What it is
Preeclampsia is high blood pressure in pregnancy plus signs that organs are under strain, such as protein in urine. Gestational hypertension is high blood pressure after 20 weeks without those signs. HELLP is a severe form that affects the liver and blood cells. Together they affect about 1 in 12 pregnancies in the United States.
The cause begins with the placenta. In some pregnancies it does not root as deeply, and over time it sends signals that tighten the mother's blood vessels and stress her kidneys, liver, and brain. Risk is higher with a first baby, twins, age over 35, high blood pressure or diabetes before pregnancy, a family history, and in Black mothers, who face higher rates and worse outcomes.
It can come on with no symptoms at all, which is why every prenatal visit starts with a cuff. It can also arrive after birth, up to six weeks later, which many mothers are never told.
What's typical
Preeclampsia is diagnosed after 20 weeks, most often in the third trimester. The cutoff is 140 over 90 or higher on two readings at least four hours apart, with protein in the urine or other lab changes. Readings of 160 over 110 are severe and treated as an emergency.
Mild cases are watched with more visits, labs, and growth scans. Birth is the only thing that ends it, so the plan weighs the baby's age against the mother's risk. Many providers aim for birth at 37 weeks, earlier if severe. Magnesium through an IV is used around birth to lower the risk of seizures. Blood pressure can stay high for weeks after, and some mothers go home on medicine for a while.
What's known
ACOG recommends that mothers at higher risk take low-dose aspirin from 12 weeks, which lowers the chance of preeclampsia; ask your provider whether you qualify. The Preeclampsia Foundation teaches the signs and encourages a home blood pressure cuff. The symptoms that matter are a severe headache, vision changes, pain under the right ribs, sudden swelling of the face and hands, and nausea late in pregnancy. No food plan has been shown to stop it. Having had preeclampsia raises heart disease risk later in life, which is a reason for a yearly checkup.
What helps
- Learn the five signs above and tell your partner too. Post them on the fridge.
- Borrow or buy an arm cuff and take readings sitting, feet flat, after five minutes of rest. Bring the log to visits.
- Ask early whether low-dose aspirin is right for you. The window to start is before 16 weeks.
- Keep every third-trimester appointment and the postpartum blood pressure check. The quiet visits are the ones that catch it.
When to call someone
- Now, 911 or go in: a severe headache that will not ease, vision changes, pain under the right ribs, trouble breathing, a seizure, or a reading of 160 over 110 or higher. This applies up to six weeks after birth too.
- Todaya reading of 140 over 90 or higher, sudden swelling of the face and hands, or the baby moving less.
- At your next visita family history of preeclampsia, a prior case, or any rise in your readings. Ask about aspirin and a home cuff.
Who helps
Tools: Due Date Calculator · Postpartum Prep Checklist
Related
- Postpartum preeclampsia: the warning signsPostpartum: Your Body
- Swelling: feet, ankles, hands, facePregnancy: Your Body
- Headaches and migrainesPregnancy: Your Body
- Induction: why, how, and what to askGetting Ready for Birth
- Postpartum warning signs: the one-page listPostpartum: Your Body
- Gestational diabetesPregnancy: Your Body
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Sources
- American College of Obstetricians and Gynecologists — Practice bulletin on gestational hypertension and preeclampsia
- Preeclampsia Foundation — Signs and symptoms patient guide
- CDC — Hear Her campaign: urgent maternal warning signs
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