Preeclampsia: Symptoms, Causes & Treatment

Preeclampsia, popularly known as pregnancy toxemia, is a serious pregnancy complication that usually appears after week 20 (that is, after mid-pregnancy), characterized by high blood pressure accompanied by protein in the urine or signs of involvement of one of the body's organs (such as the liver or kidneys). Although the exact cause is not fully understood, it is thought to relate to a problem in the formation of the placenta's blood vessels, affecting blood flow and leading to the symptoms.

The danger of preeclampsia lies in its possibly developing without clear symptoms at its onset, so measuring blood pressure and checking urine at every pregnancy follow-up visit are among the most important means of detecting it early. As it progresses, important warning signs may appear that every pregnant woman should watch for: a severe headache that does not go away, vision disturbances (blurring, or seeing flashes or spots), severe pain in the upper right abdomen (below the ribs), sudden swelling of the face and hands, rapid weight gain, and shortness of breath. The chances of developing it increase with a first pregnancy, twin pregnancy, obesity, prior high blood pressure, diabetes, or kidney disease, advanced maternal age, and its occurrence in a previous pregnancy.

Preeclampsia is a condition requiring close medical monitoring because it may worsen rapidly and affect the mother (kidneys, liver, brain, and blood clotting) and the fetus (poor growth, low fluid, and premature birth), and may progress to eclampsia (seizures), an emergency. The definitive and only curative treatment is delivering the baby and placenta at the appropriate time, and the doctor balances the condition's severity against the gestational age to determine the optimal timing. Until then the condition is managed with medications to lower blood pressure, close monitoring of mother and fetus, sometimes a medication to prevent seizures, and a low dose of aspirin is sometimes advised for prevention in high-risk pregnant women by the doctor's decision. Regular pregnancy follow-up is the first line of defense.

• High blood pressure and protein in the urine.
• A severe headache that does not go away and vision disturbances (blurring, flashes).
• Severe upper right abdominal pain and sudden swelling of the face and hands.
• Rapid weight gain and shortness of breath.

• Thought to relate to a problem in the formation of the placenta's blood vessels.
• Risk factors: first pregnancy, twin pregnancy, obesity.
• Prior high blood pressure, diabetes, or kidney disease, advanced maternal age, and previous occurrence.

• Measuring blood pressure and checking urine at every pregnancy follow-up visit.
• Blood tests for liver and kidney function and platelets.
• Monitoring fetal growth and fluid by ultrasound.

The definitive treatment

• Delivering the baby and placenta at the appropriate time (the only curative treatment), balancing the condition's severity and the gestational age.

Management until delivery

• Medications to lower blood pressure and close monitoring of mother and fetus.
• Sometimes a medication to prevent seizures.
• A low dose of aspirin for prevention in high-risk women by the doctor's decision.

This content is educational and does not replace close medical follow-up.

• Progression to eclampsia (seizures) — an emergency.
• Effects on the mother's kidneys, liver, brain, and blood clotting.
• Poor fetal growth, low fluid, and premature birth.

• Regular pregnancy follow-up and measuring blood pressure and checking urine each visit.
• A low dose of aspirin for prevention in high-risk women by the doctor's decision.
• Controlling weight, blood pressure, and diabetes before and during pregnancy.