preeclampsia. False. Any woman can develop preeclampsia in any pregnancy, regardless of BMI. While obesity can put you at higher risk for developing complications like hypertension and gestational diabetes during pregnancy, it does not guarantee that you will develop it. It's important to note, however, that weight gain of more than 3-5 pounds in a week can be an indicator of preeclampsia. Damaged blood vessels allow more water to leak into and stay in your body's tissue and not to pass through the kidneys to be excreted. Be sure to report your weight gain and swelling of your hands, face or legs to your health care provider if you are concerned. 3) Preeclampsia only happens in first pregnancies. Mostly false. While preeclampsia happens more often in first-time pregnancies, it can occur during ANY pregnancy and the postpartum period. If you've had preeclampsia, you're considered at high risk to get it again. Sometimes it appears for the first time in a later pregnancy, especially if you've developed an autoimmune condition between pregnancies. All pregnancies are at risk, which is why ALL expectant moms should be educated on the signs and symptoms to report. 4) If you eat right, you won't get preeclampsia. False. There's no difference in the diets of women who develop preeclampsia and women who don't – which makes sense, because preeclampsia is related to initial implantation of the placenta, and diet in the rest of the pregnancy isn't going to change that. So far, big trials of diet changes have found no effect on the rate of preeclampsia. As human beings, we seek to control the situation when bad things like preeclampsia happen. We hope that there is just SOMETHING we could do to make it better, but the truth is that nutrition is complex. Eating healthy during pregnancy is very important for the health of you and your baby, but there's no evidence it affects this complex condition. 5) Preeclampsia is rare. False. Preeclampsia is about as common as breast cancer, occuring in 1 out of every 12 pregnancies (or 8%). While the majority of maternal and infant mortality from preeclampsia happens in developing nation, it takes the lives of 76,000 moms and 500,000 babies each year worldwide. 6) Preeclampsia only happens right before term. False. Preeclampsia can appear any time from the second trimester to six weeks postpartum. Yes, you can get preeclampsia as early as 20 weeks’ gestation. You can get preeclampsia after you've had the baby, so call your healthcare provider if you have any symptoms during the postpartum period. 7) Pregnant women shouldn't be informed about the risk of getting preeclampsia, because it will just stress them out. Totally false. Pregnant women deserve knowledge of and resources related to this condition. Knowledge is power. One way that you can advocate for other women is to encourage your healthcare provider to take advantage of the educational resources we provide and ensure every mom is made aware during her pregnancy. 8) Preeclampsia doesn't affect the baby. Many babies, especially those who don’t have to be delivered early, may not suffer any problems from preeclampsia. However, preeclampsia can affect the baby’s growth, put extra stress on the baby during labor, or even cause the baby to die. The mother may suffer an abruption, where the placenta separates from the wall of the uterus before the baby is born, putting the baby’s life in immediate danger. Some babies will need to be delivered early and are at risk for incomplete lung development and potential long-term health problems. 9) Nausea and vomiting are normal, even later in pregnancy. This can be a sign of elevated liver enzymes – a symptom of HELLP syndrome, a severe form of preeclampsia. If you experience nausea or vomiting later in your pregnancy, give your healthcare provider a call; you may need blood work to rule out illness. There is also an association between hyperemesis gravidarum (very severe sickness during pregnancy) and preeclampsia, so be sure to speak with your health care provider. 10) Delivery is the cure for preeclampsia. Delivery starts the healing process from preeclamspia because it removes the placenta. However, during your pregnancy, the placenta exchanged blood between your blood stream and your baby's. You can get worse postpartum (or even experience it for the first time!), because the placenta has dumped chemical proteins into your system and your body has to mop them up, which cannot occur instantly. Women have had seizures as late as several weeks postpartum, which can be life-threatening. Watching for and reporting symptoms of severe headache, visual disturbances, and breathlessness after delivery is important for the safety of new moms. BONUS MYTH: 11) Health care providers give magnesium sulfate to decrease my blood pressure. False. This myth persists even among health care providers themselves! Magnesium sulfate is actually an anticonvulsant that is used to prevent the "eclampsia" or seizures, caused by the high blood pressure. Magnesium sulfate can cause a very small, temporary decrease in blood pressure (which is likely how the myth started), but it is not meant to be used as an antihypertensive. According to the American College of Obstetricians and Gynecologists and other health care provider groups who oversee patient treatment protocols, the proper treatment protocol for preeclampsia during the prenatal or postpartum period is to place the mother on mag sulfate to prevent seizures and to ALSO determine what anti-hypertensive medications and dosage she should be on based on her blood pressure and bloodwork. (There are quite a few medications that are safe for expectant and breastfeeding moms.) |
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