Episode 13: Preeclampsia

Dr. Sophia:
Hello everyone. Welcome to the Dr. Sophia Podcast. I'm an obgyn practicing for over 15 years in my native New York City, and I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we will talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more. Disclaimer, this is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician.

Hello everyone, and welcome to the Dr. Sophia Obgyn podcast. Today I am so excited to share our episode on preeclampsia. It just so happens that May is preeclampsia awareness month, and why not take the opportunity to talk about a topic that really just isn't covered enough that we all just don't know enough about, and that can affect so many women. And so we thought, why not talk about it? And as always, I am so happy to be joined by my good friend and co-host Touseef Mirza.

Touseef Mirza:
Hi everyone. So thank you for joining us again. So this time we're gonna be talking about preeclampsia. By the way, am I saying that correctly? Is it preeclampsia or preeclampsia?

Dr. Sophia:
It is preeclampsia.

Touseef Mirza:
Preeclampsia.

Dr. Sophia:
Preeclampsia. And the reason why actually it's preeclampsia is because eclampsia is also its own thing. And it's the pre part that can happen before eclampsia. And so to be fair, the goal is to identify women who are at risk for preeclampsia. So they don't even progress to eclampsia. So it's pre-eclampsia.

Touseef Mirza:
Okay. I had no idea that those were two separate things. So let's start.
Dr. Sophia:
Let's dive in.

Touseef Mirza:
So number one, can you explain what is actually preeclampsia?

Dr. Sophia:
So preeclampsia is a high blood pressure or hypertensive disorder that happens only in pregnancy. So preeclampsia, when we think about it, happens to women typically after the gestational age or after they're 20 weeks. We don't even think about a diagnosis of preeclampsia until you're after 20 weeks of pregnancy. But the majority of women who experience preeclampsia are actually in their third trimester and nearer to the time that they would deliver. So let's say 36 weeks to 40 weeks. But it can be diagnosed as early as 20 weeks.

Touseef Mirza:
So when we say preeclampsia, we know like when it occurs and it's in pregnancy, it's really for pregnant women. What actually happens in terms of symptoms?

Dr. Sophia:
So the hallmark of preeclampsia is typically it's high blood pressure that starts to happen. So it could be someone who's never experienced high blood pressure at their office visit, and all of a sudden they have a blood pressure that is 140 over 90. So normal blood pressure is anything, you know, 120 over 80 or less. And in pregnancy, women typically have low blood pressure. It’s not uncommon to see a woman come in with nineties, over seventies, and that is a completely normal blood pressure in pregnancy. So definitely we are concerned once the blood pressure hits one 40 over 90. And that is a reason for us to now start to conceptualize, hey, could this pregnancy be affected by preeclampsia? And the blood pressure is only one aspect. It's also typically associated with something called protein in your urine. So for a lot of women, they're like, oh, how come they ask me to pee every single time I go to the doctor? Don't they already know I'm pregnant? Of course we do, but we're checking other things. And one of those things that we're checking is whether or not there's protein in the urine.

Touseef Mirza:
I'll be honest, the first time that I really understood preeclampsia and the gravity of it was when I actually watched this series. I'm sure a lot of people know about it. Downton Abbey, which was about 10 years ago, I think it was on Netflix. And it's basically a historical series in the 1920s. And you had a woman who was the youngest of three daughters that were super wealthy in the area where they lived. And she had symptoms. And then after the symptoms she had just before she gave birth, then she gave birth and she seemed to be fine. And then the series depicts the woman literally going through seizures almost like convulsing and dying. And the doctor that was there said that this is preeclampsia. And so obviously there's some grave complications to my understanding that happens when you have preeclampsia. But one of the things that, that I think we don't realize is that that was a piece for me anyways, that was my understanding. That was a piece that was depicted in the 1920s. And since we don't talk about preeclampsia really now, I thought, well, this is probably something that we've dealt with and that, you know, it's not too big of a deal now. So this is why we don't really talk about it. But actually that is not necessarily the case that we still-

Dr. Sophia:
Absolutely not preeclampsia affects one in 25 pregnancies. It affects a lot of women. 16% of pregnancies here in the United States are affected by preeclampsia. And I just wanna review that. We talked about the signs of preeclampsia. So when I talk about blood pressure and elevated blood pressure, something that's one 40 over 90 as being a potential sign of preeclampsia and the protein in the urine as being a sign of preeclampsia. But a symptom of preeclampsia is typically severe headache, changes in your vision. Upper abdominal pain, especially on the right side, severe abdominal pain like around your uterus, just the whole thing feels like it's on fire. It's like a severe pain that doesn't go away. It feels like it's tight or a stabbing pain in your uterus while you're pregnant. And these are all the symptoms that can happen in terms of preeclampsia.

Dr. Sophia:
Now why is preeclampsia so dangerous? Or why is it so important that we are able to identify it and then manage it and treat it is because of exactly what you're talking about. That episode that happened in Downton Abbey, the concept that a woman could have some symptoms, then she gives birth, and then she could still have symptoms and develop eclampsia. So when she had the seizures and the convulsions that you're talking about, she now progressed to eclampsia. And that can lead to things like stroke and exactly what happened. Unfortunately, it can actually lead to death. And so it's definitely not something that is only historical. It is happening right now all the time. And there's a documentary on a young woman who passed away, and it was from complications of preeclampsia for a woman, her name is Amber Rose. And I remembered hearing her story and immediately I was like, oh my God, she had preeclampsia. And yet she was never really diagnosed until it was too late.

Touseef Mirza:
What was that? A movie called-

Dr. Sophia:
Aftershock.

Touseef Mirza:
Okay.

Dr. Sophia:
And so it's something that's happening unfortunately all the time. And the bigger problem is that you know, black women, for example, are 60% more likely to be diagnosed with preeclampsia. And we all know the statistics as far as, you know, black maternal health, that black women are dying at a higher rate, than their white counterparts. And this is one of those illnesses and complications of pregnancy that is affecting black women more, or at least certainly not treated enough. And if we don't treat and understand preeclampsia, like patients need to know what it is patients need, you know, women, we need to know that this is something that can happen. What are the signs and the symptoms so that we can have a better grasp on when we need to get help? And oftentimes it's the misdiagnosis or a diagnosis that happens too late is what leads to the mortality that's so high when we talk about preeclampsia.

Touseef Mirza:
I wanna just go back a little bit to understand what preeclampsia is in terms of, yes, you said that it was high blood pressure and, and other types of symptoms, but how is that actually causing the level of gravity of complication at the level of the uterus?

Dr. Sophia:
So the reason why preeclampsia is such a major complicated illness in pregnancy is because it can affect so many organs. It leads to multi-organ damage, basically. And when we're talking about it specifically to the uterus, it increases your risk of having something called an abruption. Now, an abruption is a big word that just means a separation of the placenta early from the uterus. So now imagine you have not given birth, your baby is still inside and your placenta separates.

Touseef Mirza:
So you have the uterus, and inside you have the placenta. And inside the placenta, you have the baby.

Dr. Sophia:
So just to be clear, yes. Actually, so you have the uterus, you have the placenta, you have the sac that's holding the baby, and all the fluid that's around the baby and the baby. So the placenta is actually the part that's attached to the uterus. And then through the placenta is the cord, the umbilical cord that connects to the baby. And so the placenta is that interface that helps to feed the baby and is breathing for the baby and helping your baby to grow your placenta is an organ and it is working for your baby. And so now a person who has preeclampsia has an increased risk of having that placenta separate, sheer off the walls of your uterus. And that the placenta is a very bloody blood-rich organ. It's the blood of the placenta that travels through the umbilical cord to give the baby all the nutrients and oxygen that it needs in order to grow and thrive. And if we separate the placenta, A. you're gonna have major bleeding. And B. We have now stopped all of the nutrients, the oxygenation, most importantly, to the baby, like immediately.

Touseef Mirza:
So it's not just a complication that affects the mothers, but can also affect the baby.

Dr. Sophia:
Yes. A major problem actually, or consequence of preeclampsia, is not just that it affects one in 25 pregnancies or that, you know, it affects up to 70,000 pregnancies worldwide and is responsible for the mortality of up to 70,000, you know, maternal deaths. It affects up to 500,000 fetal deaths as well.

Touseef Mirza:
Worldwide.

Dr. Sophia:
Worldwide. We're talking about worldwide here. Because of preeclampsia, women can lose their babies as well.

Touseef Mirza:
So when we say now the placenta has a possibility of detaching itself, is it because of the high blood pressure that is causing that?

Dr. Sophia:
The thing about preeclampsia, unfortunately, is that we know a lot, but there's still a lot we don't know. And yes, it's typically from the severe ranges of the blood pressure that then can cause this early separation of the placenta that can cause the progression to eclampsia that can cause the progression to having things like stroke that can cause the progression of having other heart issues. Something else called pulmonary edema, which is where the lungs get filled with fluid and swelling. So preeclampsia can affect, like I said, it's a multi-organ, damage, damage if it's severe and if it's allowed to progress. And at the end of the day, the cure for preeclampsia is delivery. We don't fully understand what causes preeclampsia, but we do know that there is some placental interaction that does lead to preeclampsia. And so delivery of the baby, delivery of the placenta then starts to take away all those mediators, all those things that are causing the preeclampsia in the first place.

Touseef Mirza:
So it's almost like we have to look at this type of complication from different phases. Like first it's before delivery, then during delivery. And like the episode I watched on Downton Abbey after delivery.

Dr. Sophia:
So the thing with preeclampsia is that preeclampsia can affect you during the pregnancy for sure. Like I said, it can be diagnosed as early as 20 weeks in the pregnancy. Preeclampsia is mostly diagnosed around the time of labor and delivery or those few weeks before you go into labor and delivery. And preeclampsia can still be diagnosed even after you've had the baby, despite the fact that we usually think the cure for preeclampsia is delivery. I understand what you mean now being pregnant.

Touseef Mirza:
You're basically saying if you're delivered, then most likely you will not be affected by preeclampsia.

Dr. Sophia:
More than that, if you have preeclampsia, once you are delivered, then we start to take away the mediators, the things that cause the preeclampsia in the first place, and then it starts to resolve itself.

Touseef Mirza:
So why then do-?

Dr. Sophia:
But some women, yes, I see where you're going with this.

Touseef Mirza:
You know, that I, you say I like to-

Dr. Sophia:
Investigate. I see where you're going with this. Then why is it that women can develop preeclampsia after they've had the baby? It’s because we don't understand preeclampsia all that well. And yes, preeclampsia can definitely present itself for the very first time after you've actually delivered the baby. And oddly enough, the first couple of days after you've had the baby is still a high-risk time for developing preeclampsia. And up to six weeks, even after you, up to six weeks after you've delivered a baby, you can still develop preeclampsia. Now, six weeks later, less likely. But it still has to be top of mind when a woman comes back for her, you know, she comes back four weeks later, or not even, she's two weeks later and she's complaining of a headache after she's had a baby. And then you say, well, did you check your blood pressure? And her blood pressure is 140 over 90. I need to be thinking this woman may have preeclampsia and I need to be aggressive in how I am making sure that she does not have the diagnosis or that she has a diagnosis or that I can manage it.

Touseef Mirza:
So considering that preeclampsia does have certain unknowns in terms of whether we gonna get preeclampsia after delivery or not, for example, then this knowledge is so important, for people to know that number one, this can happen even if you've had a good pregnancy. And that number two is to understand that we need to become self-aware of what our bodies are communicating to and express that. And not just to say, oh, you know, because, you know, we just have a headache, this is probably motherhood

Dr. Sophia:
The hardest part about preeclampsia is probably even after a woman has delivered because as I said, let's review, I'd like to go back over the symptoms of preeclampsia, including headache, fatigue, changes in your vision, swelling, which has fallen off of the symptoms chart per se. Used to be, first of all, preeclampsia has had a couple of different name changes, but some older people may remember it as being called toxemia. So if you, you know, speak to your grandmother and, and she'll say, oh yeah, I had a touch of toxemia, a touch. I'm telling you, because we were so designed not to really discuss things that happened, especially if they were traumatic or what have you, that this is exactly how we may remember someone back, way back in the day. The doctor may say, hey, did anyone else in your family, did your mother have preeclampsia?

Did your sister have preeclampsia? Because it's also something that is, can run in families, you know? So it's important to know, did anyone else who was a first-degree relative have preeclampsia, for example? Or high blood pressure in pregnancy and things like that as things we should know about. But moreover, it's that after a woman has delivered who develops preeclampsia, why is that such a dangerous time? It's a dangerous time because it's so easy for us to dismiss some of the symptoms like a headache. It's easy for us to say, oh, you must be tired. You haven't slept. The poor baby's keeping you up, and that's why you have a headache. You know, or for ourselves to make those kinds of rationalizations. And then by the time we realize that that headache may be the worst headache of my life, it may be too late.

Dr. Sophia:
And so that's why it's so important that we always are understanding what our bodies are trying to communicate, like you said, because if we are at least expressing how we're feeling, what's going on, then there's an opportunity there for us to address it. And it's also important that if you feel like you're not being seen or heard, right? That you are going to the doctor, you are saying that you're having a headache, or that you're feeling extra fatigued or you're more swollen than you ever were now granted you can have swelling after delivery because all of this extra fluid that our body has had during the pregnancy has nowhere else to go but down. Oftentimes women have, you know, swelling in their legs and their feet that they never had before. And it's only after pregnancy that they develop that. But if it's not an association necessarily with any of these other symptoms that I'm talking about, then it's likely not preeclampsia.

Dr. Sophia:
Right. It's just a normal, you know, process that our bodies are going through after a baby. But I think it's fair to ask the question to your physicians, to your providers, to whoever's taking care of you, your midwife, I don't know, I'm having all this new swelling. And then maybe even for yourself to say, I'm having this headache. Should I check my blood pressure? And I think all of that is fair, or at least for it to be top of mind. If you at least know that these are things that are possible, it's better to be reassured that that's not what's going on and to make sure than to wait till it's too late. And then now we have a major complication, or just-

Touseef Mirza:
A complication.

Dr. Sophia:
Or just a complication, and we have a major problem on our hands and we get to it too late.

Touseef Mirza:
The symptoms that you talk about, are they the same type of symptoms during pregnancy and after delivery? Or are there two sets of different symptoms?

Dr. Sophia:
No, the symptoms of preeclampsia are the same throughout. And the thing is, it's not, not every woman is going to experience the symptoms of preeclampsia, and they're not always going to experience it the same exact way. But in pregnancy, in delivery, and even postpartum a headache that is not being relieved with regular things like Tylenol or just increasing your fluids, you know, sometimes dehydration can cause a little bit of a headache and your headache doesn't go away.

That's maybe one indicator that maybe something else is happening. If you start having weird sensations in terms of your vision, it seems like a fuzzy tv or it's just so blurry for you, you just can't focus. It may be another indicator that you may be having a sign of preeclampsia if you start having abdominal pain. And that abdominal pain can be an adult ache, it can be very severe and intense.

Dr. Sophia:
It feels like a sharp stabbing pain, especially if we're talking about abruption, like we've said before, or especially if it's in the right side of your abdomen, the upper side of your abdomen. Because one of the complications of preeclampsia is that, as I said, it affects multiple organs. And one of the organs that it has the potential to affect is your liver. And in doing so, like I said, preeclampsia, because it has all these things that when left untreated unrecognized can lead to other major complications. Another one is platelets. Your platelets, which are what help your blood to clot, can be affected by severe preeclampsia. Your liver can be affected by severe preeclampsia.

Touseef Mirza:
So all of these, once you get to the effect, then that's called eclampsia.

Dr. Sophia:
Eclampsia is the seizure,

Touseef Mirza:
Is the final-?

Dr. Sophia:
And I hate to say final, because sometimes things you may have preeclampsia, that's not what we deem as being oh, so bad, so severe, meaning you don't necessarily show up with a headache and then all of a sudden somehow because your blood pressure has skyrocketed. Or even if you don't have super high blood pressure, but still can develop eclampsia, the seizure part of it.

Touseef Mirza:
So you had mentioned to me, and if you are open to sharing that with everybody sharing, you told me that you actually had an episode with preeclampsia with one of your pregnancies. Would you share that story with us?

Dr. Sophia:
I did. I myself personally, had preeclampsia with my first pregnancy, and again, started to develop when I went in for I think maybe on my last visit, perhaps, I had some elevated blood pressure. And then,

Touseef Mirza:
So this is like about what, two weeks before?

Dr. Sophia:
Not even. Not even, no, because I delivered within days of that. And my pregnancy was complicated for a number of reasons, but certainly, preeclampsia was one of them. It really showed itself even as being preeclampsia at the time of my delivery. During the laboring labor part, I should say, even when I was in labor, I had multiple elevated blood pressures. There's so much that preeclampsia does. I gave you the major ones, but I forgot how nauseous I was. And, that could be a sign of preeclampsia as well.

Touseef Mirza:
And was that really towards when you were closer to the pregnancy when you started to have those blood pressure issues? Or did you start to be nauseous even before?

Dr. Sophia:
No, no, no. This is in labor. And actually now that I think about it, I don't know, was I nauseous because of labor? Was I nauseous because of preeclampsia? But I certainly put those two together in my mind, but I developed high blood pressure. I remember feeling very like, I don't know, weird in my head. I can't even call it-

Touseef Mirza:
Confusion?

Dr. Sophia:
I don't know if I would say it was confusion. It was like a pressure, it was like a heaviness in my head that I remembered feeling. And then I remembered them having to give me this medication because they said, oh, you have really high blood pressure and you have something called preeclampsia. We have to treat you-

Touseef Mirza:
During labor,

Dr. Sophia:
During labor.

Touseef Mirza:
Was that a surprise to you when they said that?

Dr. Sophia:
I didn't even know what preeclampsia was.

Touseef Mirza:
This was before you were an obgyn.

Dr. Sophia:
Clearly, yes.

Touseef Mirza:
She became an obgyn after that first pregnancy, right?

Dr. Sophia:
Right. Yes. Honestly, it's a major part of how I ended up here. Why did I become an obgyn, right? Some of the things that I went through that made me, you know, feel super connected to wanting to become an obgyn. But one of the things that I definitely went through was preeclampsia. One of the things that I definitely had to go through. Now when we talk about preeclampsia, we have to talk about what are some of the measures we take to prevent seizures.

Touseef Mirza:
Before you go there. So when they said, oh my God, you have preeclampsia? What happened after that? They gave you medications to lower your blood pressure. What happened?

Dr. Sophia:
They gave me medicine to lower my blood pressure. They gave me medicine to lower my chances of developing seizures. And that medicine, ooh, boy, it burns going in through your IV and then it makes you feel lethargic and really out of it. But I'm happy about it. It made sure that I didn't have a seizure. You know? But I remembered feeling like, well, what does that mean? And am I going to be okay after, like, what's up with this blood pressure? And is my baby okay? I remember feeling that. But even in the moment, I still didn't get it. It's only now that I can say oh my God, I can't believe I had preeclampsia, because now I understand the gravity of being told that I have preeclampsia. But at the moment, I didn't necessarily understand all the things they were trying to tell me except that I needed this medicine. And I remember when the medicine was going in feeling like, oh my God, this is the worst thing ever. Do I really need this? Like anybody, like any of us would be like, right? Like my patients are like, well, do I really need this medication? Yes, yes, you do.

Touseef Mirza:
Because you're like, I'm just nauseous. I mean, does it have to be that big of, I think that's, that's sort of like the balance to think about. Like you were saying before, it's a headache. So you're just like, why am I getting all like, ramped up because of a headache? But it's considering the situation you are in, it actually has a totally different significance.

Dr. Sophia:
The other thing is, is that preeclampsia, once you've had it, you have a risk of developing it again. Number one, you have a risk of developing just high blood pressure after delivery and normal life. Unfortunately for me, I have high blood pressure.

Touseef Mirza:
And that was, it started because of that point?

Dr. Sophia:
Well, it didn't necessarily start right after, but it increased my risk of developing high blood pressure. I also have a family history of high blood pressure.

Touseef Mirza:
So there are other factors.

Dr. Sophia:
There are other things, and factors, but preeclampsia puts you at an increased risk for developing high blood pressure later on in life. You know, and so these are some of the things that we really do need to kind of tweak in our brains and say, oh boy, maybe I need to figure out how to be more careful, manage my weight better, my diet better. And of course, some of these things are hereditary or things that we'll develop even if we've done all the things and taken all the precautions. But I think it's important for us to be in touch with ourselves.

Touseef Mirza:
To know this information.

Dr. Sophia:
And to know this information.

Touseef Mirza:
This information is not something that's publicly known, honestly. Like it's not something we talk about.

Dr. Sophia:
We don't talk about it enough. It's important for us, as women, especially women, reproductive age who are having babies and that we're in the most joyous points of our lives, that we understand that there are things that can happen that can be complicated, that can go wrong. And it's important for us to know what the signs are, what the symptoms are, and to be able to bring that information to our healthcare providers, whether it's a midwife, even your doula. This is where having someone like a support person, like a doula who may not be a clinical person but understands enough to know and be able to support you and say, hey, we need to get you to your doctor, or we need to get you to a healthcare facility to address this. This is not right.

Touseef Mirza:
If you wanna know more about what a doula does, in episode 11, we just talked about everything with a doula. So just information out there about that. Now that we've looked at all the different factors and potential complications, we talked about Downton Abbey, but we are in 2024, so I hope that science has advanced. Are there certain tests or certain things that women can do preemptively to see whether or not they have a higher risk of preeclampsia?

Dr. Sophia:
I think the most important thing when it comes to women, and their pregnancy is your regular visits with your physician or your midwife or your healthcare, whoever your healthcare provider is. Those regular visits give us an opportunity to check your blood pressure, to check in with you, to make sure that you're not having any signs or symptoms that we need to be concerned about. And we get a chance to check your urine. We're looking for those things that can be assigned to us, that something is happening for women who are already with increased blood pressure, whether it's because they have high blood pressure even before they were pregnant. I mean, that's a reality for us, especially in this country where so many women already have high blood pressure or diabetes. These are some of the risk factors, the things that can increase your chances of developing preeclampsia, diabetes, a previous history of high blood pressure, obesity, very young mothers and very old mothers. So, women who are young, teen pregnancies, your first pregnancy increases your risk of developing preeclampsia. Women who are over 35 having a baby have an increased risk of preeclampsia. And there is a new blood test that actually looks for specific marker that we think is associated with preeclampsia that can help us to predict a woman who comes in with elevated blood pressure that we suspect may have preeclampsia or may already be given a diagnosis, but who may develop severe preeclampsia.

Touseef Mirza:
And so this is safeguarding the woman and the fetus, of course, because you're going to then deliver earlier to not succumb to potential severe effects.

Dr. Sophia:
Yes. So with that blood test, it's the negative predictive value of it that's so much more important that if we test the woman and she is negative for developing, you know, on the test, that has like a 96% predictive value, that she will not move on to severe preeclampsia in the next two weeks. And so that may help us to make better decisions in terms of how we hospitalize this patient. Do we keep them hospitalized? How do we monitor them outpatient? Can we monitor them outpatient? So that might be a woman who we have who comes in with elevated blood pressure, but we do this test and this test says her chance of developing severe preeclampsia over the next two weeks is very low. So now we may feel more comfortable saying, okay, we can monitor this patient outpatient, have her monitoring, her blood pressures, have her coming into the office a couple of times a week, or, you know, a few times over the next two weeks, as opposed to then having to keep that patient in the hospital. That's one aspect. But another aspect is if she has a positive and she has all these other risk factors, et cetera, then that is a person who we're gonna say we're gonna keep super close monitoring on. And any little change may help us have a lower threshold for delivery, for example because we know that delivery will help oftentimes with resolving the preeclampsia,

Touseef Mirza:
This test, is it a standardized test or it's more if there, if we see certain issues from a high blood pressure perspective?

Dr. Sophia:
It's definitely not a standardized test. It's not a test that we wanna just test every woman who walks through the door. Okay, that's a no-no. We wanna test women either that have presented with signs or symptoms, and we wanna test women who are at the highest risk.

Touseef Mirza:
Okay, so that was a lot of information. I know. So we needed, but we needed to talk about this. For me, the biggest takeaway is, number one, preeclampsia still exists. Number two, what are the signs and the symptoms that women who are either pregnant or have already delivered a baby need to be aware of? And then number three, that thankfully we now do have a test that can actually help us, guide us in certain women who might have complications due to preeclampsia.

Dr. Sophia:
And as far as women are concerned, I always go back to this, it's so important to be in tune with your own body. If something doesn't feel right, it's probably because it isn't right. If you within yourself know that you don't feel like yourself or there's a big change, oh my gosh, it's so important. Especially if you have any of the things that we've just talked about that you bring that information up to your healthcare provider. And if for whatever reason that seems like it's being dismissed, then go to your local hospital, go to your local labor and delivery, and get it checked out.

Touseef Mirza:
I'm so happy we're doing this episode. I guess there's a reason why it's called Preeclampsia Awareness Month. Because people need to become aware of, even recognize how to talk about this.

Dr. Sophia:
And we need to talk about it, we need to share it with our families. You know, women, if you have had preeclampsia, you need to tell your friends what you went through so that they then know that this is something that can happen to them. And it's not to be an alarmist. I don't want anybody to be scared. Oh my God, I'm pregnant, I'm going to have preeclampsia. No, but at least if you know, it's something that can, that exists, you can at least ask questions. When you go to your doctor's visits, you go to your prenatal visits, you can say, doc, can we talk about it? I am 200 pounds and I'm 5’5. I am a little nervous. Or, now I understand that I may be at increased risk of developing preeclampsia. What are my other risk factors? And that could be the conversation that helps you to understand and your doctor puts them on notice. Until next time, we're so happy to have shared this information with you. See you later.

Touseef Mirza:
Bye

Dr. Sophia:
Bye.

Dr. Sophia:
This is General Medical Information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.