Overview
Preeclampsia is a pregnancy-specific disorder marked by new-onset high blood pressure, usually developing after 20 weeks of gestation, together with signs of organ damage such as protein in the urine or abnormal liver and kidney function.
Disease Summary
- Category
- Non-Communicable Disease
- Cause
- Abnormal placental development leading to widespread blood vessel dysfunction
- Transmission
- Not applicable; preeclampsia is a pregnancy-specific disorder and cannot be spread between people
- Body System
- Cardiovascular System
- Preventable
- Yes
- Curable
- Yes
Symptoms
Common Symptoms
Most women with preeclampsia experience one or more of the following signs, often first noticed at a routine prenatal visit.
High Blood Pressure
Usually detected during a routine prenatal check and often the first sign identified.
Swelling
Noticeable swelling of the hands, face, or feet beyond what is typical in pregnancy.
Headache
A persistent headache that does not improve with usual pain relief.
Sudden Weight Gain
Rapid weight gain over a few days, often related to fluid retention.
Danger Signs
Seek urgent medical attention immediately if any of the following symptoms develop.
Severe Headache
A severe or worsening headache can indicate progression to more serious disease.
Vision Changes
Blurred vision, seeing spots, or temporary vision loss requires urgent evaluation.
Upper Abdominal Pain
Pain under the ribs, especially on the right side, may indicate liver involvement.
Seizures
Seizures indicate eclampsia, a medical emergency requiring immediate hospital treatment.
Diagnosis
Clinical Assessment
Diagnosis begins with measuring blood pressure at prenatal visits and reviewing symptoms and pregnancy history.
Laboratory Tests
Urine and blood tests are used to check for protein in the urine and signs of kidney or liver dysfunction.
Blood Pressure Monitoring
Confirmation typically requires two elevated blood pressure readings, at least four hours apart, after 20 weeks of pregnancy.
Laboratory Tests
Urine Protein Test
Detects protein in the urine, a key finding used to support the diagnosis of preeclampsia.
Complete Blood Count (CBC)
Checks platelet count, since low platelets can indicate worsening disease or HELLP syndrome.
Liver Function Tests
Elevated liver enzymes point to liver involvement and help assess disease severity.
Serum Creatinine (Kidney Function Test)
Assesses kidney function, which can decline as preeclampsia progresses.
Treatment
Antihypertensive Medication
Medications such as labetalol or nifedipine are used to lower severe blood pressure and reduce the risk of complications.
Magnesium Sulfate
Magnesium sulfate is recommended to prevent and treat seizures in women with severe preeclampsia or eclampsia.
Prevention
Low-dose aspirin for women at high risk
Starting low-dose aspirin before 20 weeks of pregnancy can reduce the risk of preeclampsia in women identified as high risk.
Attend regular prenatal care
Consistent antenatal visits allow blood pressure and urine protein to be checked regularly throughout pregnancy.
Monitor blood pressure at home
Self-measured blood pressure monitoring with support from a healthcare provider helps detect rising blood pressure early.
Discuss calcium intake with a provider
In populations with low dietary calcium intake, calcium supplementation during pregnancy has been associated with reduced risk.
Risk Factors
High Risk
These factors substantially increase the likelihood of developing preeclampsia.
- First pregnancy
- Multiple pregnancy (twins or more)
- Chronic hypertension or kidney disease
- Previous history of preeclampsia
Increased Risk
These factors are associated with a moderately higher risk of preeclampsia.
- Obesity
- Pre-existing diabetes
- Maternal age under 20 or over 35
- Family history of preeclampsia
Additional Contributing Factors
Other factors linked with an increased likelihood of preeclampsia.
- Long interval since a previous pregnancy
- Use of assisted reproductive technology, such as in vitro fertilisation
- Autoimmune conditions such as lupus
Complications
Eclampsia
Seizures resulting from severe preeclampsia are a medical emergency that can be life threatening for mother and baby.
HELLP Syndrome
A severe variant involving haemolysis, elevated liver enzymes, and low platelet count, which can lead to serious complications.
Placental Abruption
The placenta may separate from the uterine wall prematurely, causing bleeding and endangering the baby’s oxygen supply.
When to Seek Medical Care
Severe Headache or Vision Changes
Persistent headache or visual disturbances may signal worsening disease and require urgent evaluation.
Upper Abdominal Pain
Pain under the ribs, especially on the right side, may indicate liver involvement and needs prompt assessment.
Reduced Fetal Movement
A noticeable decrease in the baby’s movements should be reported to a healthcare provider immediately.
Seizures
Seizures are a medical emergency requiring immediate hospital care.
Prognosis
Good with Timely Management
With regular monitoring and appropriate treatment, most women with preeclampsia have healthy pregnancy outcomes.
Resolves After Delivery
Blood pressure and other signs of preeclampsia typically improve within days to weeks after delivery, though monitoring continues into the postpartum period.
Increased Future Risk
Women who have had preeclampsia face a higher lifetime risk of cardiovascular disease and may be more likely to develop it in a future pregnancy.
Differential Diagnosis
Chronic Hypertension
High blood pressure present before pregnancy or before 20 weeks, without new proteinuria or organ dysfunction.
Gestational Hypertension
New-onset high blood pressure after 20 weeks of pregnancy without proteinuria or other signs of organ damage.
HELLP Syndrome
Though part of the preeclampsia spectrum, HELLP syndrome can present without prominent hypertension and may be mistaken for other conditions.
Acute Fatty Liver of Pregnancy
A rare but serious condition with overlapping liver abnormalities that must be distinguished from severe preeclampsia with HELLP syndrome.
References
World Health Organization (WHO)
WHO recommendations for the prevention and treatment of pre-eclampsia and eclampsia.
Centers for Disease Control and Prevention (CDC)
Guidance on high blood pressure, preeclampsia, and other pregnancy complications.
American College of Obstetricians and Gynecologists (ACOG)
Patient-focused guidance on preeclampsia and high blood pressure during pregnancy.
Frequently Asked Questions
Can preeclampsia be cured?
Delivery of the baby and placenta is the only definitive cure. Medication can help manage blood pressure and reduce risks until delivery is possible.
Does preeclampsia go away after birth?
In most cases, blood pressure and other symptoms improve within days to weeks after delivery, though some women continue to need blood pressure treatment for a period afterward.
Can preeclampsia be prevented?
Low-dose aspirin started before 20 weeks in women at high risk, along with regular prenatal care, can reduce the risk, though not every case can be prevented.
Is preeclampsia dangerous for the baby?
Yes. It can restrict blood flow to the placenta, which may lead to poor fetal growth, premature birth, or in severe cases, stillbirth, which is why close monitoring is important.