Your next pregnancy & long-term health
To minimize the risk of preeclampsia or HELLP during a subsequent pregnancy, we have a number of important recommendations. Here you can read more about preventing preeclampsia in a subsequent pregnancy (or directly to: consequences at a later age).
Preventing preeclampsia in a subsequent pregnancy
To minimize the risk of preeclampsia or HELLP in a subsequent pregnancy, it is important to carefully observe the following advice before and during your pregnancy.
Heart Check
We recommend a blood pressure check and a cardiovascular function check for any woman who has experienced preeclampsia or HELLP. This is best done six weeks to three months after your pregnancy, and ensures that the cardiologist recognizes and treats any underlying problems in a timely manner. The cardiologist will also give you tips to manage other risk factors. Your gynaecologist will be happy to help you if these steps have not already been taken.
Medication
During a subsequent pregnancy you will, in addition to folic acid, also be prescribed a low dose of aspirin, from 10 to 36 weeks of your pregnancy. Aspirin helps the placenta to form better, and also improves the vascular function in the placenta. Taking aspirin is harmless for yourself and your child. If your diet does not contain enough calcium from dairy products, you will be advised to take extra calcium. Intake of L-arginine, an amino acid that is responsible for the production of substances that make your blood vessels adapt well to pregnancy, could also be started.
Self-monitoring of your blood pressure
Throughout a new pregnancy, monitoring your blood pressure daily is crucial. You can easily monitor this yourself at home using a semi-automatic blood pressure monitor.
Tips for correct blood pressure measurements
Before measuring:
During measuring:
After measuring:
If high blood pressure is suspected, your doctor will ask you to measure your blood pressure twice a day (in the morning and evening) for one week. Record your blood pressure readings at home, so you can discuss these with your doctor. If your blood pressure readings are elevated, or if other symptoms appear such as shortness of breath, headache, increased fatigue, swollen legs, etc., it is best to contact your doctor sooner.
In case of high blood pressure, medication will be initiated. But that is not all: adjustments to your lifestyle will also have an improving effect on your blood pressure.
Not sure if you are doing it right?
This link takes you to a helpful instruction video on how to measure your blood pressure at home.
Lifestyle Changes
Maintain a healthy lifestyle throughout your next pregnancy. This means enough exercise, no smoking and a healthy diet.
Sufficient Exercise
The guidelines for pregnant women are identical to the ones for the general population. The recommendation is 150-300 minutes of physical activity at a moderate intensity per week. Moderate intensity means your heart rate and breathing quicken, but you can still talk during the effort.
Exercise is safe during pregnancy! And more than that, it only has benefits. It has been proven that women who exercise before and during pregnancy have a lower risk of preeclampsia or HELLP, gestational diabetes and premature birth. Women who exercise regularly, also have faster deliveries. However, 85% of pregnant women still do not exercise enough.
Fitting sports during pregnancy are walking/hiking, cycling and swimming. Yoga, running and tennis are also possible. Discuss any questions and concerns you might have with your doctor.
Exercise reduces the chance of developing preeclampsia or HELLP again in a subsequent pregnancy. It is important that you start exercising before your new pregnancy, because this improves your vascular function, which is very important for a healthy pregnancy.
Sufficient Sleep
A good night’s sleep and lowering your stress level both have a positive influence on your blood pressure and your risk of cardiovascular disease.
Healthy Diet
A healthy diet and a normal BMI are important in avoiding pregnancy complications. On top of that, eating healthy food (grains, vegetables) and avoiding unhealthy food (salty products, simple carbs) also help to lower your blood pressure. If you have trouble incorporating this, please contact a dietician.
Quitting Smoking
It is unhealthy to smoke. Women who smoke are more likely to have pregnancy complications, especially delayed growth. Smoking also increases the risk of SIDS.
How do I eat healthily?
Eat more plant-based products instead of meat-based foods
Limit your intake of saturated fatty acids (pastries, butter, fatty meats)
Eat less than 5 grams of salt a day
Eat at least 30-45gr of grains/day
Eat at least 2-3 pieces of fruit and 2-3 servings of vegetables per day
Eat oily fish 1-2 times a week
Eat 30gr unsalted nuts per day
Avoid soft drinks
Avoid alcohol during your pregnancy. Restrict your alcohol intake after pregnancy (long term) to a maximum of 10 drinks per week
Implications of preeclampsia or HELLP in the long run?
The above measures are not only important in preventing preeclampsia or HELLP in a subsequent pregnancy, they are also crucial in preventing consequences at a later age.
Unfortunately, women who have suffered from preeclampsia or HELLP are not “cured” after pregnancy. Because of changes in your heart and blood vessels, there is a higher risk of harmful consequences later in life. Preeclampsia or HELLP is an important risk factor for cardiovascular disease, just like the traditional risk factors (such as smoking, high cholesterol, diabetes, etc).
After a pregnancy with preeclampsia or HELLP:
- your risk of developing high blood pressure is three times higher;
- heart disease is twice as common;
- you are three times more likely to develop diabetes later in life;
- you are five times more likely to develop kidney disease;
- strokes and thromboses (blood clots in legs and lungs) are more common.
Fortunately, the chance that you will develop one of the above complications is low, and with a few simple lifestyle changes and close monitoring by your doctor, you will personally be able to lower these risks even further. Here is an overview:
Heart Check
Have your blood pressure and cardiovascular function checked by a cardiologist so that any underlying problems can be identified and treated. Usually, an ultrasound of your heart, an exercise test and a vascular function test are done by, or under supervision of, the cardiologist. Even if these tests do not demonstrate any abnormalities, it remains crucial that you measure your blood pressure in a regular manner. It is also recommended to have your kidney function, blood glucose and cholesterol (the fats in your blood) levels monitored, along with a heart check approximately five years after a pregnancy with preeclampsia or HELLP.
Self-monitoring of your blood pressure
After a pregnancy with preeclampsia or HELLP, regular monitoring of your blood pressure is critical. This is best done weekly for the first year after your pregnancy and afterwards every month. Self-monitoring your blood pressure is simply done at home with a semi-automatic blood pressure monitor.
If high blood pressure is suspected, your doctor will ask you to measure your blood pressure twice a day (in the morning and evening) for one week. Record your blood pressure readings at home, so you can discuss these with your doctor. If your blood pressure readings are elevated, or if other symptoms appear such as shortness of breath, headache, increased fatigue, swollen legs, etc., it is best to contact your doctor sooner.
In case of high blood pressure, medication will be initiated. But that is not all: adjustments to your lifestyle will also have an improving effect on your blood pressure.
Lifestyle Changes
It is very important to pursue a healthy lifestyle, i.e. enough exercise, no smoking and a healthy diet.
Sufficient Exercise
Exercise improves the function of your heart and blood vessels. Women who exercise have a lower risk of cardiovascular disease. Recommended is 150-300 minutes of exercise at a moderate intensity per week. Moderate intensity means your heart rate and breathing quicken, but you can still talk during the effort. Another crucial factor is abandoning the sedentary lifestyle.
Sufficient Sleep
A good night’s sleep and lowering your stress level both have a positive influence on your blood pressure and your risk of cardiovascular disease.
Healthy Diet
A healthy diet and aiming for a normal BMI are important in avoiding cardiovascular disease. On top of that, eating healthy foods (grains, vegetables) and avoiding unhealthy foods (salty products, simple carbs) also help to lower your blood pressure. If you have trouble incorporating this, please contact a dietician.
Quitting Smoking
Discuss quitting smoking and any relevant medical treatments with your doctor.