Preeclampsia: Symptoms, Causes & What Helps — A Complete Guide
Updated: 2 days ago
Preeclampsia: Symptoms, Causes & What Helps — A Complete Guide
Medically reviewed by Dr. Baraa Alnahhal, MD | Source note: this article is based on two clinical reference pages last reviewed on April 15, 2022.
TL;DR
Preeclampsia is a pregnancy complication marked by high blood pressure after week 20 and signs of organ stress — most commonly protein in the urine. It can harm both mother and baby if untreated, but regular prenatal care catches it early. Severe headaches, blurred vision, severe belly pain, or severe shortness of breath need emergency care right away. Most cases are managed with close monitoring, blood pressure medication, and timing delivery at the safest point — often after 37 weeks for mild cases, earlier if severe.
Quick Answer
What is preeclampsia?
Definition: A pregnancy complication defined by high blood pressure after 20 weeks of pregnancy plus protein in the urine or other signs of kidney or organ damage.
Who it affects: People whose blood pressure was previously in the standard range; it can also develop after delivery (postpartum preeclampsia).
Key warning signs: Severe headaches, blurred vision or light sensitivity, pain in the upper belly (right side), and severe shortness of breath — seek emergency care immediately for these.
Who is at higher risk: A previous pregnancy with preeclampsia, twins or multiples, chronic high blood pressure, type 1 or 2 diabetes, kidney disease, autoimmune disorders, or IVF pregnancy.
How it is diagnosed: Blood pressure of 140/90 or higher confirmed with a repeat reading, plus urine protein tests, blood and liver tests, platelet count, and fetal ultrasound.
How it is treated: Close monitoring, blood pressure medicine, magnesium sulfate to prevent seizures, corticosteroids to mature the baby's lungs, and delivery at the safest timing.
Prevention: Daily low-dose (81 mg) aspirin after 12 weeks of pregnancy is recommended for those with one high-risk or multiple moderate-risk factors — but only with a provider's guidance.
What Is Preeclampsia?
Preeclampsia is a complication of pregnancy. It is defined by high blood pressure, high levels of protein in the urine indicating kidney damage, or other signs of organ damage. It usually begins after 20 weeks of pregnancy in people whose blood pressure had previously been in the standard range.
The defining combination looks like this:
| Feature | What It Means | |---|---| | High blood pressure | A reading of 140/90 mm Hg or higher after 20 weeks | | Proteinuria | Excess protein in the urine, signaling kidney stress | | Other organ signs | Liver, blood-clotting, lung, or brain involvement |
Left untreated, preeclampsia can lead to serious — even fatal — complications for both mother and baby. That is why it is monitored so closely at every prenatal visit.
Why It's Different From Normal Pregnancy Swelling
Weight gain and swelling are typical in healthy pregnancies. But sudden weight gain or sudden swelling — particularly in the face and hands — may signal preeclampsia. The same is true of symptoms that are usually harmless in pregnancy, such as headaches and nausea: when they are severe or new, they can mark something serious. If you're ever concerned about a symptom, contact your provider.
Preeclampsia Warning Signs: What to Watch For
Preeclampsia may have no noticeable symptoms at all. For many people, the first signs are detected only during routine prenatal visits. That is exactly why attending every prenatal appointment matters.
When signs do appear, they reflect stress on several organ systems:
| Sign or Symptom | What It Reflects | |---|---| | Severe headaches | Possible brain or blood-vessel involvement | | Vision changes | Temporary loss of vision, blurred vision, or light sensitivity | | Pain in the upper belly | Usually under the ribs on the right side — liver stress | | Shortness of breath | Fluid in the lungs | | Nausea or vomiting | Especially new or severe during the second half of pregnancy | | Excess protein in urine | Impaired kidney function (proteinuria) | | Decreased platelets | Blood-clotting problem (thrombocytopenia) | | Increased liver enzymes | Impaired liver function | | Sudden swelling of face or hands | Abnormal fluid retention (edema) |
When to Get Emergency Care
Seek emergency care immediately — call 911 or go to the nearest emergency room — if you have severe headaches, blurred vision or other visual disturbances, severe belly pain, or severe shortness of breath. These signs can point to eclampsia (seizures) or other life-threatening complications, and they can appear suddenly, even in people who felt fine.
Headaches, nausea, and aches are common pregnancy complaints — it can be hard to tell when a new symptom signals a serious problem, especially in a first pregnancy. If you are concerned about any symptom, contact your doctor rather than waiting.
Preeclampsia Risk Factors: Who Is Most Likely to Develop It?
Risk factors fall into two tiers. Providers use these tiers to decide whether preventive low-dose aspirin is right for you.
Higher Risk
| Higher-Risk Factor | |---| | Preeclampsia in a previous pregnancy | | Pregnant with more than one baby (twins or multiples) | | Chronic high blood pressure (hypertension) | | Type 1 or type 2 diabetes before pregnancy | | Kidney disease | | Autoimmune disorders | | Pregnancy conceived through in vitro fertilization (IVF) |
Moderate Risk
| Moderate-Risk Factor | |---| | First pregnancy with your current partner | | Obesity | | Family history of preeclampsia | | Maternal age of 35 or older | | Complications in a previous pregnancy | | More than 10 years since your previous pregnancy |
Other Factors Related to Access and Equity
Studies show a greater risk of preeclampsia among Black women compared with other women, and some evidence of increased risk among indigenous women in North America. Researchers note these differences may not be based on biology — greater risk may relate to inequities in access to prenatal care and health care, social inequities, and chronic stressors that affect health and well-being. Lower income is also associated with greater risk for similar reasons.
For prevention decisions, a Black woman or a woman with a low income is considered to have a moderately increased risk of developing preeclampsia.
What Causes Preeclampsia?
The exact cause likely involves several factors, but experts believe it begins in the placenta — the organ that nourishes the fetus throughout pregnancy.
Early in pregnancy, new blood vessels develop to supply oxygen and nutrients to the placenta. In preeclampsia, these blood vessels don't develop or work properly. Problems with blood circulation in the placenta may lead to irregular regulation of blood pressure in the mother.
Preeclampsia vs. Other Pregnancy Blood Pressure Disorders
Four related conditions are often confused. Here is how they differ:
| Condition | Definition | |---|---| | Preeclampsia | High blood pressure after 20 weeks with kidney/organ problems | | Gestational hypertension | High blood pressure after 20 weeks without kidney/organ problems; some women later develop preeclampsia | | Chronic hypertension | High blood pressure present before pregnancy or before 20 weeks; also if it continues more than 3 months after pregnancy | | Chronic hypertension with superimposed preeclampsia | Pre-existing chronic high blood pressure that worsens during pregnancy with new protein in the urine or other complications |
Why Preeclampsia Matters: Possible Complications
Untreated or severe preeclampsia can affect both mother and baby. Understanding these complications explains why monitoring is so intensive.
| Complication | What Happens | |---|---| | Fetal growth restriction | Preeclampsia affects arteries carrying blood to the placenta; less blood, oxygen, and nutrients reach the baby, slowing growth | | Preterm birth | Unplanned birth before 37 weeks — or planned early delivery as a primary treatment; premature babies face higher risks of breathing and feeding difficulties, vision or hearing problems, developmental delays, and cerebral palsy | | Placental abruption | The placenta separates from the inner wall of the uterus before delivery; severe cases cause heavy bleeding and are life-threatening | | HELLP syndrome | A severe form — hemolysis (red blood cell breakdown), elevated liver enzymes, low platelets — that affects several organ systems and can be life-threatening; signs include nausea, vomiting, headache, upper right belly pain, and a general feeling of illness | | Eclampsia | The onset of seizures or coma with preeclampsia signs; very difficult to predict, can occur with no warning, before, during, or after delivery | | Organ damage | Kidneys, liver, lungs, heart, and eyes; may cause stroke or other brain injury | | Future cardiovascular disease | Preeclampsia may increase future heart and blood vessel disease risk — especially after more than one episode or a preterm delivery |
HELLP syndrome sometimes develops suddenly, even before high blood pressure is detected, and eclampsia may strike with no previously observed signs. This is why any severe symptom deserves immediate attention.
How Is Preeclampsia Diagnosed?
Preeclampsia is diagnosed if you have high blood pressure after 20 weeks of pregnancy AND at least one sign of organ stress.
Understanding Blood Pressure Readings
| Term | Meaning | |---|---| | Systolic (first number) | Pressure when the heart is contracting | | Diastolic (second number) | Pressure when the heart is relaxed |
In pregnancy, high blood pressure is diagnosed if the systolic reading is 140 mm Hg or higher or the diastolic reading is 90 mm Hg or higher. If a high reading occurs during an appointment, your provider will likely take a second reading four hours later to confirm.
Tests Used to Confirm the Diagnosis
| Test | What It Checks | |---|---| | Urine analysis | 24-hour or single urine sample to check for protein and kidney function | | Blood tests | How well the liver and kidneys are working, plus platelet count | | Fetal ultrasound | The baby's growth, estimated weight, and amniotic fluid | | Nonstress test | The baby's heart rate response to movement | | Biophysical profile | Ultrasound measurement of the baby's breathing, muscle tone, movement, and amniotic fluid volume |
How Is Preeclampsia Treated?
The primary treatment is one of two paths: deliver the baby, or manage the condition until the best time to deliver. The decision depends on the severity of the preeclampsia, how many weeks pregnant you are, and the health of both mother and baby.
If Preeclampsia Is Not Severe
Your provider will schedule frequent visits to monitor blood pressure, symptoms, and the baby's health. You will likely be asked to check your blood pressure daily at home.
If Preeclampsia Is Severe
Hospital care is required to monitor blood pressure and possible complications, with frequent monitoring of the baby's growth and well-being. Three types of medication are commonly used:
| Medication Type | Purpose | |---|---| | Antihypertensives | Lower blood pressure | | Magnesium sulfate | An anticonvulsant used to prevent seizures | | Corticosteroids | Promote development of the baby's lungs before an early delivery |
Delivery Timing
| Severity | Typical Delivery Timing | |---|---| | Not severe | After 37 weeks of pregnancy | | Severe | Before 37 weeks, depending on complication severity and the baby's health and readiness |
Whether delivery is vaginal or cesarean depends on the severity of the disease, gestational age, and other considerations.
Can Preeclampsia Be Prevented?
Low-Dose Aspirin
The best clinical evidence for prevention is low-dose aspirin. Your primary care provider may recommend an 81-milligram aspirin tablet daily after 12 weeks of pregnancy if you have:
One or more higher-risk factors (see the risk factor table above), OR
More than one moderate-risk factor
Always talk with your provider before taking any medications, vitamins, or supplements to make sure it is safe for you.
Lifestyle Before Pregnancy
If you have had preeclampsia before and are planning another pregnancy, be as healthy as possible before becoming pregnant. Talk to your provider about managing conditions that increase risk — such as high blood pressure and diabetes — ahead of time.
Living With Preeclampsia: Coping and Support
Discovering a potentially serious pregnancy complication can be frightening. A late diagnosis may mean being surprised that immediate delivery is recommended. An early diagnosis may bring concerns about monitoring at home and attending more appointments.
Learning about the condition helps. Talk to your provider, do research, and make sure you understand when to call your provider and how to monitor your own signs and symptoms. You are not powerless — you are part of the care team.
After Delivery
You will be closely monitored for high blood pressure and other signs of preeclampsia after delivery, because postpartum preeclampsia can develop after the baby is born. Before going home, you will be instructed on when to seek medical care — watch for:
Severe headaches
Vision changes
Severe belly pain
Nausea and vomiting
Questions to Ask at Your Appointment
Preeclampsia is often diagnosed during a regularly scheduled prenatal visit. Expect your provider to ask:
Did you have preeclampsia or other complications in a previous pregnancy?
If you are having symptoms, when did they begin?
Has anything improved the symptoms or made them worse?
Have you made recent changes to medications, vitamins, or dietary supplements?
After a diagnosis, helpful questions to ask at follow-ups include:
| Topic | Sample Questions | |---|---| | Home monitoring | How do I make sure I'm taking blood pressure readings correctly at home? How often should I check? What reading counts as high? | | When to act | When should I call the clinic? When should I get emergency care? | | Baby's health | How will we monitor my baby's health? What care might my baby need after a preterm delivery? | | Delivery plan | How will we decide the right time for delivery? What are the benefits and risks of delaying delivery? |
Conclusion
Preeclampsia is one of the most closely watched complications of pregnancy — and for good reason. It can develop without obvious symptoms, so your best protection is the routine care that catches it early: every prenatal visit, every blood pressure check, and every urine test.
The good news is equally clear. With careful monitoring, blood pressure medication, seizure prevention when needed, and well-timed delivery, most people with preeclampsia go on to healthy pregnancies. Know the four emergency signs — severe headache, blurred vision, severe belly pain, severe shortness of breath — and never hesitate to seek emergency care.
If you are pregnant or planning a pregnancy, talk with your provider about your preeclampsia risk and whether low-dose aspirin is right for you. If you develop any of the emergency signs above, call 911 or go to the nearest emergency room immediately.
Frequently Asked Questions
What are the first signs of preeclampsia?
Preeclampsia often has no noticeable symptoms — the first signs are usually high blood pressure and protein in the urine detected at a routine prenatal visit. When symptoms do appear, they commonly include headaches, swelling of the face or hands, and upper right belly pain.
Can you have preeclampsia without high blood pressure?
No. Preeclampsia is defined by high blood pressure after 20 weeks of pregnancy plus at least one other sign of organ stress, such as protein in the urine, low platelets, or elevated liver enzymes. Blood pressure of 140/90 or higher is required for the diagnosis.
At how many weeks does preeclampsia start?
Preeclampsia usually begins after 20 weeks of pregnancy. It can also develop after delivery, in which case it is called postpartum preeclampsia — typically within the first 48 hours but sometimes up to six weeks after birth.
What happens if preeclampsia is left untreated?
Untreated preeclampsia can lead to serious or fatal complications for both mother and baby, including fetal growth restriction, preterm birth, placental abruption, HELLP syndrome, eclampsia (seizures), organ damage, and stroke.
How is preeclampsia treated?
Treatment is either delivering the baby or managing the condition until the safest time to deliver. Management includes frequent monitoring, blood pressure medication, magnesium sulfate to prevent seizures, and corticosteroids to mature the baby's lungs before early delivery. For non-severe cases, delivery is often recommended after 37 weeks; for severe cases, before 37 weeks.
Can preeclampsia be prevented?
The best-evidenced prevention is daily low-dose (81 mg) aspirin started after 12 weeks of pregnancy, recommended for people with one higher-risk factor or more than one moderate-risk factor. Being as healthy as possible before pregnancy and managing conditions like high blood pressure and diabetes also helps. Always confirm with your provider before taking aspirin.
Does preeclampsia go away after delivery?
Delivery is the definitive treatment and preeclampsia usually resolves afterward, but you remain at risk for postpartum preeclampsia in the days to weeks after birth. Close monitoring after delivery is standard, and emergency signs (severe headache, vision changes, severe belly pain) still require immediate care.
Does having preeclampsia affect future pregnancies or long-term health?
Having preeclampsia once increases the risk in future pregnancies and may increase future risk of heart and blood vessel disease — especially if it happened more than once or with a preterm delivery. Planning your next pregnancy with your provider, including possible early aspirin therapy, helps manage that risk.
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References
Preeclampsia — Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745
Preeclampsia — Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-20355751
This article is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.
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