Pre-eclampsia: symptoms, diagnosis and treatment

Pre-eclampsia is a pregnancy-related condition involving high blood pressure and possible organ changes. It can begin after the middle of pregnancy or soon after birth, and some people have few symptoms. Regular antenatal checks help identify changes before you feel unwell.

A severe headache, vision changes, pain high in the abdomen, sudden swelling of the face or hands, nausea or feeling very unwell can occur with pre-eclampsia. Heartburn that does not settle with usual measures may sometimes reflect pain beneath the ribs. These symptoms require prompt maternity assessment, especially when they are new, severe or worsening. A symptom does not by itself establish the diagnosis.

The exact cause is not fully understood. Pre-eclampsia is linked to how the placenta develops and how blood vessels respond during pregnancy. The condition can affect circulation between the pregnant person and placenta, which may then influence blood pressure and organs such as the kidneys, liver and brain.

Pre-eclampsia can remain mild and stable, or become more serious over a short period. Clinicians follow blood pressure, urine protein, blood tests, symptoms and the baby’s growth. Monitoring may continue as an outpatient or require hospital care. Delivery is the treatment that ends the pregnancy-related process, but observation after birth remains important.

Risk is higher with a previous pregnancy affected by pre-eclampsia, chronic high blood pressure, kidney disease, diabetes, some autoimmune conditions, or a multiple pregnancy. A first pregnancy and certain family or reproductive histories may also influence risk. Having a risk factor does not mean the condition will develop.

Assessment usually combines repeated blood-pressure readings with a urine test and blood tests that check kidney, liver and blood-cell function. The maternity team may assess symptoms and monitor the baby with growth measurements, heart-rate monitoring or ultrasound. A single reading or symptom is interpreted alongside the full clinical picture.

Treatment depends on pregnancy stage, blood pressure, symptoms, test results and the baby’s wellbeing. It may include closer antenatal monitoring, blood-pressure medicine, medication to reduce seizure risk in severe disease, and treatment to support the baby if early birth is being considered. The team balances staying pregnant with the safety of both patients. Birth may be induced or delivered by caesarean section when that is safer.

Keep appointments, take prescribed medicine as directed and record symptoms or home readings if your maternity team asks you to. Do not wait for the next appointment if severe headache, vision changes, severe abdominal pain, breathlessness or a marked change in wellbeing develops. Ask what number to call outside clinic hours.

Untreated or severe disease can affect the brain, liver, kidneys, blood clotting and placenta. It can also restrict the baby’s growth or lead to an early birth. Seizures, called eclampsia, are an emergency. Care teams monitor for these problems so treatment or delivery can be arranged promptly.

No approach prevents every case. If your history places you at higher risk, your obstetrician may discuss low-dose aspirin or other planned monitoring; do not start it without medical advice. Attend antenatal appointments, mention previous pregnancy complications and seek assessment for warning symptoms.

An obstetrician or maternal-fetal medicine specialist can coordinate blood-pressure care, fetal monitoring and birth planning. Your midwife or antenatal team can arrange assessment when symptoms change. Bring your medicines, home readings and a clear timeline of symptoms to the appointment.