17952 Preeclampsia

Overview

Preeclampsia is a condition that can happen during pregnancy, usually after 20 weeks. It causes high blood pressure and can also affect your kidneys, liver, and other organs. With good medical care, most mothers and babies do well, but it needs to be monitored carefully.

Preeclampsia is fairly common, affecting about 1 in 20 to 1 in 25 pregnancies.

It affects people during pregnancy. You are more likely to develop it in a first pregnancy, if you have a family history, if you are expecting twins or triplets, or if you already have high blood pressure, kidney disease, or diabetes.

Symptoms

Common symptoms

• New or sudden swelling of your face, hands, or feet
• A severe headache that does not go away
• Blurred vision, flashing lights, or sensitivity to light
• Pain just under the ribs, often on the right side
• Feeling sick to your stomach or vomiting
• Sudden weight gain — for example, 3 to 5 pounds in a week

Causes

Main causes

• The exact cause of preeclampsia is not fully understood.
• It is linked to a problem with the placenta, the organ that delivers oxygen and nutrients to your baby.
• The placenta’s blood vessels may not develop normally, which affects blood flow and leads to high blood pressure in the mother.

Risk factors

• First pregnancy
• Previous preeclampsia
• Family history of preeclampsia (mother or sister)
• Being 40 years old or older
• Carrying twins, triplets, or more
• Existing high blood pressure, kidney disease, or autoimmune conditions
• Obesity (a BMI of 35 or higher)
• Pregnancy through IVF
• More than 10 years since your previous pregnancy

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, such as a seizure, losing consciousness, severe chest pain, trouble breathing, or loss of vision, call your local emergency number immediately.
• If you have a sudden severe headache, visual changes, pain under your ribs, or sudden swelling, go to the nearest emergency department or call your local emergency number.

Book a routine appointment if:

• All pregnant people should attend their regular antenatal appointments. Your midwife or doctor will check your blood pressure and urine at every visit.
• If you notice any symptoms of preeclampsia between appointments, contact your midwife or maternity unit straight away — even if you have a check-up soon.

Diagnosis

Preeclampsia is diagnosed when you have high blood pressure during pregnancy plus signs that other organs may be affected, such as protein in your urine. Your doctor will use tests to confirm this and check how severe it is.

Tests that may be done

• Blood pressure measurements
• A urine test to check for protein
• Blood tests to check your liver and kidneys
• An ultrasound scan to check your baby’s growth and the placenta
• Sometimes a blood pressure monitor you wear at home for 24 hours

What to expect at your appointment

If you are diagnosed with preeclampsia, your healthcare team will want to monitor you and your baby more closely. You may need extra appointments, a short stay in hospital, or home monitoring. They will also ask you to watch for symptoms and tell them if anything changes.

Treatment

The only way to fully cure preeclampsia is to deliver your baby and the placenta. The timing of delivery depends on your health and your baby’s wellbeing. Until delivery, treatment focuses on keeping your blood pressure in a safe range and watching for any complications.

Self-care at home

• Attend every prenatal appointment and any extra monitoring your doctor recommends.
• Rest when you can and avoid overexertion. Your healthcare team will tell you if you need to reduce activity.
• Check your blood pressure at home if your doctor provides or suggests a monitor.
• Keep track of your baby’s kicks and contact your maternity unit if they slow down.
• Ask a partner or trusted person to come to appointments and help you remember what was said.

Medical treatments

Several types of medicines may be used to keep your blood pressure at a safe level and to help prevent seizures. If your baby needs to be born early, you may be given medicines to help your baby’s lungs mature faster before birth. Your doctor will choose the right treatment based on your individual situation.

When is surgery considered?

If preeclampsia becomes severe, your doctor may recommend delivering your baby before your due date. This could mean starting labor with medicines, or having a caesarean section, where the baby is born through a cut in your belly. Your obstetrician will explain why this is needed and what to expect.

Living with this condition

After a diagnosis, your daily routine may change. You might need to rest more, keep a blood pressure log, and plan to stay close to the hospital. It can feel overwhelming, but your healthcare team will guide you step by step.

Lifestyle tips

• Rest with your feet up as much as possible.
• Avoid heavy lifting, strenuous exercise, and other things that raise your blood pressure quickly.
• Do not smoke, drink alcohol, or use recreational drugs.
• Tell your care team if you are having trouble sleeping or feeling anxious.
• Keep your phone list of emergency numbers handy.

Diet and exercise

Eat a balanced, healthy pregnancy diet. There is no special diet that cures preeclampsia, but good nutrition supports both you and your baby. Gentle activities like walking may be safe, but always ask your doctor first. Drink enough fluids and eat regular meals.

Mental health and emotional wellbeing

A preeclampsia diagnosis can bring worry, fear, and stress — these feelings are normal. Talk to your partner, family, and healthcare team about how you are feeling. If you ever have thoughts of harming yourself or your baby, or feel hopeless, get immediate help by calling your local emergency number or a crisis support line.

Prevention

There is no guaranteed way to prevent preeclampsia, but regular prenatal care is the best way to catch it early. If you are at high risk, your doctor may recommend a preventive medicine, but you should always follow their advice and never start anything on your own.

Vaccines

There is no vaccine to prevent preeclampsia.

Screening programmes

Routine prenatal appointments include blood pressure and urine checks. These simple screening tests help find preeclampsia early, so treatment can begin quickly.

Complications

If left untreated

• Eclampsia — seizures that can be life-threatening
• HELLP syndrome — a serious condition affecting the liver and blood
• Stroke caused by very high blood pressure
• Placental abruption — when the placenta separates from the womb early
• Preterm birth and low birth weight for the baby
• In rare cases, stillbirth

Long-term outlook

With early detection and good care, the vast majority of people with preeclampsia have a safe outcome for themselves and their baby. The condition usually improves after delivery, but recovery may take a few weeks. You will have follow-up checks after birth to make sure you heal safely. Many people go on to have healthy future pregnancies, although the risk of preeclampsia returning is higher.

Find support

International organisations

• Preeclampsia Foundation ↗

Local organisations

• NHS – Pre-eclampsia ↗ · United Kingdom

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