Why does pre-eclampsia cause severe abdominal pain in pregnancy?

Pre-eclampsia changes how blood vessels work and can place strain on organs. When the liver is affected, pain may be felt in the upper abdomen or under the ribs, often more on the right. It may be steady, intense, tender or mistaken for indigestion. The pain can occur with headache, vision changes, nausea, vomiting or swelling, but it can also occur without those symptoms.

Severe abdominal pain has several possible causes in pregnancy, including gallbladder problems, infection, placental complications and other urgent conditions. Its location, onset and associated symptoms help clinicians decide what needs checking. A symptom does not establish a diagnosis by itself.

Call your maternity unit or obstetric clinician promptly for severe, new or continuing abdominal pain. Describe its exact location, whether it comes in waves or stays constant, and any bleeding, fever, vomiting, headache or change in fetal movement. Do not wait for a routine appointment if the pain is strong or worsening.

A clinical assessment may include blood pressure measurement, urine testing, blood tests and examination. Follow the advice given about observation, medicines and hospital review; avoid taking a new pain medicine without checking its suitability in pregnancy.

Seek emergency maternity care for severe or worsening pain, fainting, heavy bleeding, difficulty breathing, a severe headache, vision disturbance, seizures, fever, repeated vomiting, or reduced fetal movement. If you feel weak or dizzy, ask someone to stay with you and do not drive yourself.

Ask: Could the pain be related to pre-eclampsia or another pregnancy emergency? Which tests do I need today? What symptoms mean I should return immediately? How should I monitor fetal movement while I am being assessed?