Preeclampsia – what it is and how it’s treated

Preeclampsia is a condition that can happen during pregnancy, which needs to be diagnosed as early as possible.

The condition is thought to be caused by a problem with the placenta – which links your blood supply to your baby’s. It develops usually from 20 weeks of pregnancy.

If left untreated, preeclampsia can harm your baby’s growth and development, increasing the chances of an early (premature) birth and health problems afterward. It also raises the risk of stillbirth.

Treatment will depend on whether your condition is mild or severe, and you’ll have frequent scans, checks and tests throughout your pregnancy.

In most cases, you’ll need to have your baby early – usually a few weeks before your due date.

What are the symptoms?

The most common early signs of preeclampsia are high blood pressure and protein in your pee (proteinuria).

You won’t usually notice these symptoms, but your healthcare provider will check for them at your routine prenatal appointments.

Preeclampsia affects the rate at which your baby will grow, which can also be picked up when you’re measured at prenatal appointments.

Other symptoms of preeclampsia can include:

• a persistent, bad headache
• vision changes – like blurred vision, seeing spots or flashing lights
• pain just below your ribs, in your upper belly
• nausea or vomiting
• sudden swelling of face, hands or feet (edema)
• sudden weight gain
• shortness of breath.

If you notice any symptoms of preeclampsia, see your doctor – don’t wait for your next prenatal appointment.

If preeclampsia isn’t diagnosed and managed, in rare cases it can lead to serious health problems, including:

• fits (seizures) – called eclampsia
• HELLP syndrome – a liver and blood-clotting disorder
• stroke
• organ damage – such as liver or kidney failure.

What causes preeclampsia and who can be affected?

We don’t understand exactly why preeclampsia happens, but experts think it’s when the placenta doesn’t develop properly because of a problem with the blood vessels that connect to it.

This affects blood supply, meaning your baby gets less oxygen and nutrients than it should, which can affect growth.

Some things can increase your chances of developing preeclampsia including having health conditions such as diabetes, high blood pressure, kidney disease, and lupus.

If you’ve had preeclampsia in a previous pregnancy, your risk of having it again is also raised. Other factors that mean you have a smaller increased risk include:

• a family history of preeclampsia
• being over the age of 40
• obesity
• being pregnant with more than 1 baby
• having a big gap – more than 10 years – between pregnancies
• becoming pregnant by in vitro fertilization (IVF).

Seeing a doctor and getting diagnosed

Preeclampsia is usually diagnosed in the second half of pregnancy – from 20 weeks.

As the condition doesn’t usually cause noticeable symptoms at first, it’s important to attend all your prenatal appointments.

If you have symptoms of preeclampsia, or any concerns about your pregnancy, see your doctor or maternity healthcare provider immediately.

Your healthcare provider will check for early signs of preeclampsia by measuring your blood pressure and testing your pee for protein.

If they think you might have preeclampsia, you may have blood tests to confirm this.

Other tests can include an ultrasound scan to assess the growth, development, and health of your baby. You may also be referred to a specialist for assessment and/or treatment.

How is preeclampsia treated?

Being diagnosed with preeclampsia can be worrying, but most cases are mild, and you’ll be closely monitored for the rest of your pregnancy to limit the risk of complications.

This monitoring can include frequent:

• ultrasound scans
• blood pressure checks
• blood tests

In some cases you may also need:

• blood pressure medication – to control or lower blood pressure
• anticonvulsant medication – to prevent seizures
• steroid medication – to help your baby’s lung development.

You may be advised to keep an eye on your baby’s movement with ‘kick counts’ – counting the number of times you feel your baby move and recording this daily, so you know what’s normal activity for you. If you notice your baby’s kicks or movement slow down or stop, contact your maternity healthcare provider immediately.

Preeclampsia won’t go away until you give birth. In most cases, you’ll be advised to have your baby earlier than your due date – usually around 37 weeks – to reduce the risk of complications for you and your baby.

Labor may be started artificially (induced), or you may have a cesarean section.

If preeclampsia is severe, you may need to have your baby before 37 weeks. You may be admitted to hospital to be monitored and treated until you give birth.

Once you have your baby, preeclampsia should go away. You may need to stay in hospital for checks for several days, and continue to be monitored for a while after you go home.

Prevention tips

There are things you can do to reduce your risk of preeclampsia – before and after getting pregnant.

These include:

• taking daily aspirin – if your doctor thinks you’re at risk of preeclampsia, they may recommend taking a low dose (75-150mg) every day once you reach 12 weeks of pregnancy
• losing some weight if you have obesity – safely and sensibly, and ideally before getting pregnant
• managing or reducing your blood pressure and/or blood sugar
• following a healthy lifestyle, with plenty of sleep, exercise, and healthy foods
• reducing your salt intake
• avoiding caffeine.

Where to get support

Support organizations can offer information on everything from managing your condition to making better lifestyle choices, including:

• Action On Pre-Eclampsia (UK): action-on-pre-eclampsia.org.uk

• Preeclampsia Foundation (US): www.preeclampsia.org

• Heart Foundation (Australia): www.heartfoundation.org.au