Preeclampsia During Pregnancy: Symptoms, Risks, Diagnosis, and Treatment

Preeclampsia is a serious high-blood-pressure disorder that usually develops after 20 weeks of pregnancy. It can affect the placenta and organs such as the kidneys, liver, brain, lungs, and blood-clotting system.

Some pregnant people develop severe headaches, visual changes, upper-abdominal pain, sudden swelling, nausea, or breathing difficulty. Others have no noticeable symptoms and are diagnosed during routine blood-pressure, urine, or laboratory checks.

Early recognition and appropriate medical management are essential because preeclampsia can progress to serious complications for both the pregnant person and the baby.

Quick Answer: What Is Preeclampsia?

Preeclampsia is a pregnancy-related condition involving new high blood pressure, usually after 20 weeks, together with signs that another organ or body system may be affected. It can also develop after childbirth. Diagnosis requires professional assessment and cannot be made from symptoms alone.

What Is Preeclampsia?

Preeclampsia is a pregnancy-related hypertensive disorder. It usually involves new high blood pressure after 20 weeks of pregnancy together with protein in the urine or other evidence that the kidneys, liver, brain, lungs, blood, or placenta may be affected.

Protein in the urine is a common finding, but it is not required in every case. A healthcare professional may diagnose preeclampsia when high blood pressure occurs with other significant clinical or laboratory abnormalities.

Preeclampsia can range from a condition requiring close outpatient monitoring to a rapidly progressing medical emergency requiring hospitalization and delivery.

It is not possible to determine severity from swelling or headache alone. Diagnosis requires blood-pressure measurements and a professional medical evaluation.

People with diabetes during pregnancy may have an increased risk of hypertensive complications. Learn more in our guide to gestational diabetes symptoms, testing, and treatment .

Types of High Blood Pressure During Pregnancy

High blood pressure in pregnancy can be classified into several categories. The timing, laboratory findings, symptoms, and medical history help the healthcare team determine which condition is present.

These conditions may overlap or evolve. Gestational hypertension, for example, can later progress to preeclampsia.

When Can Preeclampsia Develop?

Preeclampsia most often develops after 20 weeks of pregnancy and is more frequently diagnosed during the third trimester.

Earlier-onset disease may be associated with greater risks because the pregnancy is farther from full term and the placenta may be significantly affected.

Preeclampsia can also appear for the first time after delivery. A person should therefore continue watching for warning signs even after leaving the hospital or birth center.

Review how fetal growth and organ maturation change throughout pregnancy in our fetal development week-by-week guide .

What Are the Symptoms of Preeclampsia?

Preeclampsia may cause no obvious symptoms. High blood pressure and protein in the urine are often detected during routine prenatal appointments before the pregnant person feels unwell.

Possible warning symptoms include:

• A severe headache that does not improve
• Blurred vision
• Flashing lights, spots, or other visual disturbances
• Pain in the upper abdomen or beneath the ribs
• Nausea or vomiting later in pregnancy
• Sudden or rapidly increasing swelling of the face or hands
• Rapid unexplained weight gain caused by fluid retention
• Shortness of breath
• Chest discomfort
• Feeling significantly or suddenly unwell
• Reduced urine output

Some symptoms of preeclampsia may resemble ordinary pregnancy discomforts. Compare common symptoms and important warning signs in our guide to common pregnancy discomforts and relief measures .

Who Is at Increased Risk of Preeclampsia?

Preeclampsia can affect someone without an obvious risk factor. However, the likelihood may be higher when one or more of the following factors are present:

• Preeclampsia during a previous pregnancy
• Chronic high blood pressure
• Chronic kidney disease
• Type 1 or type 2 diabetes
• Pregnancy involving twins, triplets, or other multiples
• Autoimmune conditions such as lupus
• Antiphospholipid syndrome
• A first pregnancy
• A family history of preeclampsia
• Pregnancy achieved through in vitro fertilization
• A higher pre-pregnancy BMI
• Older maternal age
• A long interval between pregnancies
• Selected placental or fetal conditions

Risk factors do not determine an individual outcome. A person with several risk factors may never develop the condition, while someone without a recognized risk factor may still be diagnosed.

Pregnancy weight should be discussed without blame or stigma. Read our article about healthy weight gain during pregnancy .

What Causes Preeclampsia?

The exact cause is complex and is not completely explained by one mechanism. Preeclampsia is strongly connected with the development and function of the placenta.

Abnormal placental blood-vessel development and changes in maternal blood-vessel function may reduce blood flow through the placenta and trigger widespread inflammation and vascular dysfunction.

This process may contribute to high blood pressure and affect the kidneys, liver, brain, lungs, blood-clotting system, and other organs.

Preeclampsia is not caused by stress, one salty meal, one food choice, exercising incorrectly, or something the pregnant person intentionally did.

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How Is Preeclampsia Diagnosed?

Preeclampsia is diagnosed through a combination of blood-pressure measurements, symptoms, medical history, physical assessment, urine testing, blood tests, and evaluation of the pregnancy.

Blood-pressure measurement

A diagnosis is not normally based on a single routine reading. The healthcare team considers repeated measurements, how the pressure was taken, gestational age, symptoms, and whether the blood pressure reaches a severe range.

Blood pressure is recorded using two numbers:

• Systolic pressure: the upper number, representing pressure when the heart contracts.
• Diastolic pressure: the lower number, representing pressure while the heart relaxes.

A reading in the severe range requires rapid professional evaluation and should not be repeatedly monitored at home without contacting the maternity team.

Urine testing

Urine may be tested for protein. This can involve a dipstick, a protein-to-creatinine ratio, or a timed urine collection.

Proteinuria may indicate that the kidneys are affected, but the absence of protein does not always exclude preeclampsia when other severe findings are present.

Blood tests

Blood tests may assess:

• Platelet levels
• Liver enzymes
• Kidney function
• Hemoglobin and other blood-cell measurements
• Signs of hemolysis or altered clotting

Fetal and placental assessment

Assessment may include:

• Ultrasound evaluation of fetal growth
• Amniotic-fluid measurement
• Umbilical or placental blood-flow studies when indicated
• Fetal heart-rate monitoring
• Maternal awareness of fetal movement

Not every patient requires every test. Monitoring is individualized according to gestational age, severity, symptoms, laboratory results, fetal condition, and available healthcare resources.

What Does “Preeclampsia With Severe Features” Mean?

Severe features indicate a greater risk of rapid deterioration or serious complications and often require hospital assessment or inpatient care.

Severe features may include:

• Blood pressure reaching a severe range
• Persistent severe headache
• Visual disturbances
• Severe upper-abdominal or right-sided pain
• Abnormal liver tests
• Low platelet levels
• Worsening kidney function
• Fluid in the lungs or breathing difficulty
• Neurological symptoms

Severe-range hypertension is generally considered a systolic pressure of at least 160 mm Hg or a diastolic pressure of at least 110 mm Hg. A reading in this range needs urgent medical attention.

How Can Preeclampsia Affect Maternal Health?

Preeclampsia can affect several organs and may progress unpredictably.

Possible complications include:

• Eclampsia, which involves seizures
• Stroke
• Placental abruption
• Liver injury
• Kidney injury
• Low platelet levels
• Abnormal blood clotting
• Fluid accumulation in the lungs
• HELLP syndrome
• Emergency delivery
• Admission to intensive or high-dependency care

What is eclampsia?

Eclampsia is the occurrence of a seizure associated with preeclampsia when another neurological cause does not better explain it. It is a medical emergency.

A person experiencing a seizure needs immediate emergency care. Do not place anything in the person’s mouth and do not physically restrain the movements.

What is HELLP syndrome?

HELLP refers to a serious combination of red-blood-cell breakdown, elevated liver enzymes, and low platelet levels.

Symptoms may include severe upper-abdominal pain, nausea, vomiting, headache, fatigue, or feeling very unwell. Diagnosis requires blood testing and urgent medical assessment.

How Can Preeclampsia Affect the Baby?

Preeclampsia may affect how well the placenta supplies oxygen and nutrients to the fetus.

Possible concerns include:

• Restricted fetal growth
• Reduced placental blood flow
• Low amniotic-fluid volume
• Abnormal fetal monitoring
• Placental abruption
• Preterm birth
• Low birth weight
• Admission to neonatal care
• Pregnancy loss in severe cases

Delivery may be recommended before full term when continuing the pregnancy presents greater risks than early birth.

When an infant is born early or requires additional support, newborn monitoring may be more intensive. Review our newborn care and warning-sign guide .

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How Is a Pregnancy With Preeclampsia Monitored?

Monitoring depends on the severity of the condition, gestational age, blood-pressure pattern, laboratory results, symptoms, fetal growth, and access to hospital care.

Maternal monitoring may include:

• Repeated blood-pressure measurements
• Review of headaches, visual symptoms, pain, swelling, and breathing
• Urine testing
• Blood tests for platelets, liver function, and kidney function
• Monitoring fluid balance and urine output
• Assessment for signs of disease progression

Fetal monitoring may include:

• Ultrasound growth measurements
• Assessment of amniotic fluid
• Fetal heart-rate testing
• Umbilical-artery Doppler studies when indicated
• Monitoring the baby’s usual movement pattern

Some patients can be monitored as outpatients, while others need hospital admission. Never change the monitoring plan or skip appointments because symptoms temporarily improve.

How Is Preeclampsia Treated?

The treatment plan aims to prevent severe maternal complications, monitor fetal health, control dangerous blood pressure, and determine the safest timing of birth.

Management may include:

• Frequent prenatal assessment
• Hospital admission
• Blood-pressure medication
• Magnesium sulfate when indicated to reduce seizure risk
• Corticosteroid medication when early delivery is expected and fetal benefit is likely
• Maternal blood and urine tests
• Fetal surveillance
• Planning induction or cesarean birth

Blood-pressure medication

Antihypertensive medicines may be prescribed when blood pressure reaches a level that requires treatment. The medication and route depend on urgency, gestational age, medical history, and local protocols.

Do not take someone else’s blood-pressure medicine or alter a prescribed dose without professional instructions.

Magnesium sulfate

Magnesium sulfate may be administered in hospital to reduce the risk of seizures in selected patients with severe preeclampsia or to treat eclampsia.

It is not primarily a routine blood-pressure medication. Patients receiving magnesium require clinical monitoring.

Is bed rest a treatment?

Strict bed rest is not a universal treatment for preeclampsia and may create additional risks, including blood clots and physical deconditioning.

Activity recommendations should come from the maternity team and be based on the individual clinical situation.

Can Preeclampsia Be Prevented?

There is no method that prevents every case. Prenatal care helps identify risk factors and detect changes early.

Low-dose aspirin may be recommended for selected people at increased risk. It should be started and dosed only according to a qualified healthcare professional’s instructions.

Do not self-prescribe aspirin during pregnancy. Aspirin may be unsuitable in some circumstances, and the appropriate timing and dose depend on the individual.

Helpful general measures include:

• Attending all prenatal appointments
• Managing chronic hypertension with professional care
• Managing diabetes and kidney disease
• Taking prescribed medicines correctly
• Reporting severe or unusual symptoms promptly
• Following individualized nutrition and activity advice

A balanced diet supports general pregnancy health but cannot guarantee that preeclampsia will be prevented. Review our pregnancy nutrition guide .

How Does Preeclampsia Affect Delivery Planning?

Delivery of the placenta is the definitive step that stops the pregnancy-related process, but the safest delivery timing depends on balancing maternal and fetal risks.

The maternity team considers:

• Gestational age
• Severity and control of blood pressure
• Headache, vision, breathing, and abdominal symptoms
• Platelet, liver, and kidney results
• Fetal growth
• Amniotic-fluid level
• Fetal heart-rate assessment
• Cervical readiness
• Previous birth history
• Availability of neonatal care

Preeclampsia does not automatically require a cesarean birth. Labor may be induced when vaginal birth is appropriate, but cesarean delivery may be required for obstetric or urgent maternal-fetal reasons.

Learn how contractions, cervical changes, and rupture of the membranes may present in our article about signs of labor and when to seek maternity care .

What Is Postpartum Preeclampsia?

Postpartum preeclampsia is preeclampsia that develops or remains after childbirth. It can occur even when blood pressure was normal during pregnancy.

Possible postpartum symptoms include:

• A severe or worsening headache
• Blurred vision or flashing lights
• Upper-abdominal pain
• Nausea or vomiting
• Sudden swelling of the face or hands
• Shortness of breath
• Chest pain
• High blood-pressure readings
• Confusion or seizure

Learn more about bleeding, wound healing, blood clots, mental health, high blood pressure, and other postpartum warning signs in our postpartum recovery guide .

Future Health After Preeclampsia

A history of preeclampsia remains an important part of a person’s medical history after pregnancy.

People who have experienced preeclampsia may have a greater future risk of:

• High blood pressure
• Preeclampsia in another pregnancy
• Heart disease
• Stroke
• Other cardiovascular or metabolic conditions

Follow-up may include blood-pressure monitoring, cardiovascular risk assessment, primary-care review, and planning before another pregnancy.

Inform future physicians, midwives, and other healthcare professionals about the history of preeclampsia, especially when planning pregnancy or receiving cardiovascular care.

Preeclampsia Emergency Warning Signs

Contact your maternity unit, obstetric professional, emergency department, or local emergency service according to symptom severity.

Do not drive yourself when you are faint, confused, having visual symptoms, experiencing a seizure, or severely unwell. Call emergency services and follow the dispatcher’s instructions.

Preeclampsia at a Glance

Frequently Asked Questions

What is preeclampsia in pregnancy?

Preeclampsia is a high-blood-pressure disorder that usually develops after 20 weeks of pregnancy and is associated with protein in the urine or evidence that an organ or body system is affected.

What are the first signs of preeclampsia?

The earliest findings are often high blood pressure and protein in the urine detected at a prenatal appointment. A person may initially have no symptoms.

What symptoms require urgent assessment?

Severe persistent headache, visual disturbances, intense upper-abdominal pain, sudden facial or hand swelling, severe breathing difficulty, chest pain, severe-range blood pressure, confusion, fainting, or seizure require urgent care.

Can preeclampsia occur without protein in the urine?

Yes. Preeclampsia may be diagnosed when new high blood pressure occurs with other significant findings, such as low platelets, impaired liver or kidney function, neurological symptoms, or fluid in the lungs.

Is swelling always a sign of preeclampsia?

No. Gradual ankle and foot swelling is common during pregnancy. Sudden swelling of the face or hands is more concerning when it occurs with headache, visual changes, upper-abdominal pain, high blood pressure, or feeling unwell.

Can preeclampsia develop after childbirth?

Yes. Postpartum preeclampsia may occur after delivery, including in someone who had normal blood pressure during pregnancy. Postpartum headaches, vision changes, upper-abdominal pain, swelling, or breathing difficulty need prompt assessment.

Does preeclampsia always require immediate delivery?

Not always. Delivery timing depends on gestational age, severity, blood pressure, symptoms, laboratory results, fetal growth, and fetal well-being. Severe or worsening disease may require urgent delivery.

Does preeclampsia require a cesarean birth?

No. Some people can have an induced vaginal birth. Cesarean delivery may be needed when labor is unsuitable, the baby is not tolerating the pregnancy or labor, or urgent maternal or fetal concerns occur.

Can low-dose aspirin prevent preeclampsia?

Low-dose aspirin can reduce risk for selected pregnant people with important risk factors. It should only be taken when recommended by a qualified healthcare professional.

Can preeclampsia affect future health?

Yes. A history of preeclampsia is associated with increased future risks of hypertension, cardiovascular disease, stroke, and preeclampsia in another pregnancy. Long-term primary-care follow-up is important.

Final Thoughts

Preeclampsia is a potentially serious pregnancy and postpartum condition, but early detection and appropriate care can reduce the risk of severe complications.

Attend prenatal appointments even when you feel well. Blood-pressure, urine, blood, fetal-growth, and symptom assessments can identify changes that are not immediately noticeable.

Never ignore a severe or persistent headache, visual changes, upper-abdominal pain, sudden swelling, difficulty breathing, severe-range blood pressure, or a significant change in fetal movement.

Continue Reading

Explore these related pregnancy, maternal, postpartum, and newborn guides:

• Gestational Diabetes: Symptoms, Testing, Diet, and Treatment
• Common Pregnancy Discomforts: Relief Tips and Warning Signs
• Healthy Weight Gain During Pregnancy: Recommendations by BMI
• Pregnancy Nutrition Guide: Essential Nutrients for Mother and Baby
• Fetal Development Week by Week: Pregnancy Milestones Explained
• Signs of Labor: True Labor, False Labor, and When to Seek Care
• Postpartum Recovery Guide: What to Expect After Giving Birth
• Newborn Care Guide: Feeding, Sleep, Diapers, Bathing, and Warning Signs
• Breastfeeding Guide for New Mothers: Latch, Milk Supply, and Common Problems
• Early Signs of Pregnancy: Symptoms, Testing, and When to Seek Care

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