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Pre-eclampsia


Expert reviewer Dr Shirin Irani, Consultant Gynaecologist
Next review due August 2022

Pre-eclampsia is a condition that can affect you when you’re pregnant. It causes high blood pressure and protein in your urine and can be harmful to you and your baby. It’s usually diagnosed during routine antenatal appointments so that you can be monitored and treated.

An image showing the baby and surrounding structures in late pregnancy

About pre-eclampsia

Pre-eclampsia is caused by a problem with your placenta, which joins you to your baby. The placenta supplies your baby with the blood and nutrients they need to grow and develop. You can get pre-eclampsia at any time after 20 weeks of pregnancy and even after you give birth.

If you have pre-eclampsia, your placenta doesn’t send enough blood to your baby, which can affect how well your baby grows. This causes your blood pressure to rise and affects how well your kidneys work. The two main signs of pre-eclampsia are:


Your hands, face or feet may also swell up.

Pre-eclampsia is thought to affect roughly five in every 100 pregnancies. Severe pre-eclampsia, which can be dangerous to the mother and baby, affects around one in every 100 pregnancies.

You can have high blood pressure while you’re pregnant without having pre-eclampsia. This is called gestational hypertension and can happen after 20 weeks of pregnancy. Your blood pressure will be higher than it should be, but you won’t have protein in your urine.

It’s natural to worry about conditions such as pre-eclampsia during your pregnancy. But by being aware of the symptoms and going to your antenatal appointments, any conditions can be diagnosed early on. You can then get the right support and treatment.

Symptoms of pre-eclampsia

If you have pre-eclampsia, you may not have any symptoms. The condition is often picked up at routine antenatal appointments, which is why it’s so important to go to these.

You may notice some symptoms if your pre-eclampsia gets worse. These symptoms may include:

  • very bad headaches, which aren’t eased by painkillers
  • problems with your sight, such as seeing flashing lights or blurred vision
  • pain in your tummy, just below your ribs
  • feeling or being sick
  • difficulty breathing
  • sudden swelling of your hands, face or feet (you may find jewellery doesn’t fit well)
  • not weeing as often as usual

If you have any of these symptoms, contact your midwife or GP straightaway, or go to the maternity unit at your local hospital.

Diagnosis of pre-eclampsia

Pre-eclampsia doesn’t always cause any symptoms. It’s often picked up at a routine antenatal appointment. At each appointment, your midwife or GP will check your blood pressure. They will also test a urine sample for protein.

If you have high blood pressure after 20 weeks of your pregnancy, and you have protein in your urine, you may have pre-eclampsia. Your midwife or GP will refer you to a hospital maternity unit if you have high blood pressure over a certain point — whether or not protein is detected in your urine.

You’ll have blood tests to check how well your liver and kidneys are working and how well your blood is clotting.

You may have an ultrasound scan to check the growth of your baby. You may also have tests to monitor the baby’s heartbeat and movements.

Treatment of pre-eclampsia

The treatment will depend on how bad your pre-eclampsia is, how it’s affecting you and your baby and how many weeks pregnant you are.

You may be admitted to hospital or you may have regular reviews in the maternity day assessment unit. You’ll be monitored closely to check that you and your baby stay well. You may need to collect your urine over 24 hours so your doctor can measure how much protein it contains. Your midwife and doctor will check your blood pressure regularly. You’ll also have regular blood tests to check your liver, kidneys and how well your blood is clotting.

Your baby’s health will also be monitored to check their heart rate and movement.

If you have mild pre-eclampsia, you may be able to stay at home and go to the day assessment unit for these tests.

Your midwife and doctor may recommend that you monitor how much fluid you drink. It’s important to follow their instructions carefully.

Giving birth

The only ‘cure’ for pre-eclampsia is to give birth to your baby and the placenta. Every pregnancy is different, but your midwife and doctor will try to treat your pre-eclampsia with medicines first. Your baby may need to be delivered before you reach the full term of your pregnancy. But your midwife and doctor will try to delay the birth until you’ve reached at least 34 weeks of pregnancy.

Your doctor and midwife will discuss with you when and how you’ll give birth. You may need to have a caesarean delivery, especially if your baby is being born very early. If you’re unsure of anything, don’t be afraid to ask. If you have pre-eclampsia, you may need to make another birth plan.

Your blood pressure will usually go back down to normal within six weeks of having your baby. But sometimes this can take up to three months. Occasionally pre-eclampsia gets worse, or you can develop pre-eclampsia for the first time, after you’ve given birth. So, your midwife will carry on checking your blood pressure after you’ve had your baby.

Medicines

If you have pre-eclampsia, your doctor may prescribe beta-blocker medicines, such as labetalol, to help lower your blood pressure. These medicines can’t cure pre-eclampsia, but they may stop you having serious health problems if your blood pressure gets very high. You may be able to take tablets, but if your blood pressure is very high, you may need to have the medicines through a drip.

You usually need to keep taking these medicines after the birth as well, until your blood pressure goes back down to normal. These medicines are safe to take if you’re breastfeeding your baby.

If your pre-eclampsia is very bad, you’ll be treated in hospital. Your doctor may give you magnesium sulphate to prevent fits. This is given to you through a drip.

Causes of pre-eclampsia

Doctors don't know exactly why some women get pre-eclampsia yet others don’t. Pre-eclampsia seems to start when the placenta doesn’t form and grow properly, which means it doesn’t get enough blood. This can be dangerous for the mother and baby.

Some things seem to increase your risk of getting pre-eclampsia. These include:

  • this is your first baby
  • you have a close family history of pre-eclampsia – if your mother or sister had pre-eclampsia, you’re more likely to get it too
  • it’s been 10 years or more since you were last pregnant
  • you're having more than one baby (such as twins or triplets)
  • you're over 40
  • you have other health conditions, such as high blood pressure, diabetes and kidney disease
  • you're very overweight

You may be more likely to get pre-eclampsia if you’ve had the condition in a previous pregnancy. But many women who have had pre-eclampsia before go on to have a normal, healthy pregnancy. If you do get pre-eclampsia again, it shouldn’t be as bad as the first time.

It’s important to tell your midwife and GP if you’ve had pre-eclampsia before as they’ll want to monitor you more closely. Make sure you go to all your antenatal appointments and have your blood pressure checked regularly.

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Complications of pre-eclampsia

Pre-eclampsia is usually mild and doesn’t cause any complications, especially if it’s diagnosed early on. But sometimes, it can be dangerous for the mother and baby.

If you’re not treated for pre-eclampsia, it may develop into a condition called eclampsia. Eclampsia causes fits (seizures), which look similar to epileptic fits. This happens in one in every 2,000 pregnancies. It can develop at any time during the second half of your pregnancy, during labour or soon after you give birth.

If a fit goes on for a long time, both you and your baby can struggle to get enough oxygen. This can be life-threatening for you and your baby, but your hospital team will do everything they can to prevent this happening. They’ll give you a medicine called magnesium sulphate to stop you having fits. Your doctor will aim to deliver your baby before you get eclampsia.

Very bad pre-eclampsia can lead to liver, kidney and lung failure and problems with how your blood clots. A combination of all of these serious health problems is called HELLP syndrome (Haemolysis, Elevated Liver enzymes, Low Platelets). This can also be life-threatening, and the only treatment is for you to have your baby as soon as possible. This may mean you have to deliver your baby early. Your doctor or midwife will support you through this decision and make sure you and your baby get the right treatment.

Prevention of pre-eclampsia

If you’re at high risk of developing pre-eclampsia, your doctor may suggest you take aspirin every day. You’ll usually need to take 75mg of aspirin from 12 weeks of pregnancy until your baby is born. But only take it if your doctor has told you to. To find out if you’re at high risk of pre-eclampsia, see our Causes of pre-eclampsia section above.

It may also help if you get some exercise and lose any excess weight, but talk to your doctor about how to do this safely. Keeping active safely and eating healthily will generally help you to stay well during pregnancy.

It’s good to keep aware of any jewellery or shoes becoming tighter, which could be a sign of swelling. Contact your midwife or GP if this happens.

Frequently asked questions

  • After your baby’s born, you’ll probably need to stay in hospital for a few days. Doctors and nurses will closely monitor your blood pressure and symptoms during this time. You’ll then usually be given an appointment to see your GP or an obstetrician between six and eight weeks later. An obstetrician is a doctor who specialises in pregnancy and childbirth.

    If you had pre-eclampsia during your pregnancy, you can still get complications after your baby is born. That’s why you’ll need to stay in hospital until your blood pressure goes down and you’re well enough to go home. This can take a few days. You may need to keep taking medicines to treat high blood pressure too.

    While you’re in hospital, your midwives and doctors will check your blood pressure regularly. If you have any symptoms, such as a headache or tummy pain, tell your midwife or doctor. If you notice symptoms when you get home, tell your midwife or GP straightaway too. You can get pre-eclampsia up to four weeks after your baby is born.

    If your blood pressure is still high after six to eight weeks, you may need to see a specialist doctor. You should also see a specialist if there’s still protein in your urine.

  • You and your baby shouldn’t have any long-term health problems after pre-eclampsia. But it may make you more likely to have high blood pressure in the future. You may also be more likely to get heart disease or have a stroke in later life. Some women get some long-term damage to their kidneys but this isn’t so common.

    Your baby shouldn’t have any health problems in the future if you had pre-eclampsia. But if they were born very early, or didn’t get enough oxygen, because of your pre-eclampsia, they may have some problems. For more information, talk to your midwife and doctor. They’ll make sure you and your baby get the right treatment.


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Related information

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  • Reviewed by Graham Pembrey, Lead Editor, Bupa Health Content Team, August 2019
    Expert reviewer Dr Shirin Irani, Consultant Gynaecologist
    Next review due August 2022



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