What Is Preeclampsia? How to Recognize Signs and Get Treatment

During pregnancy, your doctor may talk to you about monitoring your blood pressure and checking for signs of a condition called preeclampsia. Maybe you've received a preeclampsia diagnosis, or maybe you're just wondering whether you're at risk—either way, understanding this common but manageable pregnancy complication is the first step to managing it effectively.

What Is Preeclampsia?

One of several pregnancy complications related to hypertension (high blood pressure), preeclampsia affects an estimated 2–8% of pregnancies. Preeclampsia is a pregnancy condition that is characterized by high blood pressure and signs that another organ system—most often the liver, kidneys and central nervous system—may not be working normally, says Dr. Anushka Chelliah, board-certified maternal-fetal medicine specialist at Pediatrix Medical Group.

Preeclampsia often occurs even in people whose blood pressure had previously been normal. While many people with preeclampsia go on to have healthy babies, when left untreated, the condition can lead to serious complications for both you and your little one, so it’s important to be familiar with the causes and risk factors as well as the symptoms.

To help you determine if you should talk to your doctor about preeclampsia, here's a closer look at the signs and symptoms, as well as treatment options if you get diagnosed.

Preeclampsia Signs and Symptoms

According to Dr. Chelliah, preeclampsia symptoms usually start after the 20th week of pregnancy, but the signs aren't always obvious. Many preeclampsia symptoms might be mistaken for common pregnancy symptoms—which is why it’s extremely important to go to all of your prenatal doctor appointments, even if you’re not feeling anything out of the ordinary.

Elevated blood pressure

"When differentiating symptoms of preeclampsia from normal pregnancy, [there] are some key features," Dr. Chelliah says. "There may be new onset elevated blood pressure greater than 140 mmHg systolic or 90 mmHg diastolic after 20 weeks gestation." Unless you already had high blood pressure before getting pregnant, then your readings during pregnancy should be within that normal range, she says.

If your blood pressure is consistently not normal at your prenatal check-ups, then that's likely the first sign of possible preeclampsia. "Elevated blood pressure is nearly always present [in preeclampsia], but does not by itself make the diagnosis," says Dr. Tanya Sorensen, maternal fetal medicine specialist and executive medical director for Women and Children, Providence North Division Institute.

Headaches and vision changes

"Headaches can also be a symptom of an uncomplicated pregnancy and be related to hormonal changes or dehydration," Dr. Chelliah says. "However, those associated with preeclampsia tend to be more severe, and typically do not improve with usual treatments such as Tylenol." She says that preeclampsia-related headaches may also come with vision changes, so be on the lookout for things like light sensitivity, blurriness or spots, since it could be a sign that your central nervous system is being affected.

Nausea

And even though nausea is an extremely common symptom in normal pregnancies, it can also be a sign of preeclampsia, especially if it occurs later on in pregnancy (as opposed to the first trimester, when regular nausea usually happens) and comes with stomach pain, Dr. Chelliah says.

Water retention

According to the Mayo Clinic, water retention can also be a symptom of preeclampsia. Some swelling is completely normal during and after your pregnancy, but if you’re noticing something outside of what’s normal for you—particularly excessive swelling in your face, legs or hands—you should reach out to your doctor. Sudden weight gain of about two to five pounds in a week could also be a sign of preeclampsia.

Protein in urine

One symptom that doesn't occur in normal pregnancies is protein in your urine. Called proteinuria, it's caused by kidney issues and is something your healthcare provider will be checking for if preeclampsia is suspected. It’s still possible to have preeclampsia and never have protein in your urine, but it can be a sign, which is why it’s worth a check.

Experiencing just one of these symptoms isn't enough to diagnose you with preeclampsia, but if you have several in combination, then a diagnosis may happen. "We diagnose preeclampsia when there is some combination of elevated blood pressure, symptoms, protein in the urine and lab changes such as abnormal liver enzymes, low platelets and abnormal kidney function," Dr. Sorensen says.

Keep in mind that there are two different potential diagnoses: mild and severe—which one you have can determine your treatment path. "Some of these criteria can lead to the diagnosis of preeclampsia with severe features, which can change recommendations for timing of delivery," Dr. Sorensen says.

How to Treat Preeclampsia

Getting a preeclampsia diagnosis can be stressful, but thanks to medical advances, blood pressure medication and innovative monitoring options, there are lots of treatment options to help keep you and baby safe and healthy.

As odd as it sounds, "the ultimate cure for preeclampsia is delivery," Dr. Sorensen says. Unless you develop postpartum preeclampsia (which is thankfully pretty rare), the symptoms you experienced during pregnancy will disappear as soon as your baby is born. If you’re close enough to your due date and your healthcare provider feels your baby is developed enough, you’ll most likely be headed to the delivery room as soon as possible and be scheduled for either an induction or a c-section.

But if the symptoms have been going on for the majority of the pregnancy, Dr. Sorensen says the situation is more problematic. Doctors have to find the balance between ending the pregnant person's continued exposure to hypertension and other severe symptoms and risking a premature delivery.

Medication treatments

Aside from delivery itself, another treatment option is medication. "Medications used to treat high blood pressure in pregnancy and to prevent seizures (eclampsia) are safe, and the risk of untreated hypertension, such as stroke, outweigh any theoretical risk," Dr. Sorensen says. "In addition, in cases where early delivery is indicated, a steroid medication is often recommended to promote lung maturity in the fetus prior to delivery." Medications your doctor may prescribe include:

• Blood pressure medications (antihypertensives). These help lower blood pressure, and there are specific ones that are approved for use during pregnancy.

• Steroids. Corticosteroids are useful in severe cases of preeclampsia. They can help improve your liver and platelet function and mature baby’s lungs in preparation for an early delivery.

• Anti-seizure medication. Prescribed in order to reduce your risk of a seizure (one of the possible risks of preeclampsia if your blood pressure gets too high), medications like magnesium sulfate may be administered before or after delivery. Magnesium sulfate is often given intravenously either during delivery or immediately after. It’s not the most pleasant of drugs—common side effects can include drowsiness, flushing, sweating and headaches—and will interfere with your ability to breastfeed right away. But once your blood pressure returns to normal and you’re feeling a bit better, it shouldn’t have any effect on your long-term breastfeeding goals. Also, Dr. Chelliah notes that "this medication can cross the placenta and sometimes be associated with decreased fetal heart rate variability and rarely respiratory depression. However, magnesium sulfate has also been studied extensively and is still considered safe when used appropriately under medical supervision to prevent seizures, as the benefits significantly outweigh the risks." So your baby seem lethargic at first, but this usually goes away as the magnesium sulfate clears from baby’s system.

Non-medication treatments

There are also non-medication treatment options that your doctor will implement, including:

• Increased monitoring. If you’re diagnosed with preeclampsia, your healthcare provider will want to keep a close eye on you and your baby. This may mean more frequent appointments for blood pressure checks, or even having to monitor your blood pressure at home. There may also be more tests—including blood tests, ultrasounds, dopplers and nonstress tests—on your horizon than there would be during a more typical pregnancy. In some cases, your doctor may want to hospitalize you for constant monitoring either for a specific period of time or until delivery.

• Kick counts. Since preeclampsia can sometimes cause reduced fetal movement, keeping track of how often your baby moves over a certain period of time can help you notice if there’s anything out of the ordinary going on. If you’ve been diagnosed with preeclampsia, you may be asked to do kick counts each day and report back the results back to your healthcare provider.

Whether you implement some or all of these treatment options, together you and your healthcare provider will determine the best course of treatment for you and your baby.