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What Is Preeclampsia? Symptoms, Diagnosis, and Treatment

What Is Preeclampsia? Symptoms, Diagnosis, and Treatment

Preeclampsia (also known as pregnancy toxemia) is a serious condition that occurs only during pregnancy and sometimes within the first 48 hours postpartum. It develops due to placental blood flow abnormalities and affects both the mother and the unborn baby. It occurs in approximately 5–8% of all pregnancies.

Preeclampsia usually develops after the 20th week of pregnancy, most often becoming evident after 37 weeks. The disease can progress gradually or rapidly, and its severity can range from mild to severe.

Risk Factors

  • First pregnancy
  • Family history of preeclampsia (mother or sister)
  • Maternal age under 20 or over 40
  • Multiple pregnancy (twins, triplets, etc.)
  • Preexisting hypertension or kidney disease
  • Obesity

Although the exact mechanism behind preeclampsia remains unclear, it is one of the leading causes of maternal and fetal morbidity and mortality worldwide. The only definitive treatment is delivery.

Symptoms

The classic triad of preeclampsia includes:

  1. High blood pressure (≥140/90 mmHg)
  2. Edema (swelling)
  3. Protein in the urine (proteinuria)

However, elevated blood pressure alone is not sufficient for diagnosis.
Unlike normal pregnancy swelling, edema in preeclampsia:

  • Does not decrease with rest
  • Is prominent in the face and hands
  • May be accompanied by sudden weight gain

Protein levels in urine also rise significantly due to kidney involvement.

Effects on Mother and Baby

Preeclampsia causes widespread narrowing of blood vessels (vasoconstriction), leading to:

  • Increased blood pressure
  • Reduced blood flow to the liver, kidneys, brain, and uterus

Decreased placental blood flow can result in:

  • Fetal growth restriction (IUGR)
  • Reduced amniotic fluid (oligohydramnios)
  • Placental abruption (premature separation of the placenta)

In the mother, vascular changes cause:

  • Edema (fluid leakage into tissues)
  • Protein loss (protein leaking into urine due to kidney involvement)

In severe cases, patients may develop eclampsia — seizures that are life-threatening. Warning signs include:

  • Severe headache
  • Visual disturbances (blurred or flashing vision)
  • Upper abdominal pain

In such cases, magnesium sulfate therapy is administered to prevent seizures.

Approximately 20% of cases progress to HELLP Syndrome, characterized by:

  • Hemolysis (breakdown of red blood cells)
  • Elevated liver enzymes
  • Low platelet count (thrombocytopenia)

Diagnosis and Treatment

In early stages, preeclampsia may show no clear symptoms; swelling and weight gain can be mistaken for normal pregnancy changes. Thus, routine prenatal check-ups are essential for early detection.

Diagnosis is based on:

  • Consistently elevated blood pressure readings
  • 24-hour urine collection to measure protein levels
  • Blood tests and fetal growth assessments via ultrasound and NST

Mild Preeclampsia

  • After 37 weeks: Labor is induced or delivery is planned (vaginal or cesarean as appropriate).
  • Before 37 weeks: If the mother and baby are stable, the pregnancy may continue under close supervision.
    • The mother is advised to rest on her left side,
    • Monitor fetal movements, and
    • Attend frequent medical check-ups.

Severe Preeclampsia

  • Requires hospitalization.
  • Magnesium sulfate and antihypertensive medications are administered.
  • After 34 weeks: Delivery is recommended.
  • Before 34 weeks: Corticosteroid injections are given to accelerate fetal lung maturity, and the pregnancy is prolonged if possible.
  • If the condition worsens — such as seizure onset (eclampsia) or development of HELLP syndrome — immediate delivery is necessary.

Prevention

Currently, there is no proven method to completely prevent preeclampsia. The effectiveness of low-dose aspirin, vitamins E and C, or calcium supplementation remains uncertain.

The most effective preventive measure is:

  • Regular prenatal visits and monitoring,
  • Awareness of symptoms by the expectant mother, and
  • Immediate medical evaluation if warning signs appear.

At each visit, essential tests and risk assessments are performed to ensure early detection and timely management, significantly improving outcomes for both mother and baby.

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