Pregnancy comes with plenty of questions, and sometimes a few worries too
One condition you might hear mentioned during antenatal appointments is pre-eclampsia. It sounds serious, and it can be, but there are treatments and monitoring that can help. Here’s what you need to know.
What is pre-eclampsia?
Pre-eclampsia is a pregnancy-related condition that causes high blood pressure. Early signs can include high blood pressure and protein in your urine, although you are unlikely to notice these yourself. This is why routine blood pressure and urine checks during antenatal care matter.
It is most likely to develop from 20 weeks of pregnancy onwards, but it can occur at other points in pregnancy and can sometimes develop in the days or weeks after your baby is born.
Symptoms that need checking immediately
Pre-eclampsia does not always cause obvious symptoms early on. NHS guidance says the following symptoms can be serious and should be checked immediately:
- A severe headache that does not go away with simple painkillers
- Blurred vision or seeing flashing lights
- Pain below the ribs
- Sudden swelling of the face, hands or feet
- Feeling very unwell
- Heartburn that does not go away with heartburn medicines
- Vomiting
If you are pregnant and have these symptoms, contact your maternity unit urgently if you have the number. If you have recently given birth, or cannot contact your maternity unit, NHS advice is to call 111.
What can you expect from your midwife or doctor?
In the UK, routine antenatal care includes blood pressure and urine checks. If pre-eclampsia is suspected, you will usually be referred to hospital for further assessment. This can include blood tests and ultrasound scans to check your baby’s growth.
Monitoring
You may need more frequent appointments, blood pressure checks and scans so your maternity team can monitor both you and your baby.
Treatment
Treatment can include medicine to lower blood pressure. Severe pre-eclampsia may require hospital monitoring and, in some cases, medicine to reduce the risk of seizures.
Birth planning
If pre-eclampsia becomes severe, it may be safer for your baby to be born early. Your maternity team will discuss induction or caesarean birth if needed.
After birth
Symptoms usually improve after birth, but they can continue for a while. Some people need blood pressure medicine and follow-up checks after leaving hospital.
What increases the risk?
The exact cause of pre-eclampsia is not fully understood. NHS and NICE guidance identifies several factors associated with higher risk, including:
- High blood pressure, diabetes or kidney disease
- Autoimmune conditions such as lupus or antiphospholipid syndrome
- Pre-eclampsia in a previous pregnancy
- A first pregnancy
- Being aged 40 or over
- Multiple pregnancy, such as twins or triplets
- A family history of pre-eclampsia
- A gap of 10 years or more since your last pregnancy
- A BMI of 35 or more before pregnancy
Your individual risk is assessed by your maternity team rather than by any one factor in isolation.
What about aspirin?
If you are at higher risk, your midwife or doctor may prescribe low-dose aspirin. NICE recommends 75 mg to 150 mg daily from 12 weeks until birth for people at high risk, and for those with more than one moderate risk factor.
Do not start aspirin in pregnancy unless it has been recommended or prescribed by your maternity team or GP.
A final reassurance
Pre-eclampsia can sound daunting, but you are not expected to spot or manage it alone. Regular antenatal care is designed to pick up changes in blood pressure and urine before you may feel unwell.
Trust your instincts and speak up if something does not feel right. Symptoms of pre-eclampsia during pregnancy or in the weeks after birth should be checked promptly.
