By Alice Park
August 6, 2018
TIME Health
For more, visit TIME Health.

Beyonce revealed that she experienced toxemia, also known as preeclampsia, while she was pregnant with her twins, Sir and Rumi. The condition left her swollen and put her on bed rest for more than a month.

In an interview in the September issue of Vogue, the entertainer said that the condition led to an emergency Cesarean section, which required the twins to spend weeks in the neonatal intensive care unit (NICU). Here’s what you should know about toxemia, aka preeclampsia.

What is preeclampsia, and why is it also called toxemia?

About 5% of pregnant women will get preeclampsia while expecting — usually toward the end of the pregnancy, after 37 weeks or so.

It can be a sign that the placenta, the critical source of nutrients for the growing baby, is not functioning properly and may even be detaching from the uterus. (Poor blood flow to the uterus could be a contributing factor.) That’s why doctors often prescribe bed rest.

Toxemia is a broader term referring to unknown toxins that might be causing a medical condition. And since a sign of preeclampsia can be higher levels of protein in the urine, some doctors refer to this type of preeclampsia as preeclampsia toxemia. Some women only develop higher blood pressure during pregnancy; this is referred to as pregnancy-induced hypertension, which is a different condition from preeclampsia.

What are the symptoms of preeclampsia?

Women with the condition develop high blood pressure, swelling in the hands, feet and legs, and show high levels of protein in their urine. They may also develop headaches, dizziness, blurry vision and sudden weight gain.

Why is preeclampsia dangerous?

Preeclampsia can lead to eclampsia, which causes expectant mothers to have seizures and can put their lives, and their babies’ lives, at risk.

What causes preeclampsia?

It’s not clear why some women experience the condition, but women carrying twins, like Beyonce, and women with diabetes tend to be at higher risk. Older women and first-time mothers also have a higher risk for preeclampsia. Having a history of high blood pressure before pregnancy, or having a mother or sister who experienced the condition, can also increase the chances the condition will develop, since genetics may play a role.

How is preeclampsia treated?

The only way to treat the condition is to deliver the baby. If they feel the baby has developed enough, doctors will do this by inducing labor or performing a Cesarean section. (In the Vogue interview, Beyonce said she had an emergency C-section.) To get to that point, usually at 37 weeks, doctors may provide steroids to improve the baby’s lung growth and prescribe bed rest for the last weeks of pregnancy. They may also use medications to control blood pressure and do regular blood and urine tests to keep track of the excess protein.

Once you have preeclampsia, will you have it again?

Preeclampsia, if it’s properly treated during pregnancy, will resolve a week or so after delivery. While it’s more likely that women who have experienced it will develop it again in future pregnancies, that’s not always the case.

During a C-section, do organs move around?

“After the C-section, my core felt different,” Beyonce said in the interview. “It had been major surgery. Some of your organs are shifted temporarily, and in rare cases, removed temporarily during delivery.”

In a C-section, the uterus is most certainly moved; often it’s lifted partly out of the body. But most of the other organs, including the bladder and intestines, remain inside the body. However, they might be shifted slightly to give the surgeon more room to reach the uterus.

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