Signs of Preeclampsia Every Pregnant Person Should Know

Preeclampsia (also called toxemia of pregnancy) is a serious disorder that generally develops after 20 weeks of pregnancy. It's marked by high blood pressure and elevated protein levels in the urine.

Preeclampsia complicates 5 to 8% of all pregnancies, according to the Preeclampsia Foundation. It also causes about 15% of premature deliveries in the U.S.

Preeclampsia symptoms can be life-threatening, and if left untreated, they can cause serious complications for both the pregnant person and the fetus. But despite the seriousness of the condition, there's good reason to expect a positive outcome if you have it. That's because health care providers vigilantly monitor for signs of preeclampsia in the second half of every pregnancy—even when their patient is showing no obvious symptoms and feels perfectly fine.

Indeed, most pregnant people with preeclampsia will end up with a healthy baby and full recovery, though prompt medical attention is a must. Consult this guide to learn more about the signs and symptoms of preeclampsia, as well as how it's treated.

What Causes Preeclampsia?

Although it's still unclear what exactly causes preeclampsia, many experts theorize that it begins in the placenta and placental blood vessels. "There's general agreement that it's associated with abnormalities in the development of the placenta very early on in pregnancy," says Laura Hart, MD, assistant professor of clinical obstetrics, gynecology, and reproductive science at the Lewis Katz School of Medicine at Temple University.

Black birthing people have higher overall rates of developing preeclampsia and maternal mortality. This might be due to several factors, such as social and health care inequalities, chronic stressors, and lower income. They're also more likely to experience preeclampsia complications, according to the Centers for Disease Control and Prevention (CDC).

Preeclampsia Symptoms in Pregnant People

Many signs of preeclampsia are silent or resemble normal pregnancy symptoms, making this condition especially dangerous for both parent and baby. Some people have no symptoms at all, especially early on. "This is why normal prenatal care is important to detect an elevation in blood pressure," says Staci Tanouye, MD, FACOG, an OB-GYN who works in a private practice in Jacksonville, Florida.

In some cases, though, people experience identifiable signs of preeclampsia, which may include the following:

• Severe, persistent headaches
• Increase in swelling, especially of the hands and face (edema)
• Sudden rapid weight gain, related to water retention (more than two pounds in a week)
• Visual disturbances such as flashing lights or blurred vision
• Pain in the upper right area of your abdomen and/or shoulder pain
• Pain or a burning sensation behind your sternum
• Nausea and vomiting
• Shortness of breath or trouble breathing
• Blood pressure that rises to 140/90 or more
• Protein in the urine (determined by your doctor)
• Confusion or anxiety

These symptoms are more common in severe cases of preeclampsia. People might also experience impairments with kidney or liver function, decreased blood platelets, brain trouble (like vision changes), and fluid in the lungs.

If left untreated, preeclampsia can evolve into eclampsia, a rare but severe condition that causes seizures or coma.

Possible Complications of Preeclampsia

Severe cases of preeclampsia can result in serious issues for both parent and baby. "The most common complication of preeclampsia is hypertension, which can become very serious if left untreated," says obstetrician and maternal mortality expert Alan Lindemann, MD. Hypertension can cause seizures and hemorrhagic strokes, which can be fatal.

Another potential complication is HELLP Syndrome, which stands for hemolysis, elevated liver enzymes, and low platelets. "This is a severe complication with substantial injury to the liver and damage to platelets in the blood which are normally involved in the clotting process," says Dr. Hart. HELLP syndrome develops in about 20% of people with severe preeclampsia.

Eclampsia, a rare but serious condition that causes seizures or coma, can also develop in some cases.

Those with preeclampsia have an increased risk of high blood pressure and heart disease later in life. There's also an increased risk of kidney disease and heart attack.

From a fetal perspective, preeclampsia can slow the growth of the fetus and decrease the amount of amniotic fluid. Other possible complications include placental abruption and preterm birth.

How Do I Know If I Have Preeclampsia?

The hypertensive disorder usually develops in the second half of pregnancy. All prenatal health care providers offer regular blood pressure checks and urine screenings for protein because early diagnosis and diligent monitoring are essential. This has long been the standard for identifying the condition.

In July of 2023, the Food and Drug Administration (FDA) took a major step to help predict severe preeclampsia even earlier and more accurately. The FDA approved a first-of-its-kind test to identify certain proteins in the blood that are indicators of preeclampsia. The test can be used between 23 and 35 weeks of pregnancy. If a pregnant person is identified as high risk, they can then be treated at a facility best to handle complications and potential preterm delivery.

Treating Signs of Preeclampsia

There is no cure for preeclampsia. If you have a milder case, you may be treated at home with bed rest, but you'll probably need to make frequent visits to your health care provider's office for tests such as urinalysis, ultrasound, and electronic monitoring of the fetal heartbeat. You may also be asked to monitor your blood pressure at home.

The American Pregnancy Association recommends resting on your left side to take pressure off major blood vessels, reducing salt intake, increasing water intake, and ingesting more protein.

Many pregnant people who develop preeclampsia will need to be hospitalized so that the health of both the birthing person and the baby can be closely monitored. If the well-being of either is at risk, the practitioner may recommend early delivery by C-section or induction.

Medication may be prescribed to prevent seizures, which are a threat to those with preeclampsia, and to manage high blood pressure. In some cases, delivery must take place before the fetus is at term, which can have serious consequences for the baby's health. But in many instances, both the birthing person and baby come through the experience well, with no lasting damage to their health.

When Do Preeclampsia Symptoms Go Away?

Most cases of preeclampsia are fully resolved within 24 hours of delivery, says John Repke, MD, chairman of the Department of Obstetrics and Gynecology at Penn State Hershey College of Medicine in Hershey, Pennsylvania. Less commonly, it can take up to six weeks for all of your symptoms to subside.

Generally, the prognosis for those who have preeclampsia "is excellent," says Dr. Repke, but some research indicates that they may be at a higher risk for developing high blood pressure or heart disease later in life. Annual checkups are especially important if you've had preeclampsia.