What does heartburn in pregnancy feel like with pre-eclampsia?

The discomfort may sit under the ribs or in the upper abdomen and can feel like indigestion, burning, pressure or a deep ache. With pre-eclampsia, it may persist despite usual heartburn measures or occur with nausea and vomiting. Most people with Pre-eclampsia notice heartburn in pregnancy, but ordinary reflux is also common in pregnancy, so the sensation alone cannot identify the cause.

Pre-eclampsia can affect the placenta and organs such as the liver and kidneys. Upper abdominal pain is therefore a warning symptom, especially when it is new, severe or accompanied by headache, visual disturbance, sudden swelling or feeling very unwell. Read about [Pre-eclampsia](/conditions/pre-eclampsia/).

Tell your maternity team about persistent or unusual burning, particularly if it is high under the ribs rather than behind the breastbone. They may check your blood pressure, urine and blood tests, and assess you and the baby. Do not start or increase medicines for reflux without checking that they are suitable in pregnancy.

While waiting for advice, note when the discomfort began, where it is located, whether food or position changes it, and whether you have headache, visual symptoms or reduced fetal movement. This information helps the assessment.

Contact your maternity unit urgently for persistent upper abdominal or rib pain, severe headache, blurred vision or flashing lights, sudden swelling of the face or hands, vomiting, breathlessness, vaginal bleeding or reduced fetal movement. Seek emergency help for severe pain, fainting, seizures, chest pain or difficulty breathing. These symptoms require prompt assessment even if they resemble heartburn.

Could this pain be related to my blood pressure or liver? Which warning signs should send me straight to the maternity unit? Are my reflux medicines suitable? What monitoring do I need for the rest of pregnancy?