Preeclampsia — Early Signs You Should Never Ignore

Preeclampsia affects about 5–8% of pregnancies and remains a leading cause of maternal and fetal complications. Recognising early signs and acting on them saves lives. This page explains symptoms, risk factors, monitoring and what to do.

1. What preeclampsia is

Pregnancy-induced condition typically after 20 weeks gestation involving high blood pressure (140/90 or higher) plus organ involvement, most commonly proteinuria (protein in urine), but also liver dysfunction, low platelets, kidney impairment or fetal growth restriction. Mechanism involves abnormal placental development; full cure is delivery.

2. Risk factors

First pregnancy. Previous preeclampsia. Multiple pregnancy. Pre-existing hypertension. Diabetes (pre-existing or gestational). Chronic kidney disease. Autoimmune disease (lupus, antiphospholipid syndrome). Obesity. Maternal age over 40 or under 20. Family history. IVF/donor egg pregnancy. Long inter-pregnancy interval.

3. Symptoms that warrant urgent attention

Severe headache, especially persistent and not relieved by simple measures. Visual disturbances (blurriness, flashing lights, blind spots). Pain in upper right abdomen or epigastrium. Sudden swelling of hands, face or feet. Nausea or vomiting in late pregnancy. Reduced fetal movement. Shortness of breath. Each warrants same-day assessment.

4. Routine monitoring at every antenatal visit

Blood pressure. Urine dipstick for protein. Maternal weight. Fundal height. Fetal heart rate. From 24 weeks: assessment for symptoms above. Additional surveillance in high-risk women, more frequent visits, scans for fetal growth and Doppler, urine protein quantification.

5. When preeclampsia is diagnosed

Admission for evaluation. Confirm blood pressure with serial measurements. Urine protein quantification. Blood tests (liver function, renal function, platelets, uric acid, LDH). Fetal assessment (growth scan, Doppler, CTG). Severity determines management, outpatient monitoring vs admission vs delivery.

6. Treatment principles

Mild preeclampsia: close monitoring, oral antihypertensives if BP very high. Severe preeclampsia: hospital admission, antihypertensives, magnesium sulfate for seizure prevention if severe, steroids for fetal lung maturity if preterm. Delivery is definitive treatment, timing balances maternal and fetal interests.

7. Prevention in high-risk women

Low-dose aspirin (75–150 mg daily) from 12 weeks until 36 weeks reduces preeclampsia risk by approximately 40% in high-risk women. Calcium supplementation in low-calcium diets. Healthy weight, blood pressure optimisation pre-pregnancy. No supplement or food prevents preeclampsia reliably.

8. Postnatal vigilance

Preeclampsia can develop or worsen postpartum, up to 6 weeks. Blood pressure monitoring continues postnatally. Severe headache, visual changes or upper abdominal pain in postpartum period warrants urgent assessment. Future cardiovascular risk is elevated; long-term monitoring is appropriate.