Signs and Symptoms of Preeclampsia
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Medically reviewed by Peter Weiss, MD
Preeclampsia is a rare but serious condition that occurs during pregnancy or soon after giving birth. The condition causes high blood pressure, leads to high protein levels in the urine, and affects several organs in the body—which can impact the health of the pregnant parent and the baby.
Nearly 85% of all preeclampsia cases occur between the 34th and 37th week of pregnancy. However, you can develop the condition anytime after 20 weeks of gestation. Most people learn about their diagnosis during a routine checkup with the healthcare provider. It's important to know that people who receive an early diagnosis are able to get started on treatment sooner and have successful and healthy pregnancies.
However, preeclampsia is the cause of 2% to 8% of all pregnancy-related complications. Without treatment, the condition can cause severe preeclampsia or eclampsia symptoms which can result in poor health outcomes such as premature labor or death of the parent or fetus. That's why learning the symptoms of the condition and knowing when to seek care from a healthcare provider is essential.
Preeclampsia Symptoms
Preeclampsia occurs when you have hypertension (high blood pressure) after 20 weeks of pregnancy. Generally, symptoms develop between weeks 34 and 37, but can also begin soon after giving birth during postpartum.
While a normal blood pressure level is under 120/80 mm Hg (millimeters of mercury), healthcare providers define hypertension as:
A systolic (top number) blood pressure of 140 mm Hg or more
A diastolic (low number) blood pressure of 90 mm Hg or more
Aside from high blood pressure, other common symptoms of preeclampsia include:
High protein levels in your urine (pee)
Water retention
Swelling in your limbs
Severe Preeclampsia Symptoms
Around 25% of cases of preeclampsia can progress into severe preeclampsia. Generally, severe preeclampsia can develop rapidly in a matter of several days.
If your condition worsens, you may experience the following symptoms:
Severe hypertension: Blood pressure above 160/110 mm Hg
Swelling: Sudden and severe swelling in the face, legs, ankles, or hands
Weight gain: Rapid weight gain (more than 5 pounds or 2.3 kilograms in one week)
Persistent headache: A severe headache that doesn't go away
Abdominal pain: Stomach pain on the right side, just below the ribs
Vision changes: Seeing flashing lights, having blurry vision, or being sensitive to light
Breathing problems: Shortness of breath
Chest pain: Tightness or fullness in the chest, which often requires immediate medical attention
Mental changes: Irritation, anger, or confusion
Your healthcare provider may also notice severe preeclampsia symptoms through your bloodwork. Specifically, HELLP syndrome is a group of symptoms healthcare providers can find during routine blood testing. This syndrome is often a sign that preeclampsia is getting worse. The symptoms of HELLP syndrome include:
H: Hemolysis (destruction of red blood cells)
EL: Elevated liver enzymes (can cause inflammation of the liver)
LP: Low platelet counts (increases the risk of severe bleeding)
Eclampsia Symptoms
If preeclampsia is left untreated, your condition can progress into eclampsia and put you at an increased risk of developing the following complications:
Seizures, which can lead to a coma
Organ damage or failure of the heart, kidneys, liver, or brain
Hemorrhage (severe bleeding)
A stroke (disruption of blood supply to the brain due to a blockage or bleeding)
Loss of consciousness
How Preeclampsia Symptoms Can Affect the Baby
While preeclampsia can put the baby at risk, most pregnant people go on to have healthy babies. This is largely due to receiving an early diagnosis and starting treatment sooner. However, lack of access to healthcare during pregnancy or receiving a late diagnosis can lead to complications for the baby.
Severe preeclampsia can decrease the amount of amniotic fluid surrounding the baby. Amniotic fluid is a clear liquid that cushions the fetus as it grows in the pregnant parent's body. A reduction in amniotic fluid can disrupt the baby's blood flow and limit the amount of oxygen and nutrients that go to the baby. This can often affect the baby's growth and development and cause complications such as a low birth weight or developmental delays.
Babies born to pregnant parents with severe or untreated preeclampsia can also have respiratory (breathing or lung-related) problems shortly after delivery. If this happens, your healthcare provider may monitor your baby until they are stable enough to go home.
While it’s rare, severe or untreated cases of preeclampsia can cause premature birth, stillbirth, or placental abruption—a condition that causes the placenta to separate from the uterus wall before giving birth. It's also important to note that the baby is at greatest risk of developing serious complications if the pregnant parent has preeclampsia before 34 weeks of pregnancy. Keep in mind: having preeclampsia symptoms before 34 weeks is often very rare.
When to See a Healthcare Provider
During your prenatal visits, your healthcare team will monitor your blood pressure and check your urine for protein. It’s important to keep your routine appointments while you're pregnant, even if you feel healthy or aren't experiencing symptoms.
Keeping up with prenatal visits helps your healthcare provider closely monitor you for signs of preeclampsia. By doing so, they can catch the condition early and offer treatment to help protect you and your baby. If you notice that your blood pressure is rising above 135/85 mm Hg, notify your healthcare provider as soon as possible. High blood pressure above 140/90 mm Hg may indicate preeclampsia.
If you are at high risk for preeclampsia, your provider may increase the frequency of your prenatal appointments so they can monitor you more closely. They may also prescribe a low-dose medication to lower your blood pressure.
Risk factors for preeclampsia include:
Obesity
Having a history of preeclampsia, miscarriage, or stillbirth
Chronic high blood pressure
Being in your first pregnancy
Multi-gestational pregnancy (or, having twins or triplets)
Using fertility treatments such as in-vitro fertilization (IVF) or assisted reproductive technology
Smoking cigarettes
A Quick Review
Preeclampsia is a rare pregnancy complication that causes high blood pressure and affects several organs in the body. The conditional can develop anytime after 20 weeks of pregnancy, but is most common between weeks 34 and 37. Initial symptoms may include high blood pressure over 140/90 mm Hg, protein in the urine, and swelling in the face, hands, legs, ankles, and feet.
If preeclampsia progresses, your blood pressure may rise above 160/110 mm Hg. Severe cases of preeclampsia may also cause headaches, vision changes, abdominal pain, shortness of breath, and chest pain. Your healthcare provider should screen you for preeclampsia and monitor your condition routinely if you receive a diagnosis.
If the condition is left untreated, you may be at risk of developing eclampsia which can cause serious complications to you and your baby's health. That's why keeping up with your prenatal appointments, talking to your provider about any changes in your symptoms, and receiving early treatment are important.
Frequently Asked Questions
Can stress bring on preeclampsia?
Stress is a risk factor for high blood pressure, but there is no evidence that it is a risk factor for preeclampsia specifically. That said, managing stress during pregnancy is essential for your and your baby's well-being.
Who is at greatest risk for preeclampsia?
While there are multiple risk factors for pre-eclampsia, a study from the International Journal of Obstetrics and Gynaecology notes that people with obesity and pregestational diabetes (type 1 or 2) carry the highest risk of developing the condition.
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