Kristin Apicella of El Dorado Hills was excited about her first pregnancy. Everything was going relatively well. As a labor and delivery nurse at UC Davis Health, she was well-versed on how to keep her patients healthy, specifically in relation to high blood pressure.

Although she had gestational diabetes, it was diet controlled. And her blood pressure had been normal throughout the nine months. The pregnancy was almost textbook.

“Everything went great,” Apicella said. “There was nothing out of the ordinary. Even my labor was quick and I had a good delivery at my local hospital.”

A headache emerges

Apicella welcomed a baby girl, Brooklyn, in September of 2021. She was thrilled.

Mom and baby went home the next day and Apicella settled into her new routine, which included the normal struggles after delivery. But then, five days postpartum, she developed a headache.

“I wouldn't call it severe,” Apicella said. “It was just like a dull headache.”

Preeclampsia sat in the back of my mind. But I was kind of like, ‘No, you didn't have any blood pressure issues during pregnancy, so it’s probably not that.’” —Kristin Apicella

She messaged some of her friends. The consensus was that a nap would help, or perhaps some Tylenol. But as a postpartum nurse, Apicella had a nagging feeling.

“Preeclampsia sat in the back of my mind,” Apicella said. “But I was kind of like, ‘No, you didn't have any blood pressure issues during pregnancy, so it’s probably not that.’”

Warning signs persist

Preeclampsia is a serious condition typically associated with pregnancy. It is characterized by high blood pressure, elevated levels of protein in urine (proteinuria) and headache, among other symptoms. Preeclampsia usually begins after 20 weeks of pregnancy. Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and baby. It typically resolves with the birth of the baby.

But Apicella had not experienced any of those symptoms during her pregnancy. Only afterward did she develop a low-grade headache. She tried to talk herself out of it.

“I knew it could still happen, but it's very rare, especially with no other issues prior to delivery,” Apicella said. “As a new mom, I was so caught up with my baby. You're often not looking out for things for yourself.”

Apicella reached for her blood pressure cuff and took a reading. Her blood pressure, which was usually low, was mildly elevated.

“It wasn’t crazy initially, but I kept monitoring my blood pressure through the day and it just kept creeping up,” Apicella said. “I still had a headache and some swelling in my feet, and when I took my blood pressure later that evening, it was in the severe range, so I decided to go to the ER near my home.”

Postpartum preeclampsia  

“I was very tearful as I sat down with the triage nurse in the emergency room and shared what had been going on,” Apicella said. 

Apicella was told that her headache was likely due to lack of sleep. The triage nurse attributed her high blood pressure to stress and her swelling to fluids during labor.

“As he’s telling me this, the blood pressure cuff is just squeezing and squeezing," Apicella said. "It can't get a reading because it's so high."

When the blood pressure machine finally completed its reading, it displayed 182/110, which is dangerously high.

“He got a really shocked look on his face and then everything went really fast from there,” Apicella said. “I am shaking just thinking back to it.”

Apicella was soon diagnosed with a rare condition nearly identical to preeclampsia, only that it occurs after giving birth. Postpartum preeclampsia usually develops within 48 hours after birth but can appear up to 6 weeks or later postpartum.

I was very tearful as I sat down with the triage nurse in the emergency room and shared what had been going on.” —Kristin Apicella

Apicella’s sky-high blood pressure prompted the care team to rush her from the emergency room to the labor and delivery unit on the postpartum floor where she received intravenously doses of blood pressure medicine and magnesium. Apicella was hospitalized for several days and then released with blood pressure medication.

Preeclampsia symptoms to watch out for

Apicella is emotional when she thinks back to her ordeal. She wants people to know the importance of taking symptoms like hers seriously.

“The fact is, that this can happen to anybody, even if they didn't have issues during pregnancy,” Apicella said. “The warning signs can appear suddenly.”

Shared symptoms of preeclampsia and postpartum preeclampsia include:

• High blood pressure
• Excess protein in urine or other signs of kidney problems
• Severe headaches or headaches that don’t go away
• Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
• Shortness of breath, caused by fluid in the lungs
• Pain in the upper belly, usually under the ribs on the right side
• Nausea or vomiting

Awareness is key

Apicella had a second baby in 2023 and the same thing happened, except this time, she was six days postpartum. She knew the signs and trusted her instincts, seeking treatment right away.

Working at UC Davis Health, and leaning on personal experience, Apicella is passionate about sharing her cautionary tale.

“My cousin had a friend who died from postpartum preeclampsia, so just realizing that could've very well happened to me is scary,” Apicella said. “I always make it a point to tell my patients about what to look for, even if they don’t any history of blood pressure issues.”

Looking back, she noted: “It was a kind of a whirlwind and something I didn't expect, especially having such a healthy pregnancy. It makes me really passionate about getting the information out. Just letting women know about the condition.” 

Plus, Apicella wants moms to be informed so they can advocate for themselves.

“I feel like our nurses all do a really good job of always asking our patients if they’re experiencing any preeclampsia warning signs and our physicians here are top notch. But every woman and their partner need to know the symptoms so they can speak up and get the care they need,” Apicella said.