Preeclampsia: Symptoms, Causes And Treatment

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Preeclampsia in pregnancy is a condition characterized by high blood pressure and high protein in the urine during pregnancy or right after delivery. It usually develops after 20 weeks of pregnancy. Occasionally, preeclampsia may even develop in the first six weeks of postpartum. Early-onset preeclampsia may occur before 34 weeks of pregnancy and is often accompanied by severe symptoms.

Preeclampsia can occur in pregnant women with existing chronic hypertension or previously normal blood pressure. The US Centers for Disease Control and Prevention (CDC) reports that the condition affects one in 25 women (1). The disorder affects the woman’s organs and risks the unborn baby’s health.

Learn more about the symptoms of preeclampsia in pregnancy, its causes, risk factors, prevention, diagnosis, and treatment.

Signs And Symptoms Of Preeclampsia

The early symptoms and signs of preeclampsia may include (2):

• Hypertension (high blood pressure)
• Proteinuria (proteins in the urine)

High blood pressure alone cannot suggest preeclampsia, and this may indicate other problems. A combination of these symptoms suggests the presence of preeclampsia. Pregnant mothers do not often notice these symptoms and are often identified during medical checkups in routine antenatal care (prenatal) visits.

Pregnant mothers may experience the following symptoms as the preeclampsia progresses (2).

• Severe headaches

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• Nausea and vomiting
• Vision issues such as seeing flashing lights or blurred vision
• Pain below ribs
• Weight gain due to fluid retention
• Sudden edema (swelling) on face, hands, legs, and feet
• Decreased urination

It is recommended to contact your doctor right away if you notice any of these symptoms rather than waiting for the next prenatal visit.

Things to know

Some other symptoms of preeclampsia are right-side abdominal pain, shoulder pain, and shortness of breath (3).

Risk Factors And Causes Of Preeclampsia

The exact causes of preeclampsia are not identified in many cases. However, placental problems are often associated with the development of preeclampsia in many women. This can also be due to poor development of placental blood vessels in women with preeclampsia in early pregnancy (3).

The following conditions or factors may increase the risk of developing preeclampsia (3) (4).

• Maternal age less than 20 or more than 40
• History of chronic hypertension
• History of preeclampsia in previous pregnancies
• Expecting the first baby
• Overweight or obese

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• Positive family history of preeclampsia and chronic hypertension
• Kidney diseases
• Diabetes
• Multiple gestations
• Immune system disorders such as rheumatoid arthritisⁱA chronic autoimmune inflammatory condition characterized by swelling, stiffness, and pain in the joints. and lupusⁱAn autoimmune condition affecting multiple organs, including the muscular and nervous systems.
• In vitro fertilization
• Short or long intervals between pregnancies, such as having babies with less than a two-year gap or more than a ten-year gap
• New paternity may increase the risk of preeclampsia than next pregnancies with the same partner

Complications Of Preeclampsia

Pregnant mothers with uncontrolled preeclampsia are at higher risk of complications. Some of the complications are medical emergencies since, if left untreated, it can be life-threatening for both the mother and the unborn baby. Indeed, the Centers for Disease Control and Prevention revealed approximately 0.9 fatalities per 100,000 live births as a consequence of eclampsia and preeclampsia. You may seek emergency medical care if you notice any complications of preeclampsia at any time during the pregnancy.

Possible complications of preeclampsia may include (4):

• Intrauterine growth restriction (IUGR): Preeclampsia may reduce the blood flow in placental blood vessels. This may lead to inadequate delivery of oxygen and nutrients to the fetus, causing slow growth and low birth weight.

• Premature birth: Severe preeclampsia can be harmful to both mother and baby and often require early delivery by C-section or preterm labor induction. Doctors may give certain medications to enhance the baby’s lung maturity and plan the delivery based on the maternal health status and the baby’s condition. Cara Jane, a mother, shares her experience with preeclampsia and having a premature birth. She says, “I had an emergency C-section at 33 weeks. I went for a regular appointment where the nurse checked my blood pressure twice, and it came higher than usual. The nurse suggested I should go to the hospital and talked about inducing labor (i). Jane had her baby delivered by a C-section.”

• HELLP syndrome: This syndrome includes hemolysis (destruction of erythrocytes or red blood cells), low platelet count, and increased liver enzyme levels in the body. Headaches, nausea, vomiting, and upper right abdomen pain are symptoms of HELLP, and it indicates multiorgan damage. HELLP syndrome is the most severe form of preeclampsia, leading to life-threatening risks to the mother and the baby. This can have sudden onset even before the onset of symptoms or before detecting high blood pressure.

• Placental abruption: This is a condition where the placenta separates from the uterine wall before delivery. Severe abruption can be life-threatening to the mother due to heavy bleeding and the baby due to inadequate or lack of blood supply.

• Eclampsia: Preeclampsia with seizures (convulsions) is called eclampsia, and it is a medical emergency. This is usually when the preeclampsia is uncontrolled. There are no warning signs or symptoms to predict the risk of eclampsia, and this may pose serious health risks to maternal and fetal health.

• Multiorgan damage: Preeclampsia can cause maternal morbidity by damaging vital organs such as the kidneys, lungs, liver, heart, and eyes in the mother. This can also increase the risk of strokes that may result in brain injury. The severity of organ damage may depend on the severity of preeclampsia.

• Cardiovascular diseases: Preeclampsia may increase the risk of cardiovascular diseases in the future. The risk can be higher for mothers who had preeclampsia in more than one pregnancy and had a preterm delivery. However, maintaining weight, following a healthy diet, avoiding smoking, and regular exercise throughout life can minimize the risk.

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The severity and risks of preeclampsia can be higher if it occurs in early pregnancy. In some cases, an early delivery through cesarean section (C-section) is recommended to avoid severe obstetric complications.

Prevention Of Preeclampsia

There are no clear strategies to prevent preeclampsia. However, trying to be healthy, such as keeping weight in the normal range, and managing chronic conditions, such as hypertension or diabetes, can be helpful to reduce the risk of preeclampsia, especially if you had it before. Seeking regular prenatal care can help to limit complications if you are already pregnant.

The following medications may reduce the risk of preeclampsia in some women (4):

• Low-dose aspirin: Daily low-dose aspirin can be prescribed for pregnant women with certain risk factors for preeclampsia from 12 weeks of pregnancy. Usually, aspirin is prescribed for women with risk factors such as kidney diseases, chronic hypertension, autoimmune diseasesi, diabetes, multiple pregnancies, and a history of preeclampsia.

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• Calcium supplements: Women with calcium deficiency before or during pregnancy may benefit from calcium supplements to prevent preeclampsia. Calcium deficiency is less common in the US and many other developed countries.

Restricting calories, reducing salt consumption, and consuming fish oil or garlic are not scientifically proven to prevent preeclampsia. Vitamin C and E intake are also not shown to have many benefits in preeclampsia prevention. Although some studies show that vitamin D is beneficial to lower preeclampsia risks, others fail to establish the link. So you may inform your doctor before taking any medications or supplements.

Quick fact

Some studies found that for women with normal blood pressure, ample and regular rest, with or without nutritional supplements, may help prevent preeclampsia. However, more research is required to confirm the finding (6).

Diagnosis Of Preeclampsia

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Blood pressure measurements and urine tests can help determine preeclampsia. If these test results indicate the presence of preeclampsia, doctors may order liver and kidney function tests and platelet measurements through blood tests.

In later stages, fetal ultrasound and biophysical profileⁱTests performed to evaluate the health status of the fetus, including fetal muscle tone, heart rate, and amounts of amniotic fluid. help determine the unborn baby’s health. Prenatal ultrasounds may also help to identify placental abnormalities and growth restrictions due to preeclampsia (5).

Treatment For Preeclampsia

The most effective treatment for preeclampsia is delivery. Hospitalization is needed for preeclampsia with severe features. Delivery is recommended as early as possible. However, you may wait for delivery if the condition is stable. Delaying delivery allows time to give corticosteroids to enhance fetal lung maturity.

In addition, mothers may receive antihypertensive medications to decrease blood pressure and anticonvulsants to prevent seizures. However, if the condition is not stable, immediate delivery is recommended (5). If the benefits outweigh the risks, doctors may recommend an early delivery by labor induction with medications or cesarean section to prevent life-threatening complications in both mother and baby. This decision may be crucial to reduce maternal mortality and fetal mortality.

Infographic: Risk Factors Associated With Preeclampsia In Pregnancy

Preeclampsia is a significant pregnancy-related complication that can affect the mother and the baby. However, understanding the risk factors can help in early diagnosis and management of the condition. Explore the following infographic to learn about factors that increase the likelihood of developing preeclampsia.

Illustration: Momjunction Design Team

Image: Dall·E/MomJunction Design Team

Preeclampsia is a serious life-threatening condition that can affect pregnant women. Learn how to recognize the signs and manage them during pregnancy. Also, learn the importance of follow-up care in this informative video.

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Dr. Swati ChitnisMS, DNB

Dr. Swati Chitnis is a gynecologist and endoscopic surgeon with over 8 years of experience. She did her bachelor in medicine at BJ Medical College & Sassoon Hospital, Pune, India  and MS at the prestigious King Edward Memorial Hospital, Mumbai.

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Dr Bisny T. JosephMedical Doctor

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has around 5 years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert.

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction.

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