Overview

Preeclampsia is a potentially life-threatening pregnancy complication that involves elevated blood pressure and often signs of damage to another organ system—typically the liver and kidneys. It usually develops after 20 weeks of gestation in previously normotensive individuals, but it can also occur postpartum.

While preeclampsia varies in severity, early detection and careful management are key to reducing risks for both the birthing parent and the baby. Without treatment, it can escalate into serious complications, including preterm birth, eclampsia (seizures), and even maternal or fetal death.

Mild vs. Severe Preeclampsia

Although there is no formal classification into “types,” preeclampsia is often described based on its severity.

Mild preeclampsia

  • Blood pressure of 140/90 mmHg or higher

  • May or may not include protein in the urine

  • Often asymptomatic

  • May be discovered during routine prenatal appointments

Severe preeclampsia

  • Blood pressure of 160/110 mmHg or higher

  • Symptoms include headaches, visual disturbances, liver pain

  • Blood or urine tests reveal organ dysfunction

  • Requires immediate monitoring and potential hospitalization

Common Symptoms

Preeclampsia can be difficult to detect without regular prenatal care, especially in its mild form. However, as the condition progresses, symptoms may include:

  • Persistent headaches

  • Blurred vision or light sensitivity

  • Swelling of the face, hands, or legs

  • Pain in the upper right abdomen (liver area)

  • Shortness of breath

  • Sudden weight gain

In severe cases, fluid may accumulate in the lungs, or the number of platelets in the blood may drop, both of which can pose serious health threats.

What Causes Preeclampsia?

The exact cause of preeclampsia remains unclear, but several factors may contribute:

  • Abnormal placental development

  • Immune system dysfunction

  • Genetic predispositions

  • Poor blood flow to the uterus

  • Preexisting medical conditions like hypertension or diabetes

Research suggests that improper formation of blood vessels in the placenta may restrict blood flow and trigger inflammatory responses, leading to high blood pressure and systemic complications.

Who Is at Risk?

Certain groups of people are more likely to develop preeclampsia, including those who:

  • Are under 20 or over 35 years of age

  • Are pregnant with twins or more

  • Became pregnant through IVF

  • Have a history of preeclampsia or chronic hypertension

  • Have diabetes, kidney disease, or autoimmune conditions

  • Have a BMI over 30

  • Have a family history of the condition

Studies also indicate that preeclampsia disproportionately affects Black women and people in medically underserved areas.

How Preeclampsia Is Diagnosed

Diagnosis typically involves a combination of clinical signs and lab results.

  • Blood pressure monitoring: Readings of ≥140/90 mmHg on two occasions at least 4 hours apart

  • Urinalysis: Measuring protein levels (proteinuria)

  • Blood tests: Assessing liver enzymes, kidney function, and platelet counts

  • Ultrasound: To monitor fetal growth and assess amniotic fluid levels

  • Fetal nonstress test (NST): To check fetal heart rate and oxygen levels

If preeclampsia is suspected, further tests and close observation will follow to determine severity and treatment strategy.

Treatment Options

The only definitive cure for preeclampsia is the delivery of the baby and placenta. However, treatment strategies depend on the gestational age and severity of the condition.

If you're near full term (≥37 weeks):

  • Labor may be induced or a cesarean delivery may be performed

  • Continuous monitoring of both mother and baby

If preeclampsia develops before 37 weeks:

  • Close monitoring of blood pressure and fetal growth

  • Medications such as:

    • Antihypertensives (e.g., labetalol, nifedipine) to manage blood pressure

    • Magnesium sulfate to prevent seizures

    • Corticosteroids to mature the baby’s lungs if early delivery is likely

In severe cases, hospitalization may be necessary until the baby can be safely delivered.

Can You Prevent Preeclampsia?

Complete prevention may not always be possible, but early action can reduce risk:

  • Prenatal care: Consistent checkups to catch early signs

  • Low-dose aspirin: For high-risk pregnancies, starting after 12 weeks

  • Calcium supplementation: In areas with low dietary calcium intake

  • Healthy lifestyle: Managing weight, blood sugar, and blood pressure

  • Early screenings: Particularly if you’ve had preeclampsia before

If you have a history or are at high risk, discuss a proactive management plan with your healthcare provider early in pregnancy.

Possible Complications

Without timely treatment, preeclampsia can lead to serious complications for both mother and baby.

For the birthing parent:

  • Eclampsia (seizures)

  • HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets)

  • Liver or kidney failure

  • Stroke

  • Pulmonary edema

  • Placental abruption

  • Death in extreme cases

For the baby:

  • Intrauterine growth restriction (IUGR)

  • Premature birth (before 37 weeks)

  • Low birth weight

  • Breathing problems

  • Learning or developmental delays

  • Stillbirth or neonatal death in severe untreated cases

Regular checkups and compliance with treatment plans significantly reduce these risks.

Life After Preeclampsia

Preeclampsia typically resolves within days to weeks after childbirth, but close monitoring is still required.

  • Postpartum follow-up: Blood pressure should normalize within 12 weeks

  • Future pregnancies: Risk of recurrence is higher, so early prenatal care is essential

  • Long-term health: Increased risk of cardiovascular disease, including chronic hypertension and stroke

Lifestyle adjustments such as healthy eating, physical activity, and stress management are crucial for long-term health and preventing recurrence.

Final Thoughts

Preeclampsia is a serious yet manageable condition with the right care. Whether you're in your first or fourth pregnancy, awareness, regular monitoring, and open communication with your healthcare team are the best tools to protect you and your baby.