Preeclampsia Symptoms: Warning Signs During and After Pregnancy

Watercolor illustration of a pregnant woman experiencing a headache beside a blood pressure monitor displaying 145/95.

Preeclampsia is a serious pregnancy condition that involves high blood pressure and can happen in the second half of pregnancy or after birth. It can be dangerous for both the mother and the baby, but it can be treated when it is found early. That is why blood pressure is checked at every prenatal visit.

This article explains the warning signs, who is at higher risk, how preeclampsia is diagnosed and treated, and when to get urgent help. For what happens at prenatal visits, see Prenatal Appointments and Tests: What to Expect.

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Quick Answer

Preeclampsia is a pregnancy condition that starts after 20 weeks. It means high blood pressure together with signs that organs such as the kidneys or the liver are affected, most often protein in the urine (2) (5). High blood pressure alone, with no other signs, is called gestational hypertension (5).

Preeclampsia happens in about 2% to 8% of pregnancies, according to the CDC (1). Warning signs include a headache that will not go away, vision changes, pain in the upper belly, and swelling of the face or hands. Contact your provider right away if you notice them.

What Preeclampsia Is

Preeclampsia usually starts in the last three months of pregnancy and often affects organs such as the liver or the kidneys (2). It can also appear after delivery, which is called postpartum preeclampsia. The CDC says it can happen even if you had no problems during pregnancy (1).

Eclampsia is preeclampsia that has become severe enough to cause seizures, and the CDC calls it a medical emergency (1). A rarer and serious form, called HELLP syndrome, damages the liver and blood cells (2).

Who Is at Higher Risk

The CDC lists these factors that raise the risk (1):

This is your first pregnancy.
You had preeclampsia before.
You had high blood pressure or kidney disease before you were pregnant.
You are expecting more than one baby, or you became pregnant with IVF.
You have diabetes, obesity, or lupus.
Someone in your family had preeclampsia.
You are over age 40.

Many women who get preeclampsia have no risk factors at all. If you have a high risk, your provider may suggest low-dose aspirin starting after 12 weeks of pregnancy. The U.S. Preventive Services Task Force recommends this to help prevent the condition (3). Do not start aspirin on your own without asking your provider.

Warning Signs

During Pregnancy

High blood pressure is often found at a visit, and many women feel fine at first. Symptoms, when they appear, can include (1):

A headache that will not go away.
Changes in vision.
Pain in the upper belly, often on the right side.
Nausea or vomiting.
Swelling of the face or hands.
Sudden weight gain.
Trouble breathing.

Swelling in the feet alone is common in pregnancy and often does not mean a problem (4). Swelling of the face or hands, or swelling that comes on suddenly, needs a call to your provider.

After Birth

The CDC says postpartum preeclampsia is usually found within 48 hours of delivery, but it can appear up to six weeks later (1). The warning signs are the same. Do not assume a bad headache after birth is only tiredness. Tell your provider or call 911 right away if you have symptoms. For what your checkup covers, see Postpartum Checkup: What to Expect After Birth.

Signs of an Emergency

The NICHD says these signs are a cause for immediate concern: seizures, a severe headache, vision problems such as temporary blindness, pain in the upper right belly, nausea and vomiting, and very little urine (4). Call 911 for a seizure.

How It Is Diagnosed

Your provider checks your blood pressure at every prenatal visit. If the reading is 140/90 or higher, especially after 20 weeks, more tests follow (5). These include a urine test for protein and blood tests that look at how the kidneys and the liver are working (5).

Preeclampsia is diagnosed when high blood pressure comes with protein in the urine or other signs of organ problems, such as abnormal kidney or liver tests, low platelets, or fluid in the lungs (5). High blood pressure with no protein and normal tests is called gestational hypertension. It can develop into preeclampsia, so it is watched closely (5).

A single high reading does not always mean preeclampsia. Your provider may repeat the measurement and look at the full picture. If you have high blood pressure before pregnancy, see High Blood Pressure Explained for the basics.

Treatment

The treatment depends on how severe the condition is and how far along you are. Close monitoring of you and your baby is needed, and medicine can lower your blood pressure and prevent seizures. One medicine used to prevent seizures is magnesium sulfate (3).

The only cure is delivery of the baby. At 37 weeks or later, delivery is usually recommended. Before 37 weeks, the team weighs the risks of waiting against the risks of an early birth, and may give steroid injections to help the baby’s lungs develop (3). Symptoms usually go away within about 6 weeks after delivery (3).

Why It Matters

The NICHD says preeclampsia can cause organ damage, stroke, and preterm birth for the mother. For the baby, it can mean less oxygen and fewer nutrients, preterm birth, and stillbirth (4). These risks are why early treatment matters so much, and why you should never wait to see whether symptoms pass.

When to Call Your Doctor

Contact your midwife, doctor, or maternity unit right away if:

You have a headache that will not go away.
You have changes in your vision, such as blurry sight or flashing lights.
You have pain in the upper belly.
You notice sudden swelling of your face or hands.
Your blood pressure at home is higher than usual.
You have any of these signs in the weeks after your baby is born.

Call 911 if you have a seizure, trouble breathing, or severe pain. It is better to be checked and told everything is fine than to wait.

Conclusion

Preeclampsia is a serious but treatable pregnancy condition. It can start in the second half of pregnancy or in the weeks after birth, and a headache that will not go away, vision changes, upper belly pain, and swelling of the face or hands are the signs to take seriously.

Regular blood pressure checks are the best way to find it early. If you are at higher risk, ask your provider whether low-dose aspirin is right for you. When something feels wrong, call your care team right away.

Preeclampsia: Warning Signs You Should Not Ignore

Quick Answer

What Preeclampsia Is

Who Is at Higher Risk