What is Preeclampsia—and How Is It Treated?

Learn how to recognize common signs of this serious pregnancy complication.

Someone with a clipboard takes notes while two other people speak to them about preeclampsia.

Updated on September 20, 2023.

If you’re pregnant, you may notice that every time you have a prenatal appointment, your health care provider (HCP) will check both your blood pressure and your urine. There’s a good reason for this: They’re looking for signs of preeclampsia, a pregnancy complication that can have serious long-term health effects for both the parent and the fetus.

The condition, which affects around 3.4 percent of pregnancies in the United States, is mainly characterized by higher-than-normal blood pressure during pregnancy or after giving birth; it also can involve elevated levels of protein in urine and a decrease in blood platelets.

Preeclampsia most often occurs after 20 weeks of pregnancy, about halfway through the second trimester. Without proper medical attention, it can lead to serious outcomes, increasing a pregnant person’s risk of organ damage and seizures, and potentially leading to stillbirth.

Preeclampsia can also set in after the parent has delivered the baby—this is known as postpartum preeclampsia, and it usually happens within 48 hours of delivery, though it can take a few weeks to appear. We spoke with Jennifer Guggenheim, MD, an OBGYN with Presbyterian/St. Luke's Medical Center in Denver, CO, to learn more about preeclampsia's signs, risks and causes, as well as the treatment options that can lead to a safe delivery and healthy parent and baby.

Spot the signs

One reason it’s so important to get your blood pressure checked frequently during pregnancy: Preeclampsia can develop without any symptoms at all, and it may only be detected during routine screenings. Asymptomatic preeclampsia is often less severe than cases with symptoms, but even a mild case should be closely monitored by your HCP in case it gets worse.

This is why your HCP will track your blood pressure throughout your pregnancy. Some numbers to keep in mind: A reading that exceeds 140/90 (mm Hg) on two different occasions at least four hours apart is considered high and requires attention. Even if your blood pressure is higher than 120/80 mm Hg your HCP may want to watch you closely for any further changes.

In addition to high blood pressure, other signs of preeclampsia can include:

  • Severe headaches
  • Vision changes, including blurred vision and light sensitivity
  • Nausea and vomiting
  • Difficulty breathing
  • Swelling of the arms, legs, hands, feet and face
  • Confusion
  • Abdominal pain
  • Rash

"For patients who have any of these symptoms, it's worth calling their physician's office," Dr. Guggenheim says. "It's so much better to call with a concern than to miss something and end up in trouble."

Understand the causes

"It's not totally clear why some people develop preeclampsia," Guggenheim says. The cause may have to do with improper development of the placenta, the organ responsible for providing a growing fetus with blood, oxygen and nutrients. When the new blood vessels that develop during pregnancy to supply the placenta are too narrow or don't function properly, it can affect blood pressure regulation in the pregnant person.

Know your risks

Even though we don’t know the exact cause of preeclampsia, we do know that there are several factors that can make it more likely for a pregnant person to develop the condition. Many of those risk factors are unmodifiable, meaning there isn't much you can do to prevent them, but it’s helpful to be aware of them:

  • First pregnancy
  • Family history of preeclampsia
  • Older than age 40
  • African-American descent
  • Being pregnant with twins or other multiples

There are also a host of risk factors that are within your control. "If you already have hypertension,” Guggenheim says, “you should get it under control prior to pregnancy. If you’re overweight, weight loss would be advised."

It may not be possible to reverse certain conditions but managing them is a crucial step. If you plan to get pregnant, speak with your HCP about existing conditions such as obesity and hypertension, as well as kidney disease and diabetes.

Be clear about complications

Preeclampsia poses risks to the pregnant person both before and after delivery. Although 75 percent of cases of preeclampsia are considered mild and the condition typically subsides six weeks after childbirth, there is still the potential for long-term complications, including brain, kidney and liver damage, organ failure, stroke and heart disease. Eclampsia, which is a condition characterized by seizures, is another potential complication stemming from preeclampsia.

Although it’s very rare, preeclampsia-related death is a risk; it is responsible for an estimated 10 to 15 percent of maternal deaths worldwide.

The fetus faces risks, too, including impaired growth, preterm delivery and even death. Infants born to people with preeclampsia may be at an increased risk of blindness, epilepsy, learning disorders and cerebral palsy.

Understand the treatments

The most effective way to reduce the risks to both parent and fetus is to deliver the baby. If you’ve reached at least 37 weeks without serious preeclampsia-related symptoms, your HCP may choose to induce delivery—though if symptoms are severe, your HCP may recommend induction as early as 34 weeks. Preeclampsia typically goes away in the days and weeks following delivery.

If the condition is detected early in the pregnancy, however, delivery may not be feasible.

"Preeclampsia with severe features is managed differently," Guggenheim explains. "Those patients are typically hospitalized, and we would deliver them when the risks outweigh the benefits of keeping the patient pregnant."

If your HCP deems early delivery unsafe, they may recommend bed rest or hospitalization, so the pregnancy can be monitored closely. They may also prescribe medications such as blood-pressure lowering drugs, anticonvulsant medicine to prevent seizures and corticosteroids to improve liver and platelet function and promote fetal lung maturation.

Recognize the post-delivery risks

Although rare, new parents can develop postpartum preeclampsia within days of delivery or even up to six weeks or more after giving birth. This can occur even without high blood pressure during pregnancy. If you have recently given birth and experience severe headaches, changes in vision or vision loss, upper abdominal pain or decreased urination, call 911 or notify your HCP immediately.

Postpartum preeclampsia and preeclampsia that persists after giving birth can pose serious risks to you and your baby. It requires immediate treatment to decrease the risk of seizures, organ damage and stroke. The condition can be treated with the same medications as preeclampsia during pregnancy, which prevent seizures and lower blood pressure. Your HCP may also recommend more frequent blood pressure monitoring.

Article sources open article sources

Mayo Clinic. Preeclampsia. Last reviewed April 15, 2022.

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