Preeclampsia/Eclampsia

Preeclampsia is a serious condition that occurs when you have elevated blood pressure and protein in your urine after 20 weeks of pregnancy.

Preeclampsia occurs in about 4% of pregnancies. People with preeclampsia are more likely to deliver their baby preterm or via cesarean section (C-section).

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On this page:  

• What Is Preeclampsia?
• What Are the Symptoms of Preeclampsia?  
• How Do You Diagnose Preeclampsia? 
• How Do You Treat Preeclampsia?

What Is Preeclampsia?

Doctors define preeclampsia as a serious condition that occurs when you have elevated blood pressure and protein in your urine after 20 weeks of pregnancy.

Most people have mild high blood pressure during pregnancy, which carries few problems. But preeclampsia may cause you to have headaches, abdominal pain, or visual disturbances. Your blood pressure may return to normal after delivery, but in some cases, it can stay elevated for weeks or months.

Preeclampsia, also called toxemia or pregnancy-induced hypertension, can be dangerous for you and your baby. It can reduce oxygen and blood flow to your baby and cause damage to your liver, kidneys, or brain.

If you have preeclampsia, you're more likely to have an early (preterm, before 37 weeks) delivery or a C-section.

While preeclampsia is a serious pregnancy condition, outcomes for both you and your baby can be significantly improved through early diagnosis, routine monitoring, and timely medical intervention.

What is eclampsia?

Severe preeclampsia can lead to dangerous seizures and a condition called eclampsia. Seizures greatly reduce the oxygen supply to the baby and, in rare cases, can be life-threatening.

About 1% of women who have preeclampsia have these life-threatening seizures. If you have a seizure during pregnancy, you should go to the nearest emergency department immediately.

What is postpartum preeclampsia?

While rare, some people develop preeclampsia after they deliver their baby, even if they didn't have blood pressure problems during their pregnancy. This is called postpartum preeclampsia. 

Postpartum preeclampsia most often occurs within the first few days after giving birth. But for some people, it can occur within the first six weeks after giving birth. If this happens, you may need to be readmitted to the hospital to have your blood pressure treated and/or receive medication to help prevent seizures.

Postpartum preeclampsia is just as high-risk as preeclampsia and requires immediate treatment.

You should continue to watch for signs and symptoms of preeclampsia for the first few weeks after you deliver your baby and contact your doctor right away if you notice any symptoms. Your doctor may want to measure your blood pressure and test your urine and blood regularly to monitor your condition.

How common is preeclampsia?

Preeclampsia occurs in about 4% of pregnancies and accounts for 2% to 8% of pregnancy-related complications.

What causes preeclampsia?

The exact cause of preeclampsia isn't known, but it may occur because the placenta doesn't grow the usual network of blood vessels and limits blood flow to the baby.

The placenta is a round, flat organ that forms during pregnancy and gives your baby food and oxygen from your body. Any disruption to the proper development of the placenta can have serious implications for your health and your baby's health.

Preeclampsia risk factors and complications

Preeclampsia risk factors

Certain factors can increase your risk of developing preeclampsia.

The factors include:

• Having a history of diabetes, kidney disease, lupus, or rheumatoid arthritis.
• Being over age 35.
• Being obese (having a BMI, or body mass index, of 30 or higher).
• Being pregnant as a teenager.
• Being pregnant for the first time.
• Being pregnant with multiples.
• Belonging to a group that experiences health disparities. Black and Hispanic people are more likely to have preeclampsia than White people. In general, people of low socioeconomic status have less access to quality health care.
• Having gestational hypertension, which is a mild form of high blood pressure after 20 weeks of pregnancy. Although it doesn't cause symptoms and usually isn't risky to you or your baby, gestational hypertension can lead to preeclampsia in some people.
• Having intrauterine fetal growth restriction, in which your baby doesn't grow as big as expected.
• Having had pregnancy complications, such as a low birth weight baby, in your previous pregnancy.
• Having a family history of preeclampsia.
• Having high blood pressure before pregnancy.
• Having preeclampsia during a prior pregnancy.
• Undergoing in vitro fertilization (IVF), a fertility treatment, to get pregnant.

Preeclampsia complications

Preeclampsia may put you at a higher risk of high blood pressure and heart disease later in life.

It's important to know that most people with preeclampsia give birth to healthy babies. But without treatment, preeclampsia can cause serious health complications for both you and your baby.

Complications caused by preeclampsia may include:

• Bleeding after birth.
• Bleeding from your liver.
• Blood clot problems, such as thromboembolism, a condition in which a clot travels through the bloodstream and blocks a blood vessel.
• Brain damage.
• Eclampsia, which causes seizures.
• Heart disease, diabetes, or kidney disease later in life.
• A low birth weight baby.
• Maternal death.
• Placental abruption, which occurs when your placenta separates from your uterine wall.
• Postpartum hemorrhage. 
• Preterm delivery. Babies born prematurely have an increased risk of learning disabilities, epilepsy, cerebral palsy, hearing problems, and vision impairment.
• Renal failure, when your kidneys stop working properly.
• Reversible blindness.
• Stillbirth.
• Stroke.
• Pulmonary edema, or water in your lungs.

Many people with mild preeclampsia have no lasting effects, and their blood pressure returns to normal within a few weeks or months after birth. Sometimes, you'll need to continue taking blood pressure medication during this time.

How can I prevent preeclampsia?

Managing your blood pressure before and during pregnancy may lower your risk of preeclampsia.

Ways to help manage blood pressure include:

• Eating plenty of fruits and vegetables.
• Getting enough exercise.
• Maintaining a healthy weight.
• Reducing sodium intake.

If you're at risk of getting preeclampsia, your doctor may suggest that you take a low-dose aspirin (also known as baby aspirin). Most doctors will recommend starting a regimen of low-dose aspirin between 12 to 28 weeks of pregnancy until delivery.

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What Are the Symptoms of Preeclampsia?  

Common symptoms of preeclampsia include:

• Abdominal pain.
• Bleeding from an injury that lasts longer than normal.
• Changes in your reflexes.
• Difficulty breathing.
• Dizziness.
• Excessive vomiting or nausea.
• Rapid weight gain (two pounds or more per week) from retaining body fluids.
• High blood pressure.
• Pain in your belly (especially the upper right area).
• Pain in your shoulder.
• Severe and persistent headaches.
• Swelling of the hands, feet, and legs.
• Too much protein in your urine, which can make it appear bubbly or foamy.
• Reduced urine output or no urine output.
• Vision changes, such as blurry vision, flashing lights, light sensitivity, or floaters.

In most cases, the signs and symptoms of preeclampsia tend to appear in pregnancies that are approaching full-term. But if you experience these symptoms at any point in your pregnancy, see your doctor right away. 

Some people with preeclampsia don't experience any of these symptoms, so it's important to attend regular prenatal exams to ensure that your blood pressure and urine tests are normal throughout your pregnancy.

Preeclampsia is easier to manage when detected in its early stages. 

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How Do You Diagnose Preeclampsia?

Most often, your doctor will diagnose preeclampsia during a prenatal visit. They'll check your blood pressure and test the protein levels in your urine at each visit.

Though you may have some symptoms, your doctor will only confirm a diagnosis of preeclampsia if you experience any or all of the following after 20 weeks of pregnancy:

• High levels of protein in your urine.
• Systolic blood pressure over 140 and/or diastolic pressure over 90 that occurs twice over four hours.
• Systolic blood pressure reading over 160 and/or diastolic pressure over 110 (signals severe preeclampsia).
• If you have preeclampsia, your doctor may want to check on the health of your baby.

They'll conduct these tests:

• Biophysical profile — A combination of a nonstress test and ultrasound that measures the level of amniotic fluid and monitors your baby’s movements.
• Nonstress test (NST) — Checks your baby’s heart rate.
• Transabdominal (of your belly) ultrasound — Assesses your baby’s development and weight.

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How Do You Treat Preeclampsia?

The only way to cure preeclampsia is to give birth. Your doctor will wait to deliver as long and as close to term as possible to keep both you and your baby safe. Treatment of preeclampsia will depend on the severity of your condition and how far along you are in your pregnancy.

You can better manage preeclampsia by listening to your doctor’s advice, which may include:

• Bed rest.
• Closely monitoring your blood pressure and urine throughout pregnancy.
• Collecting a 24-hour urine specimen to check for protein levels.
• Frequent ultrasound exams.
• Hospitalization to monitor moderate or quickly worsening preeclampsia.
• Inducing preterm delivery. Your doctor may give you medication or manually break your amniotic sac to start labor. Most babies of people with severe preeclampsia before 34 weeks of pregnancy have better outcomes being delivered early in the hospital than remaining in the womb. Induced preterm delivery is almost always recommended if you have preeclampsia and HELLP syndrome (high liver enzymes and low platelets).
• C-section delivery. If your baby is close to full term (37 weeks gestation or more), your doctor may recommend inducing labor or delivering via cesarean section.
• Reducing your activity.
• Routine monitoring of fetal heart rate.
• Taking corticosteroids to speed up the development of your baby’s lungs for a healthier and safer delivery.
• Taking magnesium sulfate to stop or prevent seizures. In cases of moderate to severe preeclampsia, you're still at an increased risk of seizures 24 to 48 hours after delivery.
• Taking medicine to try to lower your blood pressure and prevent seizures.
• Tracking your baby’s kick counts to measure how often your baby moves. You can do this by tracking how long it takes for your baby to kick 10 times or how many times your baby kicks in one hour.
• Weekly or biweekly checkups.

If you have mild preeclampsia, you still may be able to have a vaginal delivery as long as you and your baby are both stable. If your baby has trouble handling contractions or your preeclampsia quickly gets worse, then you may need an emergency C-section delivery.

By UPMC Editorial Staff. Last reviewed on 2024-09-05.