Understanding Preeclampsia
Preeclampsia is a pregnancy-related high blood pressure disorder that requires careful medical evaluation and monitoring. Understanding the warning signs and receiving appropriate prenatal care can help your obstetric team identify concerns and determine the safest plan for you and your baby.
A severe or persistent headache, changes in vision, upper abdominal pain, trouble breathing, or blood pressure of 160/110 mm Hg or higher during pregnancy or after childbirth requires urgent medical attention.
What is preeclampsia?
Preeclampsia is a serious condition involving high blood pressure during pregnancy and signs that another organ system may be affected.
Preeclampsia usually develops after 20 weeks of pregnancy, although it can also occur after delivery. It can affect multiple organ systems and may become serious if it is not recognized and appropriately managed.
Some women have few or no noticeable symptoms. This is one reason routine prenatal care is so important. Blood pressure measurements and, when appropriate, urine and blood testing can help your obstetrician identify changes that need further evaluation.
Preeclampsia is different from ordinary pregnancy swelling. Swelling can occur during a healthy pregnancy, but sudden swelling of the face or hands, particularly when accompanied by other warning signs, should be discussed promptly with your healthcare provider.
A condition that deserves careful monitoring
The goal of care is to protect the health of the pregnant patient while monitoring the baby's well-being and determining the safest timing and method of delivery when delivery becomes necessary.
Preeclampsia symptoms
Preeclampsia may occur without noticeable symptoms. When symptoms are present, recognizing them early is important.
Persistent headache
A headache that does not go away or becomes severe can be a warning sign that requires prompt evaluation.
Vision changes
Seeing spots, blurred vision or other changes in eyesight should be reported to your obstetrician.
Upper abdominal pain
Pain in the upper abdomen or shoulder can be associated with preeclampsia and should be evaluated.
Sudden swelling
Sudden swelling of the face or hands can be a warning sign, especially when it occurs with other symptoms.
Difficulty breathing
New or worsening difficulty breathing can be a sign of a serious pregnancy complication and needs prompt attention.
Sudden weight gain
Rapid or unexpected weight gain may occur with fluid retention and should be discussed with your provider.
Who may be at higher risk?
Preeclampsia can occur in women without known risk factors, but certain health and pregnancy characteristics can increase the likelihood.
Previous preeclampsia
A history of preeclampsia in a previous pregnancy can increase risk in a future pregnancy.
Multiple pregnancy
Carrying twins, triplets or more can increase the risk of pregnancy-related hypertensive disorders.
Chronic hypertension
High blood pressure that existed before pregnancy is an important factor in pregnancy risk assessment.
Kidney disease
Certain kidney conditions can increase the risk of pregnancy-related blood pressure complications.
Diabetes
Diabetes is among the medical factors considered when assessing preeclampsia risk.
Autoimmune conditions
Certain autoimmune conditions, including lupus, can increase pregnancy-related risk.
First pregnancy
Being pregnant for the first time is considered one of the moderate risk factors identified by ACOG.
Family history
A family history of preeclampsia, such as in a mother or sister, may increase risk.
How is preeclampsia diagnosed?
Diagnosis involves more than a single symptom. Your obstetrician considers blood pressure readings, urine findings, laboratory results and your overall clinical picture.
Blood pressure
Blood pressure is checked during prenatal care. Elevated readings may be repeated to confirm the result.
Urine testing
Urine may be evaluated for protein as part of the assessment for preeclampsia.
Blood tests
Laboratory testing may evaluate platelet count and kidney and liver function.
Baby monitoring
Depending on your situation, your provider may monitor fetal growth, movement and well-being.
Care may include closer monitoring.
When pregnancy-related hypertension or preeclampsia is identified, your care plan depends on factors such as gestational age, blood pressure, symptoms, laboratory results and the health of the baby.
How is preeclampsia managed?
Management is individualized. The goal is to reduce risks while giving the pregnancy as much time as is safely possible when continued pregnancy is appropriate.
Close observation
Some women with preeclampsia without severe features may be monitored closely as outpatients or in a hospital, depending on their individual circumstances.
Blood pressure treatment
When blood pressure becomes severely elevated, medication may be used to reduce the risk of serious complications. Medication decisions are individualized during pregnancy.
Seizure prevention
In certain severe cases, magnesium sulfate may be used to help prevent seizures. Your obstetric team determines when this treatment is appropriate.
Fetal monitoring
Your provider may recommend additional monitoring to assess fetal growth, heart rate, movement and overall well-being.
Corticosteroids
When early delivery may be necessary, corticosteroids may be considered in appropriate pregnancies to help accelerate fetal lung maturity.
Delivery planning
Delivery is ultimately the definitive treatment for preeclampsia. Timing depends on disease severity, gestational age and maternal and fetal health.
Finding the safest time to deliver.
The timing of delivery is one of the most important decisions when preeclampsia is diagnosed. Your obstetrician considers your blood pressure, symptoms, laboratory results, gestational age and your baby's condition.
For some women, close monitoring allows pregnancy to continue. In other situations, delivering the baby may be the safest option for the mother, the baby, or both.
Preeclampsia can happen after childbirth, too.
The need for awareness does not necessarily end when the baby is born. Preeclampsia can occur or continue during the postpartum period.
Watch your symptoms
Report severe headache, vision changes, trouble breathing, chest or abdominal pain, sudden swelling or other concerning symptoms promptly.
Monitor blood pressure
Your provider may recommend blood pressure monitoring after delivery, particularly if you had hypertension or preeclampsia during pregnancy.
Think about future health
A history of preeclampsia is important information to share with future healthcare providers because it can be associated with increased long-term cardiovascular risk.
Preeclampsia FAQs
What is preeclampsia?
Preeclampsia is a serious pregnancy-related disorder involving high blood pressure and signs of organ involvement. It usually develops after 20 weeks of pregnancy but can also occur after childbirth.
What are the symptoms of preeclampsia?
Possible symptoms include a persistent headache, vision changes, swelling of the face or hands, upper abdominal or shoulder pain, nausea or vomiting later in pregnancy, sudden weight gain and difficulty breathing. Some women may have no noticeable symptoms.
Can preeclampsia happen without symptoms?
Yes. Preeclampsia may develop without obvious symptoms. This is why routine prenatal visits and blood pressure checks are important during pregnancy.
When does preeclampsia usually develop?
Preeclampsia usually develops after 20 weeks of pregnancy, often during the third trimester. It can also occur after delivery.
How is preeclampsia diagnosed?
Diagnosis may involve repeated blood pressure measurements, urine testing for protein, blood tests that evaluate platelets and kidney and liver function, and assessment of maternal and fetal well-being.
Does preeclampsia always require early delivery?
Not necessarily. Some women can be monitored closely while pregnancy continues. The timing of delivery depends on gestational age, disease severity, maternal symptoms, laboratory findings and fetal well-being.
Can preeclampsia happen after delivery?
Yes. Preeclampsia can develop after childbirth. New or worsening symptoms such as severe headache, vision changes, difficulty breathing or significant blood pressure elevation should receive prompt medical attention.
Can preeclampsia happen again in another pregnancy?
A history of preeclampsia increases the risk of developing it again in a future pregnancy. Your obstetrician can review your history and discuss an appropriate monitoring and prevention plan.
Can low-dose aspirin prevent preeclampsia?
Low-dose aspirin may reduce the risk of preeclampsia for certain women who are considered high risk or who have multiple moderate risk factors. It should only be started during pregnancy when recommended by your obstetrician.
When should I seek emergency medical attention?
Seek urgent medical care for severe or persistent headache, vision changes, significant upper abdominal pain, difficulty breathing, chest pain, seizures, or a blood pressure reading of 160/110 mm Hg or higher. Do not wait for a routine appointment if you are experiencing concerning symptoms.
Thoughtful care for every stage of pregnancy.
If you have questions about blood pressure, pregnancy complications, or your risk for preeclampsia, speak with your obstetrician about your individual situation.
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Medical Information Sources
The medical information on this page is based on established patient education and clinical guidance from reputable medical organizations.
American College of Obstetricians and Gynecologists (ACOG): Preeclampsia and High Blood Pressure During Pregnancy
National Heart, Lung, and Blood Institute (NIH): Pregnancy and High Blood Pressure
National Heart, Lung, and Blood Institute (NIH): Maternal Health
Medical disclaimer: This page is provided for general educational purposes and is not a substitute for medical diagnosis, treatment or advice from a qualified healthcare professional. Pregnancy-related symptoms can have multiple causes. If you are pregnant or recently gave birth and develop severe symptoms, significant blood pressure elevation, difficulty breathing, chest pain, seizures, severe headache or vision changes, seek urgent medical evaluation.