Preeclampsia is one of the most serious complications of pregnancy — and one of the most unpredictable. It can develop in women with no prior history of high blood pressure, no obvious risk factors, and no symptoms at first.
That’s what makes awareness so important. Knowing what to watch for, and knowing when to act on it, can make a significant difference in outcomes for both mother and baby.
What Is Preeclampsia?
Preeclampsia is a condition characterized by high blood pressure that develops during pregnancy, typically after 20 weeks. It often comes with signs of stress on the kidneys, liver, or other organs — which is what separates it from standard gestational hypertension.
It affects roughly 5 to 8 percent of pregnancies in the United States and is one of the leading causes of maternal and fetal complications worldwide. The only definitive treatment is delivery of the baby and placenta.
Who Is at Higher Risk?
Preeclampsia can happen to anyone, but certain factors raise the likelihood. These include a first pregnancy, a history of preeclampsia in a previous pregnancy, carrying multiples, obesity, diabetes, kidney disease, and a family history of the condition.
Age also plays a role — women under 20 and over 35 are at higher risk. So is race: Black women develop preeclampsia at higher rates and are more likely to experience severe complications, which is an important reason early and consistent prenatal care matters.
Warning Signs to Know
One of the challenges with preeclampsia is that many women have no symptoms until it’s picked up at a prenatal visit through blood pressure monitoring or a urine test. This is exactly why regular prenatal appointments aren’t optional — they’re how early preeclampsia gets caught.
When symptoms do appear, the most common ones are:
- Sudden swelling of the face, hands, or eyes — particularly when it appears quickly and feels different from the normal leg and foot swelling of pregnancy
- Persistent headache — a headache that doesn’t go away with rest or over-the-counter pain relief and keeps returning
- Vision changes — blurred vision, seeing spots or flashing lights, or temporary vision loss
- Upper abdominal pain — typically under the ribs on the right side, which can be mistaken for heartburn or indigestion
- Sudden significant weight gain — more than a pound or two in a single day due to fluid retention
- Nausea or vomiting in the second half of pregnancy — particularly when it’s new and not explained by something else
None of these symptoms alone confirms preeclampsia. But any of them in the second half of pregnancy — especially more than one together — should prompt a same-day call to your OB-GYN rather than a wait-and-see approach.
Severe Warning Signs: When to Seek Emergency Care
Some presentations of preeclampsia indicate a rapidly worsening situation that requires immediate evaluation. Don’t wait for a callback if you experience:
- A severe headache that is sudden and intense, unlike any you’ve had before
- Vision changes accompanied by confusion or altered awareness
- Severe upper abdominal pain with nausea or vomiting
- Difficulty breathing or sudden shortness of breath
- Decreased fetal movement alongside any of the above symptoms
These are signs of preeclampsia with severe features. Untreated, severe preeclampsia can progress to eclampsia — seizures during pregnancy — or HELLP syndrome, a serious condition involving breakdown of red blood cells, elevated liver enzymes, and low platelet counts. Both are medical emergencies.
How Preeclampsia Is Diagnosed
There’s no single test that confirms preeclampsia. Diagnosis is made based on a combination of findings: blood pressure readings of 140/90 mmHg or higher on two separate occasions, plus evidence of organ involvement — most commonly protein in the urine or abnormal blood work showing kidney or liver involvement.
Your prenatal visits are specifically designed to catch these changes early. Blood pressure is checked at every appointment, and urine is regularly tested for protein. When numbers start trending in the wrong direction, your provider can intervene before the condition escalates.
How Preeclampsia Is Managed
Management depends on how severe the preeclampsia is and how far along the pregnancy is. The goal is to keep the pregnancy going as safely as possible for as long as the mother’s health allows.
For preeclampsia without severe features, close monitoring is the primary approach — more frequent blood pressure checks, regular lab work, and fetal monitoring to track the baby’s growth and wellbeing. This often becomes a high-risk pregnancy situation requiring more frequent care.
Medications may be used to control blood pressure and, in more serious cases, magnesium sulfate is given to prevent seizures. When preeclampsia is severe or the pregnancy is sufficiently advanced, delivery is recommended — even if it means delivering early.
After delivery, most women see their blood pressure improve within days to weeks. But monitoring doesn’t stop at birth.
Preeclampsia Can Also Develop After Delivery
Postpartum preeclampsia can occur within 48 hours of giving birth, or up to six weeks afterward — including in women who showed no signs during the pregnancy itself.
Symptoms are the same: high blood pressure, severe headache, vision changes, and facial or hand swelling. These are not normal postpartum symptoms. If you experience any of them after giving birth, seek medical attention right away rather than attributing them to normal recovery.
Frequently Asked Questions
- Can preeclampsia be prevented?
Not entirely, but certain measures may lower the risk. For women at high risk, low-dose aspirin started early in pregnancy is sometimes recommended. Maintaining a healthy weight before and during pregnancy, managing any underlying conditions like diabetes or hypertension, and attending all prenatal appointments are all important. The earlier a high-risk pregnancy is identified and monitored, the better positioned your provider is to act quickly if preeclampsia develops.
- Can preeclampsia affect my baby?
Yes. Preeclampsia can restrict blood flow to the placenta, which limits the oxygen and nutrients reaching the baby. This can cause restricted fetal growth, low amniotic fluid, and in severe cases, placental abruption. Close fetal monitoring is a core part of managing preeclampsia — your provider will watch the baby’s growth and wellbeing alongside yours.
- If I had preeclampsia before, will I get it again?
A history of preeclampsia does increase the risk in future pregnancies, particularly if it was severe or developed early. That said, many women who had preeclampsia in one pregnancy go on to have uncomplicated subsequent pregnancies. Your provider will classify you as higher risk and monitor you more closely from early on.
- Is preeclampsia the same as gestational hypertension?
They’re related but not the same. Gestational hypertension is elevated blood pressure in pregnancy without the additional organ involvement that defines preeclampsia. It requires monitoring because it can progress to preeclampsia, but by itself it doesn’t carry the same level of risk. The distinction is made through blood work and urine testing at your prenatal visits.
Conclusion
Preeclampsia is not rare, it doesn’t always give obvious warning, and it can progress quickly when it does.
The best defense is showing up to your prenatal appointments consistently — that’s where elevated blood pressure and early warning signs get caught before they become a crisis. And if something feels off between visits, that’s worth a call. You don’t have to be certain something is wrong to reach out.
At KEM Health, our team monitors closely for signs of preeclampsia throughout pregnancy. If you have risk factors or have had preeclampsia before, we can work with you from early on to build a monitoring plan that fits your situation. Schedule your prenatal care with us today.