⚠️When to Worry

⚠️Pre-Eclampsia: The Pregnancy Condition Every Mum Needs to Know About

Name: Pre-Eclampsia: The Pregnancy Condition Every Mum Needs to Know About
Creator: The MMF Team
Published: 2026-06-01T22:07:02.120683+00:00

Pre-eclampsia affects 5% of pregnancies and is a leading cause of maternal and foetal death worldwide. It is also detectable, manageable, and sometimes preventable. Here is what to know.

7 min readWeeks 20–42By The MMF Team

Pre-Eclampsia: The Pregnancy Condition Every Mum Needs to Know About Pre-eclampsia affects approximately 5% of pregnancies worldwide. It is a leading cause of maternal and foetal death globally. It is also detectable through standard antenatal monitoring and, in many cases, manageable when caught early. This is the condition your blood pressure checks are looking for. ## What Pre-Eclampsia Is Pre-eclampsia is a condition that develops after 20 weeks of pregnancy (most commonly in the third trimester, but sometimes earlier), characterised by high blood pressure and signs of organ damage, most commonly to the kidneys (shown by protein in the urine). The underlying cause is rooted in abnormal placenta development in early pregnancy. The placenta fails to embed properly into the uterine blood vessels, which leads, through a cascade of events, to maternal blood vessel dysfunction that causes elevated blood pressure, reduced blood flow to organs, and a systemic inflammatory response. This is not caused by anything you did or didn't do. ## Who Is at Higher Risk Risk factors for pre-eclampsia: - First pregnancy - Previous pre-eclampsia (risk of recurrence is approximately 15-25%) - Carrying multiples (twins, triplets) - Pre-existing high blood pressure, kidney disease, or diabetes - BMI over 35 - Age over 40 - Black ethnicity (2x higher risk in the UK) - Family history (mother or sister with pre-eclampsia) - More than 10 years since a previous pregnancy - Certain autoimmune conditions (lupus, antiphospholipid syndrome) In the UK, NICE guidance says women at high risk of pre-eclampsia, or with more than one moderate risk factor, should be offered low-dose aspirin (75-150mg daily) from 12 weeks of pregnancy until birth (NICE NG133). In one large trial of high-risk women, 150mg of aspirin a day reduced preterm pre-eclampsia by 62% (Rolnik et al., New England Journal of Medicine, 2017). These doses come from NICE and the trial, not from My Maternity Friend. Only take aspirin in pregnancy if your midwife or doctor recommends it. If you have risk factors and have not been offered aspirin, ask your midwife or doctor. ## What the Symptoms Are Pre-eclampsia can be silent (present on blood pressure measurement without noticeable symptoms), which is exactly why blood pressure is checked at every antenatal appointment. When symptoms are present, they include: Headache: Severe, persistent, not relieved by paracetamol. Not a 'normal' headache: a headache that feels different and does not respond to standard pain relief. Visual disturbance: Blurred vision, flashing lights, spots, or temporary loss of vision. These are symptoms of cerebral involvement. Severe pain under the ribs or on the right side: Often described as upper abdominal or epigastric pain. Reflects liver involvement (the liver capsule stretching under raised pressure). Sudden severe swelling: Particularly of the face, hands, and feet. Mild ankle swelling is common in pregnancy and not specific to pre-eclampsia. Sudden, severe, or facial swelling is different and requires assessment. Rapid weight gain: Sudden weight gain of more than 900g (2lb) in a week can indicate fluid retention associated with pre-eclampsia. Feeling generally unwell: A vague but significant sense that something is wrong. ## When to Seek Help Immediately Contact your maternity unit immediately (do not wait for a scheduled appointment) if you have: - A severe headache that is not relieved by paracetamol - Visual disturbance of any kind - Sudden, severe swelling of the face, hands, or feet - Pain under the ribs - A sense that something is not right Pre-eclampsia can progress rapidly. The time between symptom onset and severe complication can be hours, not days. This is not an area for a wait-and-see approach. ## How It's Managed Mild to moderate pre-eclampsia is monitored closely, often with twice-weekly or more frequent blood pressure checks, blood tests (to monitor kidney and liver function), and foetal monitoring (growth scans, Doppler blood flow measurements, CTG). Blood pressure medication may be prescribed to lower blood pressure and reduce the risk of maternal stroke. The only definitive treatment for pre-eclampsia is delivery of the baby and placenta. The timing of delivery depends on the severity of the condition and the foetal gestation. After 37 weeks with any pre-eclampsia, induction of labour is typically recommended. Before 37 weeks, the decision involves balancing the risks of prematurity against the risks of continuing the pregnancy with worsening pre-eclampsia. Magnesium sulfate is given intravenously to prevent eclamptic seizures in severe pre-eclampsia. ## After Delivery Blood pressure often remains elevated for days to weeks after delivery. You will be monitored in hospital initially and then by community midwife with regular blood pressure checks. Blood pressure medication is continued until levels normalise. Women who have had pre-eclampsia are at increased long-term risk of cardiovascular disease. Annual blood pressure checks and appropriate lifestyle modification are recommended. Pre-eclampsia does not affect your ability to have a healthy subsequent pregnancy, though the risk of recurrence is higher than the general population baseline.

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Around the World

Cultural practices & traditions, medically contextualised

Black British / African-Caribbean

Black women in the UK are significantly more likely to develop pre-eclampsia than white women and are more likely to experience severe outcomes when they do. The mechanisms are multifactorial (genetic, physiological, and structural) but the disparity in outcomes is substantially driven by delayed diagnosis and undertreatment. MBRRACE-UK data consistently documents worse pre-eclampsia outcomes in Black women, making it essential that symptoms in Black women are taken seriously at first presentation, not after escalation.

Sub-Saharan African

Pre-eclampsia is responsible for approximately 9% of maternal deaths in Africa, a disproportionate burden compared to high-income countries. Limited access to antenatal monitoring (blood pressure measurement, urine dipstick), limited access to magnesium sulfate (the most effective seizure prevention drug), and limited capacity for surgical delivery all contribute. Blood pressure cuffs at community health posts and magnesium sulfate availability at district hospitals are among the highest-impact, lowest-cost maternal health interventions in sub-Saharan Africa.

South Asian

Women of South Asian ethnicity who have pre-existing high blood pressure, diabetes, or kidney disease have elevated pre-eclampsia risk. In South Asia, the combination of high rates of gestational diabetes, hypertension, and reduced access to consistent blood pressure monitoring creates significant risk. However, low-dose aspirin (75-150mg daily from 12 weeks) is one of the most evidence-supported preventive measures for women at risk, and its use in high-risk South Asian populations is an area of active clinical guideline development.

East Asian

Pre-eclampsia rates vary across East Asian populations, with Chinese women showing lower rates than the global average in some studies and Korean women showing similar rates to European populations. The mechanisms behind these differences are not fully understood but may relate to differences in placentation biology. Japan has notably comprehensive blood pressure monitoring in antenatal care, which likely contributes to early detection and better outcomes.

Middle Eastern

In Gulf countries, pre-eclampsia risk is elevated by the high rates of gestational diabetes, obesity, and multiple pregnancies (partly from higher rates of IVF) in these populations. Saudi Arabian and UAE maternity units report pre-eclampsia rates of 6-12%. The combination of these risk factors with the high summer temperatures common in the Gulf (which affect blood pressure and fluid balance) creates a specific risk environment that antenatal care protocols in these regions are beginning to address.

Cultural practices are presented for educational purposes. Always discuss traditional remedies and practices with your midwife or health worker before adopting them during pregnancy or postpartum.

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Pre-Eclampsia: The Pregnancy Condition Every Mum Needs to Know About Pre-eclampsia affects approximately 5% of pregnancies worldwide. It is a leading cause of maternal and foetal death globally. It is also detectable through standard antenatal monitoring and, in many cases, manageable when caught early. This is the condition your blood pressure checks are looking for. ## What Pre-Eclampsia Is Pre-eclampsia is a condition that develops after 20 weeks of pregnancy (most commonly in the third trimester, but sometimes earlier), characterised by high blood pressure and signs of organ damage, most commonly to the kidneys (shown by protein in the urine). The underlying cause is rooted in abnormal placenta development in early pregnancy. The placenta fails to embed properly into the uterine blood vessels, which leads, through a cascade of events, to maternal blood vessel dysfunction that causes elevated blood pressure, reduced blood flow to organs, and a systemic inflammatory response. This is not caused by anything you did or didn't do. ## Who Is at Higher Risk Risk factors for pre-eclampsia: - First pregnancy - Previous pre-eclampsia (risk of recurrence is approximately 15-25%) - Carrying multiples (twins, triplets) - Pre-existing high blood pressure, kidney disease, or diabetes - BMI over 35 - Age over 40 - Black ethnicity (2x higher risk in the UK) - Family history (mother or sister with pre-eclampsia) - More than 10 years since a previous pregnancy - Certain autoimmune conditions (lupus, antiphospholipid syndrome) In the UK, NICE guidance says women at high risk of pre-eclampsia, or with more than one moderate risk factor, should be offered low-dose aspirin (75-150mg daily) from 12 weeks of pregnancy until birth (NICE NG133). In one large trial of high-risk women, 150mg of aspirin a day reduced preterm pre-eclampsia by 62% (Rolnik et al., New England Journal of Medicine, 2017). These doses come from NICE and the trial, not from My Maternity Friend. Only take aspirin in pregnancy if your midwife or doctor recommends it. If you have risk factors and have not been offered aspirin, ask your midwife or doctor. ## What the Symptoms Are Pre-eclampsia can be silent (present on blood pressure measurement without noticeable symptoms), which is exactly why blood pressure is checked at every antenatal appointment. When symptoms are present, they include: Headache: Severe, persistent, not relieved by paracetamol. Not a 'normal' headache: a headache that feels different and does not respond to standard pain relief. Visual disturbance: Blurred vision, flashing lights, spots, or temporary loss of vision. These are symptoms of cerebral involvement. Severe pain under the ribs or on the right side: Often described as upper abdominal or epigastric pain. Reflects liver involvement (the liver capsule stretching under raised pressure). Sudden severe swelling: Particularly of the face, hands, and feet. Mild ankle swelling is common in pregnancy and not specific to pre-eclampsia. Sudden, severe, or facial swelling is different and requires assessment. Rapid weight gain: Sudden weight gain of more than 900g (2lb) in a week can indicate fluid retention associated with pre-eclampsia. Feeling generally unwell: A vague but significant sense that something is wrong. ## When to Seek Help Immediately Contact your maternity unit immediately (do not wait for a scheduled appointment) if you have: - A severe headache that is not relieved by paracetamol - Visual disturbance of any kind - Sudden, severe swelling of the face, hands, or feet - Pain under the ribs - A sense that something is not right Pre-eclampsia can progress rapidly. The time between symptom onset and severe complication can be hours, not days. This is not an area for a wait-and-see approach. ## How It's Managed Mild to moderate pre-eclampsia is monitored closely, often with twice-weekly or more frequent blood pressure checks, blood tests (to monitor kidney and liver function), and foetal monitoring (growth scans, Doppler blood flow measurements, CTG). Blood pressure medication may be prescribed to lower blood pressure and reduce the risk of maternal stroke. The only definitive treatment for pre-eclampsia is delivery of the baby and placenta. The timing of delivery depends on the severity of the condition and the foetal gestation. After 37 weeks with any pre-eclampsia, induction of labour is typically recommended. Before 37 weeks, the decision involves balancing the risks of prematurity against the risks of continuing the pregnancy with worsening pre-eclampsia. Magnesium sulfate is given intravenously to prevent eclamptic seizures in severe pre-eclampsia. ## After Delivery Blood pressure often remains elevated for days to weeks after delivery. You will be monitored in hospital initially and then by community midwife with regular blood pressure checks. Blood pressure medication is continued until levels normalise. Women who have had pre-eclampsia are at increased long-term risk of cardiovascular disease. Annual blood pressure checks and appropriate lifestyle modification are recommended. Pre-eclampsia does not affect your ability to have a healthy subsequent pregnancy, though the risk of recurrence is higher than the general population baseline.

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