What Is Preeclampsia? A Clear Guide to Symptoms, Risks, and Care
Understanding this condition helps you recognize warning signs early—and know when to contact your care team.
Quick Guide: What You Need to Know - If you only have 2 minutes:
What is it? Preeclampsia is high blood pressure that develops during pregnancy, usually after 20 weeks. It can also happen up to 6 weeks after delivery.
How common? About 2-8% of pregnancies. Your care team checks for it at every visit.
Is it serious? Yes, but it's manageable when caught early and managed. Women with preeclampsia can have healthy babies.
Warning signs to watch for:
Bad headache that won't go away
Vision changes (blurry, spots, flashing lights)
Pain under your ribs on the right side
Sudden swelling in your face or hands
Trouble breathing
Throwing up in late pregnancy
Gaining several pounds in just a few days
Heartburn that antacids don't help
Peeing less, darker urine, or burning when you pee
What to do: If you notice any warning signs, contact your care team immediately. Don't wait. Don't worry about "bothering" them—this is exactly what they need to know.
It's not your fault. Preeclampsia isn't caused by anything you did or didn't do.
One action to take today: Ask your provider what your normal blood pressure is. Write it down. This helps you spot changes.
- Want to understand more? Keep reading for a more complete guide. -
The Complete Guide
What Is Preeclampsia?
Preeclampsia is a condition where high blood pressure develops during pregnancy, usually after 20 weeks. It affects multiple organs in your body, most commonly the kidneys and liver.
According to the American College of Obstetricians and Gynecologists (ACOG), preeclampsia occurs in 2-8% of pregnancies worldwide [ACOG Practice Bulletin 202]. That means it's common enough that your care team screens for it at every prenatal visit—but most pregnancies don't develop it.
Why it matters: Preeclampsia is one of the leading causes of complications during pregnancy. When caught early and managed properly, women with preeclampsia have healthy pregnancies and healthy babies. The key is to monitor and catch changes before they become serious.
Important: Preeclampsia can also develop after delivery. Up to 6 weeks postpartum, you're still at risk—which is why monitoring doesn't stop when your baby arrives [ACOG; Hirshberg 2018, Steele 2023 SR].
Types of Pregnancy-Related High Blood Pressure
Not all high blood pressure during pregnancy is preeclampsia. Here's how to understand the different types:
Condition - What It Means
Chronic hypertension = High blood pressure that existed before pregnancy or develops before 20 weeks
Gestational hypertension = High blood pressure that develops after 20 weeks, without other organ involvement
Preeclampsia = High blood pressure after 20 weeks, WITH signs of organ involvement (protein in urine or other features)
Preeclampsia with severe features = Preeclampsia with very high blood pressure (≥160/110) or significant organ damage
The connection: Research shows that up to half of women diagnosed with gestational hypertension eventually develop preeclampsia [ACOG Practice Bulletin 202]. This is why your care team monitors you closely if your blood pressure is elevated—they're watching for progression.
What's changed: Doctors previously required protein in the urine to diagnose preeclampsia. That's no longer true. Today, preeclampsia can be diagnosed based on other signs of organ involvement, even without protein in your urine [ACOG Practice Bulletin 202]. This means earlier detection for some women.
Warning Signs to Know
Some symptoms require immediate attention. Knowing these can help you act quickly if something doesn't feel right.
Call your care team immediately if you experience:
Severe headache that won't go away with rest or typical remedies
Vision changes including blurry vision, seeing spots, flashing lights, or sensitivity to light
Upper right abdominal pain (under your ribs on the right side), sometimes mistaken for heartburn
Sudden swelling of your face or hands (different from the gradual ankle swelling common in pregnancy)
Shortness of breath or difficulty breathing
Nausea or vomiting in the second half of pregnancy (when morning sickness should be long gone)
Rapid weight gain—several pounds in just a few days, often from fluid retention
Heartburn that won't go away even after taking antacids
Changes in your urine—darker color than usual, urinating less often, or any burning when you urinate
A note about symptoms: You can have preeclampsia without obvious symptoms—that's why regular blood pressure checks matter. And you can have symptoms without extremely high blood pressure numbers. Both the readings and how you feel are important information for your care team.
This Is Not Your Fault
If you've been told you're at risk for preeclampsia, or you've been diagnosed, please know this: preeclampsia is not caused by anything you did wrong.
It's not because you ate the wrong foods, didn't exercise enough, or were too stressed. Researchers are still working to understand exactly why preeclampsia develops, but they know it relates to how the placenta forms and functions—something outside your control.
Your job isn't to prevent preeclampsia through perfect behavior. Your job is to show up for your prenatal appointments, know the warning signs, and communicate with your care team. That's it.
Risk Factors
Certain factors make preeclampsia more likely. Having one or more doesn't mean you'll develop it—many women with multiple risk factors never do. And some women with no risk factors develop preeclampsia unexpectedly.
You may be at higher risk if you have:
A first pregnancy
History of preeclampsia in a previous pregnancy
Chronic high blood pressure, diabetes, or kidney disease
Age under 20 or over 40
A multiple pregnancy (twins, triplets)
Family history of preeclampsia (mother or sister)
A pregnancy interval of more than 10 years since your last pregnancy
Certain autoimmune conditions like lupus
Obesity
Pregnancy through IVF (in-vitro fertilization)
Sickle cell disease
Black or African ancestry—research shows Black women face higher rates of preeclampsia, which experts believe reflects longstanding inequities in healthcare access and quality, not biological differences [ACOG]
What this means: If you have risk factors, your provider may recommend more frequent monitoring. Some women are prescribed low-dose aspirin starting in the first trimester to reduce preeclampsia risk—talk to your provider about whether this applies to you [ACOG, USPSTF recommendations].
How Preeclampsia Is Diagnosed
Your care team uses several tests to diagnose preeclampsia:
Blood pressure measurement: A reading of 140/90 or higher on two separate occasions, at least 4 hours apart, is considered elevated [ACOG Practice Bulletin 202].
Urine tests: Checking for protein in your urine, which can indicate kidney involvement.
Blood tests: Looking at liver function, kidney function, and platelet count.
Severe features are diagnosed when: Blood pressure reaches 160/110 or higher, platelet count drops significantly, liver enzymes become elevated, kidney function is impaired, or you develop fluid in the lungs or neurological symptoms [ACOG Practice Bulletin 202].
Your provider interprets these results together—no single test tells the whole story.
Treatment and Management
There is no cure for preeclampsia except delivery. But that doesn't mean immediate delivery is always necessary. Your care team will work with you to balance managing the condition while giving your baby time to develop.
Management may include:
Close monitoring: More frequent prenatal visits, blood pressure checks, blood work, and fetal monitoring
Blood pressure medication: To keep your readings in a safer range
Magnesium sulfate: Given during labor or when severe features develop, to prevent seizures
Steroids: If early delivery might be needed, to help your baby's lungs mature faster
Delivery: The definitive treatment. Timing depends on how severe your condition is and how far along you are
After delivery: Preeclampsia doesn't end when your baby is born. Your blood pressure should be monitored after delivery, and some women experience their highest readings in the first week or two postpartum [ACOG].
This is where home blood pressure monitoring becomes especially valuable. Remote monitoring programs have been shown to help more women complete their recommended postpartum blood pressure checks and can reduce hypertension-related hospital readmissions [Hirshberg 2018 RCT; Steele 2023 systematic review; Arkerson 2023 RCT].
What You Can Do
You're not powerless. Here's how to be an active partner in your care:
1. Attend all your prenatal appointments. Those routine blood pressure checks and urine tests exist for a reason.
2. Know your baseline. Ask your provider what your typical blood pressure is. This helps you notice meaningful changes.
3. Learn the warning signs. Recognizing symptoms early gives you and your care team more time to respond.
4. Consider home monitoring. Tracking your blood pressure between appointments can help catch changes early. When used correctly, home readings closely match clinic readings and give your provider valuable data between visits [Bowen 2021; Albadrani 2023 systematic review].
5. Communicate openly. If something feels off, say something. Your care team would rather hear about a concern that turns out to be nothing than miss something important.
The Bottom Line
Preeclampsia is serious—but it's manageable when caught early and monitored carefully.
Understanding this condition doesn't have to increase your anxiety. Instead, it gives you the knowledge to recognize warning signs, ask informed questions, and work effectively with your care team.
You're not alone in this. Millions of women are monitored for preeclampsia every year, and the vast majority have healthy outcomes. Your care team is watching for it. And now, you know what to watch for too.
Next steps: If you want to learn how home blood pressure monitoring can help you and your care team stay connected between appointments, [learn more about getting started].
This article is for educational purposes only and does not replace medical advice. Always consult your healthcare provider with questions about your specific situation.
Sources
American College of Obstetricians and Gynecologists [ACOG]. Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstetrics & Gynecology. 2019.
ACOG Committee Opinion No. 767: Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period. 2019.
Hirshberg A, et al. Randomized controlled trial of a text message blood pressure monitoring program for postpartum hypertension. American Journal of Obstetrics & Gynecology. 2018.
Steele DW, et al. Remote Blood Pressure Monitoring in Pregnancy and Postpartum: A Systematic Review. Obstetrics & Gynecology. 2023.
Arkerson BN, et al. Postpartum remote blood pressure monitoring RCT. 2023.
Bowen L, et al. Home vs. clinic blood pressure measurement agreement in hypertensive pregnancy. BJOG. 2021.
Albadrani S, et al. Remote blood pressure monitoring in pregnancy: A systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2023.
