Preeclampsia: A Pregnancy Complication That Needs Close Monitoring

01

What Preeclampsia Is

Preeclampsia is a pregnancy complication marked by new high blood pressure after 20 weeks, usually along with protein in the urine or signs that it's affecting the liver, kidneys, or blood clotting. It's thought to start with a problem in how the placenta develops and connects to the mother's blood supply, which then triggers effects throughout the body.

It affects a meaningful share of pregnancies and is one of the main reasons blood pressure and urine are checked at every prenatal visit — the condition often develops with few noticeable symptoms until it's already underway, which is exactly why routine screening matters.

Risk is higher with a first pregnancy, a prior pregnancy affected by preeclampsia, chronic high blood pressure, diabetes (including gestational diabetes), kidney disease, carrying twins or multiples, obesity, and pregnancies conceived through IVF. For those at higher risk, taking low-dose aspirin starting around 12 weeks and continuing through most of the pregnancy meaningfully lowers the chance of developing preeclampsia — this is worth discussing with a prenatal care provider early, since starting aspirin later in pregnancy is less effective.

02

Warning Signs to Know

Symptoms can include a persistent headache that doesn't respond to usual remedies, vision changes such as blurring or seeing spots, upper abdominal pain (often described as under the ribs on the right side), sudden swelling of the face or hands, nausea or vomiting later in pregnancy, new shortness of breath, noticeably less urine than usual, and a clear decrease in the baby's movement.

Severe headache, vision changes, upper abdominal pain, or shortness of breath during pregnancy should prompt an immediate call to a prenatal care provider or a trip to labor and delivery rather than waiting for a scheduled appointment — these can signal the condition is progressing. A seizure during pregnancy or after delivery, a complication called eclampsia, is a call-emergency-services situation, not something to manage by calling in the morning.

03

How It's Monitored and Diagnosed

Blood pressure and a urine protein check are standard at every prenatal visit specifically to catch preeclampsia early. Once suspected, blood tests check platelet count, liver enzymes, kidney function, and sometimes uric acid, since preeclampsia can affect all of these, and an ultrasound checks the baby's growth and the placenta's blood flow.

A diagnosis usually needs blood pressure above a set threshold on two occasions, along with one of the supporting lab or symptom findings — a single high reading alone, especially in a clinic setting, isn't enough to diagnose it. That two-reading rule is about confirming the diagnosis, not about how fast to act: a severely high blood pressure reading on its own is treated as urgent and should prompt immediate contact with a provider, not a wait to see if it repeats.

04

Managing It During Pregnancy

Management depends heavily on how far along the pregnancy is and how severe the findings are. Milder cases further from full term may be managed with closer monitoring, blood pressure medication, and sometimes hospital observation, aiming to safely extend the pregnancy while watching closely for worsening.

Severe preeclampsia, or preeclampsia close to or at full term, is typically managed with delivery, since delivery of the placenta is the only way to resolve the underlying process. Magnesium sulfate is often given during labor in more severe cases to prevent seizures, a rare but serious complication called eclampsia. A related and more severe pattern — low platelets, liver strain, and breakdown of red blood cells, known as HELLP syndrome — can develop alongside preeclampsia and usually also points toward prompt delivery regardless of how far along the pregnancy is.

05

After Delivery and Future Pregnancies

Blood pressure is monitored closely in the first couple of weeks after delivery, but new-onset preeclampsia and its rare seizure complication, eclampsia, can also appear for the first time up to about six weeks after delivery — including after a pregnancy that went smoothly. The same warning signs — severe headache, vision changes, shortness of breath, upper abdominal pain — deserve emergency evaluation in the postpartum weeks just as they would during pregnancy.

A history of preeclampsia raises the chance of it happening in a future pregnancy and roughly doubles the long-term risk of cardiovascular disease and stroke, which is why many doctors recommend ongoing blood pressure and cardiovascular risk monitoring well beyond the pregnancy itself.