Preeclampsia
Preeclampsia is a hypertensive disorder of pregnancy that usually develops after 20 weeks and can affect multiple organ systems as well as placental and fetal health. Early detection and appropriate monitoring are important because deterioration can be rapid.
At a glance
Quick facts
- Category
- Hypertensive disorder of pregnancy
- Typical onset
- After 20 weeks
- Core sign
- New hypertension
- May involve
- Kidneys · liver · brain · placenta
- Major emergency
- Eclampsia / severe features
- Definitive endpoint
- Birth of the baby and placenta
Dr. Sony Sherpa
Obstetrics & Gynecology · Patan Academy of Health Sciences
Reviewed for clinical accuracy, safety language and gynecology context.
Names & terminology
How this entity may be named or searched
- Canonical name
- Preeclampsia (also written pre-eclampsia).
- Related condition
- Eclampsia means seizures associated with the hypertensive disorder after other causes are excluded.
- Not the same as
- Gestational hypertension can occur without the additional features used to diagnose preeclampsia.
- Definition nuance
- Diagnostic definitions vary internationally; contemporary criteria may include maternal organ or uteroplacental dysfunction even without proteinuria.
Structured entity profile
Clinical profile
Overview
Preeclampsia is more than high blood pressure alone. It is a pregnancy-specific syndrome that can involve the kidneys, liver, blood system, brain and placenta. WHO estimates that it affects about 3–8% of women who give birth worldwide. [1]
Some people feel well when hypertension or proteinuria is first detected during routine antenatal care. Others develop severe headache, visual symptoms, upper abdominal pain or other signs of organ involvement. This is why blood-pressure measurement and clinical assessment during pregnancy are central to detection. [1] [2]
Symptoms and warning signs
Preeclampsia can be asymptomatic, especially early in its course. Possible warning symptoms include severe or persistent headache, visual disturbance, pain in the upper abdomen or epigastrium, nausea or vomiting later in pregnancy, and sudden or concerning swelling. Symptoms must be interpreted with blood pressure, laboratory tests and fetal assessment rather than used alone to diagnose the condition. [1] [2]
SYMPTOM MATRIX
What may be noticed — and what clinicians look for
Symptoms are variable; severe disease can occur even when symptoms are limited.
- Persistent or severe headache
- Blurred vision, flashing lights or visual spots
- Upper abdominal or right-upper-quadrant pain
- Nausea or vomiting later in pregnancy
- Swelling of hands or face
- New hypertension after 20 weeks
- Proteinuria
- Abnormal kidney or liver tests
- Low platelet count
- Evidence of fetal growth or placental compromise
- Severe hypertension
- Neurologic symptoms or seizure
- Severe persistent pain or breathing difficulty
- Reduced fetal movement or major fetal concerns
Emergency symptoms during pregnancy or postpartum require immediate medical assessment.
Diagnosis
Diagnosis is based on blood pressure after 20 weeks plus evidence consistent with preeclampsia. NICE defines preeclampsia as new hypertension after 20 weeks with one or more new features such as proteinuria, maternal organ dysfunction or uteroplacental dysfunction. WHO's 2025 fact sheet gives a simpler definition centered on hypertension plus proteinuria and notes that global definitions are being reviewed. [1] [2]
I would not rely on blood pressure or proteinuria alone. Atypical presentations occur, so the diagnosis should integrate blood pressure, urine findings, symptoms and evidence of organ involvement.
Assessment may include repeat blood-pressure measurements, urine protein testing, full blood count, kidney and liver tests, and fetal assessment. NICE also supports placental growth factor–based testing in selected patients with suspected preterm preeclampsia. [2]
Diagnostic pathway
From suspected hypertension to risk assessment
Local protocols differ, but the pathway combines maternal and fetal assessment.
Blood-pressure thresholds and monitoring intervals are guideline-specific; this pathway follows NICE NG133. Source [2]
Risk factors and prevention
Risk is higher with factors such as a previous preeclampsia history, first pregnancy, multifetal pregnancy, chronic hypertension, kidney disease, diabetes and obesity. Preventive recommendations depend on individual risk. WHO recommends low-dose aspirin for people at high risk and calcium supplementation in settings where dietary calcium intake is low. [1] [3]
Treatment and management
Management aims to prevent maternal complications while balancing fetal maturity and placental function. Antihypertensive treatment is used when blood pressure warrants it, and magnesium sulfate is used to prevent or treat eclamptic seizures in appropriate patients. WHO notes that magnesium sulfate can reduce the risk of eclampsia by more than half. [1] [2]
Birth is the definitive endpoint of the pregnancy-specific disease process, but timing is individualized according to gestational age, severity and maternal/fetal condition. Severe or worsening disease may require earlier birth. [2]
Treatment & care hub
Management depends on severity and gestational age
Preeclampsia requires clinician-led care; the priorities are maternal stabilization, seizure prevention when indicated, fetal surveillance and safe timing of birth.
Maternal + fetal surveillance
Blood pressure, symptoms, blood tests and fetal assessment are repeated according to severity.
Antihypertensive treatment
Medication is used to control hypertension; drug choice follows pregnancy-specific guidance and patient factors.
Magnesium sulfate
Used for prevention or treatment of eclampsia in appropriate clinical settings.
Timing of birth
Gestational age and maternal/fetal wellbeing determine whether expectant management or planned birth is safer.
After birth and future health
Preeclampsia can present or worsen after birth, so postpartum symptoms and blood pressure still matter. Follow-up is also important because hypertensive disorders of pregnancy identify a group with higher later cardiovascular risk. Medication and follow-up plans should be individualized after delivery. [2]
Global burden · WHO
Preeclampsia worldwide
WHO provides a global range rather than a single country-by-country prevalence dataset.
Common questions
Frequently asked questions
Yes. High blood pressure or other abnormalities may be detected during routine antenatal care before a person feels unwell.
Not in every contemporary diagnostic framework. Some guidelines allow diagnosis when new hypertension is accompanied by other maternal organ or uteroplacental dysfunction.
Eclampsia refers to seizures occurring in association with the hypertensive disorder of pregnancy after other causes are excluded.
Yes. New or worsening hypertension and preeclampsia-related complications can occur postpartum, so urgent symptoms after birth still require assessment.
No. Risk reduction may include low-dose aspirin for selected high-risk patients and calcium supplementation where dietary calcium intake is low, alongside appropriate antenatal care.
Sources
- WHO — Pre-eclampsia fact sheet, 10 December 2025
- NICE — Hypertension in pregnancy: diagnosis and management (NG133)
- WHO — WHO recommendations on maternal health, 2nd edition (2025)
This article is based on trusted medical sources and has undergone clinician review. It is not a substitute for personalized medical advice.
In assessment, cough or shortness of breath raises concern for pulmonary edema as a potential complication of preeclampsia and warrants urgent evaluation.
Severe headache, visual symptoms and upper abdominal pain are warning features that require urgent assessment because they can accompany severe preeclampsia or impending eclampsia.