Pre-eclampsia is a serious pregnancy complication. Early detection and treatment protect you and your baby.
What Is Pre-eclampsia?
High blood pressure with organ damage during pregnancy
- Develops after 20 weeks of pregnancy
- Affects 5-8% of pregnancies
- Can be mild or severe
- Requires close monitoring
- Only cure is delivery
Can develop suddenly – that’s why regular appointments are crucial.
Risk Factors
You’re at higher risk if:
High-risk factors:
- First pregnancy
- History of pre-eclampsia in previous pregnancy
- Multiple pregnancy (twins, triplets)
- Pre-existing high blood pressure
- Pre-existing kidney disease
- Pre-existing diabetes
- Autoimmune conditions (lupus, antiphospholipid syndrome)
- Age under 20 or over 40
- Family history (mother or sister had it)
Moderate-risk factors:
- Obesity (BMI > 30)
- More than 10 years since last pregnancy
- IVF pregnancy
Even without risk factors, can still develop pre-eclampsia.
Warning Signs: Know Them!
Symptoms You Might Notice
Severe headache:
- Won’t go away
- Not relieved by pain medication
- Feels different from normal headaches
- Throbbing or persistent
Vision changes:
- Blurred vision
- Seeing spots or flashing lights
- Temporary vision loss
- Light sensitivity
- Aura (like migraine aura)
Severe swelling:
- Face (especially around eyes)
- Hands (rings suddenly tight)
- Sudden, rapid swelling (not gradual)
- One side significantly more swollen
Pain under ribs on right side:
- Upper right abdomen
- May feel like heartburn but isn’t
- Liver involvement
Severe nausea or vomiting:
- Especially in second half of pregnancy
- After morning sickness should be over
Shortness of breath:
- Fluid in lungs
- Beyond normal pregnancy breathlessness
Sudden weight gain:
- More than 2 kg (5 lbs) in a week
- Due to fluid retention
Symptoms You Won’t Notice
Detected at appointments:
High blood pressure:
- 140/90 or higher
- May have no symptoms
- That’s why BP checked at every visit
Protein in urine:
- Indicates kidney damage
- No symptoms
- Checked at appointments
Low platelet count:
- Blood clotting cells
- Found on blood tests
Elevated liver enzymes:
- Liver damage
- Found on blood tests
Reduced kidney function:
- Blood tests show
THIS IS WHY YOU MUST ATTEND ALL PRENATAL APPOINTMENTS! Many signs are silent.
Severity: Mild vs. Severe
Mild Pre-eclampsia
High blood pressure with:
- Minimal protein in urine
- No symptoms or mild symptoms
- Normal lab values
- Close monitoring required
- May manage at home with frequent visits
Severe Pre-eclampsia
High blood pressure PLUS one or more:
- Severe symptoms (headache, vision changes, pain)
- Very high blood pressure (≥ 160/110)
- Significant protein in urine
- Abnormal liver enzymes (2x normal)
- Low platelet count
- Kidney dysfunction
- Fluid in lungs
Requires hospitalization and close monitoring. May need immediate delivery.
Complications of Pre-eclampsia
HELLP Syndrome
Life-threatening variant of pre-eclampsia:
- Hemolysis (red blood cells breaking down)
- Elevated Liver enzymes
- Low Platelet count
Symptoms:
- Right upper abdomen pain
- Nausea/vomiting
- Headache
- Fatigue
- Flu-like symptoms
Medical emergency – immediate delivery needed.
Eclampsia
Seizures caused by pre-eclampsia:
- Can occur during pregnancy, labor, or after delivery
- Life-threatening for mother and baby
- Prevented by treating pre-eclampsia
- Treated with magnesium sulfate
Placental Abruption
Placenta separates from uterus:
- Causes heavy bleeding
- Endangers baby’s oxygen supply
- Emergency delivery needed
Stroke
Severe uncontrolled blood pressure can cause stroke.
For Baby
Complications include:
- Growth restriction (poor placenta function)
- Preterm birth (early delivery needed)
- Stillbirth (if untreated)
- Low birth weight
Treating pre-eclampsia protects baby.
Diagnosis and Monitoring
Blood Pressure Monitoring
At every prenatal visit:
- Rest 5 minutes before measuring
- Sitting, arm at heart level
- Two readings, 4 hours apart to confirm
High BP: 140/90 or higher
Very high BP: 160/110 or higher (severe)
Urine Testing
Protein in urine (proteinuria):
- Dipstick at each visit
- 24-hour urine collection (measures exact amount)
- Spot urine protein-to-creatinine ratio
Significant proteinuria: 300mg+ in 24 hours
Blood Tests
If pre-eclampsia suspected:
- Complete blood count (platelets)
- Liver function tests
- Kidney function tests
- Repeated frequently to monitor
Ultrasound Monitoring
Check baby’s growth and well-being:
- Growth scans (every 2-3 weeks)
- Amniotic fluid level
- Doppler studies (blood flow to baby)
- Non-stress tests or biophysical profiles
Treatment and Management
Mild Pre-eclampsia
Close monitoring:
- Blood pressure checks 2-3 times weekly
- Twice-weekly non-stress tests
- Weekly blood tests
- Frequent ultrasounds
- Daily kick counts at home
- Rest (not strict bed rest)
May manage at home if:
- Blood pressure not too high
- No symptoms
- Baby doing well
- You live close to hospital
- Can attend frequent appointments
Severe Pre-eclampsia
Hospitalization required:
- Continuous monitoring
- IV magnesium sulfate (prevents seizures)
- Blood pressure medications
- Corticosteroids (if before 34 weeks, for baby’s lungs)
- Daily blood tests
- Continuous fetal monitoring
- Prepare for delivery
Medications
Blood pressure medications:
- Labetalol, nifedipine, methyldopa
- Safe for pregnancy
- Lower dangerously high BP
Magnesium sulfate:
- Prevents seizures (eclampsia)
- Given IV during labor and after delivery
- Continued 24-48 hours postpartum
- Side effects: warmth, flushing, temporary blurred vision
Corticosteroids (betamethasone):
- If delivery likely before 34 weeks
- Helps baby’s lungs mature
- Reduces complications of prematurity
The Only Cure: Delivery
Pre-eclampsia is cured by delivering the baby and placenta.
Timing depends on:
- Severity of pre-eclampsia
- Gestational age
- Baby’s well-being
- Your symptoms and lab values
Delivery timing:
- Mild, well-controlled: May wait until 37 weeks (full term)
- Severe pre-eclampsia: Deliver at 34 weeks
- Very severe or HELLP: Immediate delivery regardless of gestational age
Difficult decision: Balance risks of continuing pregnancy vs. prematurity
Labor and Delivery with Pre-eclampsia
Vaginal delivery preferred if possible and safe
During labor:
- Continuous fetal monitoring
- IV magnesium sulfate
- Blood pressure medications as needed
- Close monitoring of you and baby
- Epidural often recommended (helps lower BP)
Cesarean delivery if:
- Baby’s condition deteriorating
- Your condition worsening
- Induction fails
- Other obstetric reasons
After Delivery
Pre-eclampsia doesn’t disappear immediately after delivery.
Postpartum Monitoring
First 48-72 hours critical:
- Blood pressure monitored frequently
- Magnesium sulfate continued 24-48 hours
- Blood tests to ensure improving
- Watch for complications
Can develop postpartum pre-eclampsia:
- Up to 6 weeks after delivery
- Watch for warning signs
- Report symptoms immediately
Recovery
Blood pressure usually normalizes:
- Within days to weeks
- May need BP medication for weeks to months
- Follow-up with doctor
Postpartum check-up (6 weeks):
- Blood pressure check
- Labs if needed
- Ensure full recovery
Prevention
Low-dose aspirin (75-150mg daily):
- Started at 12-16 weeks
- Continued until delivery
- For women at high risk
- Reduces risk by 15-20%
Your doctor will prescribe if you have risk factors.
Calcium supplementation:
- 1000-1500mg daily
- If low dietary calcium intake
- Some benefit in prevention
No other proven prevention methods, but healthy lifestyle helps:
- Maintain healthy weight
- Exercise regularly
- Attend all prenatal appointments
Future Pregnancies
If you had pre-eclampsia:
- 15-25% chance in next pregnancy
- Higher risk if severe or early pre-eclampsia
- Lower risk if it was mild and late
Planning next pregnancy:
- Wait at least 18-24 months
- Achieve healthy weight
- Control pre-existing conditions
- Low-dose aspirin from early pregnancy
- Early and frequent monitoring
Inform new provider of previous pre-eclampsia.
Long-Term Health
Pre-eclampsia increases lifetime risk of:
- High blood pressure (chronic hypertension)
- Heart disease
- Stroke
- Kidney disease
- Diabetes
Protect your future health:
- Maintain healthy weight
- Exercise regularly
- Eat balanced diet
- Don’t smoke
- Regular medical check-ups
- Control blood pressure
Awareness and healthy lifestyle matter.
When to Call Doctor Immediately
Don’t wait if you experience:
🚨 Severe headache that won’t go away
🚨 Vision changes (blurred, spots, flashing lights)
🚨 Severe pain under right ribs
🚨 Sudden severe swelling (face, hands, feet)
🚨 Nausea/vomiting (in second half of pregnancy)
🚨 Shortness of breath
🚨 Decreased fetal movement
Call immediately, day or night. Go to hospital if you can’t reach provider.
Better to be checked and told everything is fine than to ignore warning signs.
Living with Pre-eclampsia Diagnosis
Emotional Impact
Normal to feel:
- Scared and anxious
- Worried about baby
- Frustrated by restrictions
- Guilty (you didn’t cause this!)
- Stressed about early delivery
- Loss of control
Coping strategies:
- Ask questions – understanding helps
- Connect with others who’ve experienced it
- Accept help from family and friends
- Focus on what you can control (rest, appointments)
- Talk to counselor if needed
Practical Tips
If on modified activity:
- Ask for help with chores, older children
- Keep phone charged and nearby
- Hospital bag packed early
- Meal prep or accept meal train
- Entertainment for resting (books, shows)
Frequent appointments:
- Arrange childcare if needed
- Take time off work (your health matters!)
- Keep appointment log
- Bring list of questions
- Bring support person
Remember
Pre-eclampsia is serious, but with close monitoring and appropriate treatment, most mothers and babies do well.
Your body is giving you warning signs. Listen to them.
Never hesitate to call your doctor if something feels wrong.
Attending every prenatal appointment is crucial – silent signs are detected there.
You’re not overreacting. Pre-eclampsia requires immediate attention.
Trust your instincts. Advocate for yourself. Your life and your baby’s life matter.