What is pre-eclampsia?
Pre-eclampsia is a condition that only occurs in pregnancy - typically after 20 weeks - and affects 2-8 in 100 women. It is diagnosed through a combination of hypertension (raised blood pressure) and proteinuria in pregnancy (the presence of protein in your urine).
Up to 6% of UK pregnancies will be affected by pre-eclampsia.
Read more pre-eclampsia statistics.
Women with mild pre-eclampsia may not show any symptoms, and it is usually only discovered during routine antenatal appointments (through standard blood pressure checks and urine samples).
If the condition gets more severe, various pre-eclampsia symptoms can develop, including:
- Severe headache that doesn’t go away with simple painkillers
- Problems with vision, such as blurring or flashing before the eyes
- Severe pain just below the ribs
- Nausea or vomiting
- Heartburn that doesn’t go away with antacids
- Rapidly increasing swelling of the face, hands or feet (for example if your watch or rings suddenly don't fit.)
- Feeling very unwell.
These symptoms are serious and you should seek medical help immediately.
Most cases of pre-eclampsia are mild and may have no effect on the pregnancy.
However, if left untreated, pre-eclampsia can be dangerous for both the mother and baby.
Sometimes other organs, such as the liver, can become affected, and there can be problems with blood clotting.
Pre-eclampsia can potentially progress to a more dangerous condition known as eclampsia, which occurs in 1-2% of pregnancies.
Eclampsia can cause fits or convulsions. In severe cases, eclampsia can sometimes cause the death of the mother or the baby. Therefore, it is important to manage the condition safely.
Pre-eclampsia can only be cured completely by delivering the baby and the placenta. If your regular prenatal appointments and checks pick up any symptoms of mild pre-eclampsia the focus of treatment before birth will be blood pressure management, and monitoring the growth of the baby and the health of the mother.
You may also be given medicine to control high blood pressure in pregnancy: Women with a high risk or more than one risk factor for developing pre-eclampsia will be asked to take a low daily dose of aspirin from the 12th week of their pregnancy until the baby is born.
It’s not recommended that you go over your due date, even with mild pre-eclampsia, so if your baby isn’t born by that date, your labour will be induced. Some hospitals may look to induce from 34-37 weeks. It is recommended that women with mild or moderate pre-eclampsia should give birth soon after 37 weeks.
Pre-eclampsia is a risk factor for premature birth
If mild pre-eclampsia progresses to more severe pre-eclampsia, you’ll need to be admitted to hospital. That way you’re in the right place if you need treatment and/or if the baby needs to be delivered early.
If necessary you’ll be given medication to control your blood pressure. You’ll be cared for by an experienced midwife, senior obstetrician and anaesthetist.
You may have the following tests:
- Regular blood pressure checks: If you’re stable and are showing no symptoms, this will most likely be every four hours. However, if the pre-eclampsia is severe, this may be as often as every 15 minutes, and after you have stabilised, every half hour.
- Daily urine tests to measure the level of protein present.
- You may be on a fluid balance chart to monitor your hydration.
- Blood tests: These will be taken to check your blood count, clotting, liver and kidney function.
- Ultrasound scans: These scans will help your medical team to measure your baby’s growth and wellbeing.
- Fetal heart monitoring: If pre-eclampsia is severe, you may have twice-weekly monitoring. While in labour, your baby’s heart rate will need to be monitored continuously.
If you develop pre-eclampsia in late pregnancy, it is common practice to induce the baby. The baby is usually delivered if the doctors can’t control your blood pressure, if the liver, kidney or clotting blood tests become very abnormal, or if the baby becomes distressed.
The risk to your baby is small if he or she is born just a few weeks early. Pre-eclampsia is the cause of around 15% of induced premature births.
However, if you are less than 34 weeks, the decision between delivery or other treatment will depend on the severity of the pre-eclampsia (and its risks to you and the baby) versus the risk of being born prematurely to your baby.
Every situation is different and your medical team will discuss all the options with you and let you know what the risks are.
The exact cause of pre-eclampsia remains unknown. Research indicates that genetics and the placenta could be factors in the development of the condition. Read more about our pre-eclampsia research.
Women are more likely to suffer from pre-eclampsia if their mothers and sisters have a history of it.
Women who have already had pre-eclampsia in one pregnancy have a 16% greater chance of developing it again in a next pregnancy.
However, women with a previous pregnancy or pregnancies without pre-eclampsia have less chance of developing it in later pregnancies.
Therefore it appears that there is something in the make-up of some women that makes them more vulnerable to the condition than others.
It’s believed that the placenta is involved in the development of pre-eclampsia. The placenta connects a mother to her unborn baby, and the baby receives oxygen and nutrients through it.
It’s thought that the development of the blood vessels of the placenta is incomplete in women who develop pre-eclampsia.
Am I at risk of developing pre-eclampsia?
As we don’t know the exact causes of pre-eclampsia, it’s hard to predict who will develop it during pregnancy and who won’t. However, there are some things that tell health professionals that you are at greater risk of pre-eclampsia.
The following indicate that you are at a high risk:
- you have had pre-eclampsia in a previous pregnancy
- hypertensive disease during a previous pregnancy
- you have chronic kidney disease
- you have autoimmune disease such as systemic lupus erythematosus or antiphospholipid syndrome
- you have type 1 or type 2 diabetes
- you have chronic hypertension (high blood pressure).
You will be offered a daily dose of aspirin from 12 weeks onwards if you have ONE of the above.
The following indicate that you are at moderate risk:
- this is your first pregnancy/your first pregnancy with a new partner
- this is your first pregnancy in 10 or more years
- you’re aged 40 or over
- you are having a multiple pregnancy (twins, triplets or more)
- you, your mother or sister have already had pre-eclampsia during pregnancy
- you have a BMI (body mass index) of 35 or more
You will also be offered a daily dose of aspirin from 12 weeks if you have TWO of the above.
There is also some evidence that women who become pregnant from egg donation are more susceptible to pre-eclampsia.
Can you suffer from pre-eclampsia after birth?
Pre-eclampsia will improve soon after your baby is born. You will be closely monitored in the days following the birth.
If you have severe pre-eclampsia, you will be monitored in a high dependency unit until the medical team is sure you are stable and not at risk of having eclampsia.
You will need to take medicine to control your blood pressure, and you will have to rest and recover in hospital, but you are likely to make a full recovery.
Your baby’s health is also likely to be fine once he or she is born. However, your baby will need to be monitored closely in the days following the birth to make sure no complications develop.
If he or she was born prematurely there may be some complications associated with that. The most common result of having pre-eclampsia during your pregnancy is that your baby might be small for gestational age.
HELLP syndrome is a severe form of pre-eclampsia, and is potentially as dangerous as eclampsia. It is most likely to occur immediately after the baby is delivered, but can appear any time after 20 weeks of pregnancy, and in rare cases before 20 weeks.
- haemolysis (where the red blood cells disintegrate)
- raised levels of liver enzymes
- a low count of platelets (which help with blood clotting).
The main symptoms are:
- Nausea and vomiting
- Upper abdominal pain
- Vision problems.
The only way to treat the condition is to deliver the baby as soon as possible.
Read about our hypertension research.
Read the NICE guidelines on hypertension in pregnancy.
The problem of premature birth in the UK needs to be addressed. Too many parents are currently enduring this anxious experience that can have a lasting impact.
A 'premature' or 'preterm' baby is one that is born before 37 weeks. If your baby is born early they may need special care as they may not be fully developed.
- NICE (2012) High blood pressure in pregnancy, Understanding NICE guidance, National Institute for Health and Clinical Excellence
- RCOG (2006) The Management of Severe Pre-eclampsia/Eclampsia, Royal College of Obstetricians and Gynaecologists
- RCOG (2012) High blood pressure in pregnancy, iNFORMATION FOR YOU, Royal College of Obstetricians and Gynaecologists
- James D, Steer P et al (2011) High risk pregnancy, management options, fourth edition, Elsevier Saunders
- NHS Choices (accessed March 2014) http://www.nhs.uk/Conditions/Pre-eclampsia/Pages/Complications.aspx
- NICE (2010) Hypertension in pregnancy, The management of hypertensive disorders during pregnancy, National Institute of Health and Clinical Excellence
ℹLast reviewed on September 3rd, 2016. Next review date September 3rd, 2019.
By Onyebuchi Nwaeze (not verified) on 30 Nov 2019 - 11:00
My fiance is 26 weeks pregnant and was diagnosed of having preeclampsia at 20 weeks...till this moment her pressure has not come down a bit after all I have spent.. I have spent more than I have to get her going till she can be able to deliver...lately a test showed that the baby in the womb is tired and can't go too further...the most disappointing and saddest side of it is that the baby gave up yesterday.
By Kate wearing (not verified) on 23 Nov 2019 - 14:07
Are the hospital going to do the pre eclampsia test. Can we hear about it on the facebook and radio areas please.
By Rebecca Isack (not verified) on 9 Aug 2019 - 06:04
Hi I'm 26 weeks and days pregnant
I experience upper abdominal pains mostly after eating
I went to the Doctor several times and took me for sonar but they said everything is fine but the pain still comes and goes. I'm confused. I feel nauseous sometimes and I vomit a very acidic substance. Please help me.
By Kisha (not verified) on 28 Apr 2019 - 12:58
I'm 34 weeks and 4 days I have Preeclampsia and my blood pressure is up and down I've been in the hospital for 3days how long can they keep me before the induce labor or send me home
By Mrs Fat (not verified) on 6 Dec 2018 - 11:47
Although I was induced at 38weeks and 6days but I lost the baby.
My question is this "When can I get pregnant again???" or How many months can I wait till I get another pregnancy???
Thanks in anticipation
By Midwife @Tommys on 12 Dec 2018 - 12:44
I am so sorry to read this post. Please don't hesitate to contact us if we can support you more or if you want to talk. We are here monday to Friday 9-5pm
We have a link to this subject about when to try for another baby which you may be interested in https://www.tommys.org/pregnancy-information/pregnancy-complications/baby-loss/stillbirth/trying-another-baby-after-stillbirth
I hope this is helpful to you. Best wishes from Tommy's midwives
By Winnie (not verified) on 5 Aug 2019 - 01:51
My condolences I too lost my daughter on 16 November 2017 due to pre eclampdia but last year October I got pregnant again and pre-eclampsia returned I had an emergency c section done at 32 weeks of pregnancy my son spent a month in hospital and guess what we are 2 month home now. Don't loose hope heal and try again most importantly monitor your blood pressure with next pregnancy.
By Midwife @Tommys on 28 Nov 2017 - 10:27
Thank you for your comment
I hope by now you have been able to see your midwife and had further assessment to see if you have any complications.
Please do not hesitate to contact your midwife or maternity unit if you have any concerns or worries.
You can also contact us on Tommy's PregnancyLine 0800 0147 800
By Rebecca mcelhinney (not verified) on 27 Nov 2017 - 09:05
This information was so usefully as I thought I was getting pre eclampsia.