What is preeclampsia?

Preeclampsia is a condition that causes high blood pressure during pregnancy or after childbirth. It can also lead to high levels of protein in the urine and damage organs throughout the body, including the kidneys, liver, heart and brain. The condition occurs after 20 weeks of pregnancy and, less frequently, in the days and weeks after delivery—known as postpartum preeclampsia.

How common is preeclampsia?

Preeclampsia affects up to 5 to 8% of pregnant women and is a serious and potentially life-threatening condition that increases the risk for other pregnancy complications. It’s also the cause of about 15% of premature deliveries (delivery before 37 weeks of pregnancy) in the US.

However, keeping up with your prenatal care appointments allows your obstetrician-gynecologist (OBGYN) to help you prevent preeclampsia or identify the symptoms and signs of preeclampsia early so you can be monitored and treated.

Doctor measuring blood pressure of a smiling woman

Preeclampsia symptoms

Many people with preeclampsia may not notice any signs or symptoms until a healthcare provider visit. For those who do experience symptoms, early indicators of preeclampsia can include high blood pressure, protein in the urine and water retention, which may lead to weight gain and swelling.

Other symptoms of preeclampsia may include:

  • Headaches
  • Blurry vision or sensitivity to light
  • Dark spots in your vision
  • Upper right side abdominal pain
  • Swelling in your hands, ankles and face (edema)
  • Shortness of breath

Often, preeclampsia is detected when your healthcare provider checks your blood pressure and urine during a prenatal appointment. It's crucial to inform your healthcare provider of any symptoms you’re experiencing.

Severe preeclampsia may present with additional signs such as:

  • Hypertensive emergency (blood pressure of 160/110 mmHg or higher)
  • Reduced kidney or liver function
  • Fluid in the lungs (pulmonary edema)
  • Low blood platelet levels (thrombocytopenia)
  • Decreased urine output

If preeclampsia is severe, your healthcare provider may admit you to the hospital for closer monitoring, and in some cases, early delivery of your baby may be necessary.

When to see a doctor

Call your OBGYN whenever you experience concerning symptoms. They can help you identify if your symptoms are related to preeclampsia or another issue.

Seek emergency care immediately if you experience any of the following:

  • A seizure or stroke-like symptoms (which indicate progression from preeclampsia to eclampsia, a condition that can cause seizures or a stroke)
  • A severe headache
  • High blood pressure of 160/110
  • Severe difficulty breathing
  • Severe pain in your belly
  • Sudden swelling of your face or hands
  • Vision changes

What causes preeclampsia?

The exact cause of preeclampsia likely involves multiple factors, with experts believing it begins in the placenta, the organ that nourishes the baby during pregnancy.

Normally, new blood vessels form early in pregnancy to supply oxygen and nutrients to the placenta. However, these blood vessels don't develop or function properly in preeclampsia. This poor blood circulation in the placenta may contribute to poor regulation of the mother's blood pressure.

Risk factors for preeclampsia

The risk of developing preeclampsia is typically divided into moderate and high risk.

Moderate risk factors include:

  • Becoming pregnant more than 10 years after your first pregnancy
  • Being age 35 or older
  • Race/ethnicity (Black/African American women are at higher risk)
  • A first pregnancy
  • Having a mother or sister who had preeclampsia
  • Having limited financial resources
  • Having obesity
  • A history of pregnancy complications, such as low birth weight babies
  • In vitro fertilization (IVF)

Factors that may put you at high risk for preeclampsia are:

  • Previous preeclampsia
  • Multiple pregnancy (twins, triplets or more)
  • Chronic high blood pressure (hypertension)
  • Pre-existing Type 1 or Type 2 diabetes
  • Kidney disease
  • Autoimmune disorders such as lupus

Complications

Most women with preeclampsia will have a safe delivery and recover well. However, if preeclampsia goes unrecognized, it can progress quickly and increase the risk of serious complications, which include:

  • Fetal growth restriction: Reduced blood flow to the placenta can limit the baby's oxygen and nutrients, leading to slow growth.
  • Preterm birth: Preeclampsia may require early delivery, increasing risks of breathing issues, developmental delays and cerebral palsy.
  • Placental abruption: Increased risk of the placenta detaching from the uterus, causing severe bleeding.
  • HELLP Syndrome: A severe form of preeclampsia causing hemolysis (breakdown of red blood cells), liver damage and low platelet count, with symptoms like nausea, headache and abdominal pain.
  • Eclampsia: Seizures or coma related to preeclampsia, often without warning signs.
  • Organ damage: Potential damage to kidneys, liver, lungs, heart or eyes, and risk of stroke or brain injury.
  • Cardiovascular disease: Increased future risk of heart disease, especially after repeated preeclampsia or preterm delivery.

How is preeclampsia diagnosed?

Preeclampsia is typically diagnosed by your OBGYN, who will take your blood pressure, ask about your symptoms and perform a physical exam and tests. Tests may include blood and urine analysis, as well as monitoring your baby’s health.

Blood pressure

Your OBGYN will take your blood pressure during each office visit. If you are 20 or more weeks pregnant and your blood pressure is higher than 140/90, your OBGYN will typically repeat the measurement after a short period (often 15 minutes to a few hours), ideally while you are seated or resting. If your reading is still high, your doctor may order additional tests to confirm a diagnosis.

Preeclampsia treatment

The main treatment for preeclampsia involves either delivering the baby or managing the condition until the best time for delivery. The decision will be based on the severity of preeclampsia, your baby's gestational age and your overall health and that of your baby.

If preeclampsia is not severe, you may visit your OBGYN frequently to monitor your blood pressure, any changes in symptoms and your baby's health. You'll likely be asked to monitor your blood pressure daily at home.

How can you prevent preeclampsia?

You may not be able to prevent preeclampsia. However, if you have at least one high-risk factor or two or more moderate-risk factors, your OBGYN may recommend taking a daily low-dose aspirin. Do not start aspirin therapy on your own before talking with your doctor.

If you have a risk factor for preeclampsia, there are several steps you can take before and during pregnancy to reduce your risk. These include:

  • Losing weight if you have obesity (before gaining weight during pregnancy)
  • Managing blood pressure and blood sugar if you had high blood pressure or diabetes before pregnancy
  • Maintaining a regular exercise routine
  • Getting adequate sleep
  • Eating a balanced diet low in salt and avoiding caffeine
pregnant mother and her daughter

Find specialized care for preeclampsia

Our maternal-fetal medicine specialists offer compassionate care for preeclampsia and other pregnancy complications that can lead to high-risk pregnancies. We offer several locations, including specialized high-risk pregnancy centers in North and Central Texas, and can help you get care at a location that fits your needs.

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