Preeclampsia During Surrogacy: Here’s What You Should Know

2021-04-29

Preeclampsia is a condition that affects pregnant women and, if left untreated, can cause serious health problems for both the mother and the unborn baby. This complication occurs in about 2-8% of pregnancies but is much more common in surrogates. 

For this reason, the risk of preeclampsia is something to watch out for when considering gestational surrogacy. However, you should note that the condition affects fewer pregnancies than previously believed and usually does not cause severe problems. 

In this article, we’ll help give you a clear understanding of these risks and try to alleviate any fears you might have about preeclampsia during your surrogacy journey.

What is Preeclampsia? 

Preeclampsia is a condition that causes high blood pressure and excess protein in the urine and usually goes undetected until the 20th week of pregnancy. The earlier it is detected, the better. 

Although preeclampsia sometimes occurs with no symptoms, many women experience headaches, blurred vision, cerebral hemorrhage, seizures, or kidney and liver problems. In some instances, additional symptoms develop—like fluid retention, which causes swelling of the feet, ankles, face, and hands, and physical pain just below the ribs.

If not treated quickly, preeclampsia can lead to premature birth or placental abruption, often resulting in stillbirth. It’s essential to monitor your symptoms so as not to put yourself or the baby at risk. 

What Causes Preeclampsia?

According to experts, preeclampsia develops when blood vessels in the placenta do not function properly. These new and evolving blood vessels are narrower than normal ones and react differently to hormonal signaling, limiting blood flow through them.

Preeclampsia can be triggered by problems with your immune system, blood flow to the womb, damage to blood vessels, or genetic factors.

How will Preeclampsia Affect My Surrogacy?

As surrogacy is a long and challenging journey, one of the prerequisites to becoming a surrogate is having already had at least one child. If you have had preeclampsia in your previous pregnancy, unfortunately, you may be disqualified from becoming a surrogate for your health and safety.

Complications with Severe Preeclampsia

The severity of your condition and how far into your pregnancy you develop symptoms can help predict preeclampsia complications. Depending on how severe and how early signs occur, you may require induced labor or cesarean delivery, especially if there are any extenuating circumstances present. 

Some complications with severe preeclampsia include:

  • Fetal growth restriction: This can happen when the placenta does not get enough blood and nutrients to grow. If this happens, it may lead to slow fetal development or causing you to have a premature birth.
  • Premature birth: Your health care provider may recommend delivering before the due date to save both your life and the life of the baby. A baby born prematurely can experience breathing problems or other complications, so make sure to speak with your doctor about a preterm birth plan.
  • Placental abruption: The placenta is a part of the body that connects to your uterus and provides nutrients for your baby. Sometimes, the placenta peels away from your uterine wall before delivery which can cause heavy bleeding with scary consequences.
  • HELLP syndrome: This is a more severe form of preeclampsia that can quickly become life-threatening for both you and the baby. Symptoms include nausea, vomiting, headache, or upper right abdominal pain. HELLP syndrome damages several organ systems that may develop suddenly even before high blood pressure is detected or without any symptoms at all. We don’t know exactly what causes this dangerous condition, but it’s believed that pregnancy hormones could play a role in its development.
  • Eclampsia: When preeclampsia progresses without being controlled, it can result in a seizure-inducing complication called “eclampsia.” Once you have developed this condition, the baby must be delivered quickly so his or her development won’t be compromised.

Is There a Treatment for Preeclampsia?

If diagnosed with preeclampsia, the surrogate must be referred to a specialist immediately. Doctors usually advise bed rest and plenty of water or protein-rich foods and medication like magnesium or hydralazine to help lower blood pressure levels and prevent seizures. A regular prenatal checkup will also monitor both your and the baby’s health, while ultrasounds keep an eye out for any abnormalities like heart problems. 

Taking up to 81 mg of aspirin per day after 12 weeks into your pregnancy has been shown to decrease the risk for preeclampsia without evidence of adverse effects on the baby. However, after you reach 37 weeks in your surrogate pregnancy, the best option is to deliver the baby to prevent the condition from getting worse.

Does Preeclampsia Cause Any Long-term Effects for the Baby or Surrogate?

In general, no. The long-term risks for surrogate mothers are usually very low, even after induced labor. There is a slightly increased risk for both surrogate and baby that they will develop chronic kidney disease or hypertension in their lifetime—but these diseases have manageable treatments available. Surrogates may also be at an increased risk of diabetes mellitus, ischemic heart disease, cerebrovascular disease, or other cardiovascular and urinary diseases.  

]