Viewers of Hulu's critically acclaimed series "Paradise" were met with a tragic turn on Monday night when Shailene Woodley's character, Annie, died shortly after giving birth due to preeclampsia. The storyline has sparked discussions about this serious pregnancy complication, which the Centers for Disease Control and Prevention (CDC) estimates occurs in 5 to 7 percent of all pregnancies, as noted in a CDC blog post.
According to the American Heart Association, preeclampsia is new-onset high blood pressure that occurs after the 20th week of pregnancy. It is defined by a systolic pressure of 140 mm Hg or higher and/or a diastolic pressure of 90 mm Hg or higher on two readings taken at least four hours apart. Other indicators include high protein levels in the urine or signs of organ damage. In the show, Annie regularly monitored her blood pressure, and her high readings hinted at the condition before the fatal outcome.
Symptoms of preeclampsia can include headaches that don't respond to medication, vision changes, upper abdominal pain, nausea, vomiting, shortness of breath, and rapid swelling, particularly of the feet. However, some women may not experience any noticeable symptoms, underscoring the importance of regular prenatal care.
Currently, there is no routine test in the U.S. to predict preeclampsia. While there is no proven way to prevent it, women at risk can reduce their chances by taking low-dose aspirin during pregnancy, but they should consult their healthcare provider first. The American Heart Association recommends that pregnant women get early and regular medical care, check their blood pressure at home if advised, eat a heart-healthy diet, and engage in regular physical activity.
Treatment depends on the severity of the condition and the health of the mother and baby. Medications such as beta-blockers (e.g., labetalol) or calcium channel blockers (nifedipine) are often used to lower blood pressure. In severe cases, early delivery may be necessary to protect the mother's health. If the mother is at least 34 weeks pregnant and has severe symptoms, experts recommend delivery as soon as it is safe. For pregnancies less than 34 weeks, medication may help the baby prepare for an early delivery. If the condition is not severe, delivery at 37 weeks is advised. Symptoms may persist after delivery but typically resolve within six weeks.
Women who have had preeclampsia are at higher risk for high blood pressure, neurologic issues, diabetes, heart disease, and stroke later in life. The American Heart Association provides resources for women's heart health through its Go Red for Women initiative, which aims to raise awareness and reduce cardiovascular disease—the leading cause of death among women.
