What Is Preeclampsia and Why It Matters

Preeclampsia is a serious pregnancy condition that affects about 3-5% of pregnancies in the United States. It occurs when a pregnant person develops high blood pressure and protein in their urine after 20 weeks of pregnancy. The condition can develop suddenly and progress quickly, making it important for pregnant people to understand what it is and how to recognize potential warning signs.

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During a healthy pregnancy, blood pressure typically stays lower than it was before pregnancy. When preeclampsia develops, blood pressure rises to dangerous levels. At the same time, the kidneys begin to leak protein into the urine—a sign that the blood vessels and organs are under stress. The placenta, which nourishes the developing baby, may not receive enough blood flow, which can affect fetal growth.

Preeclampsia can range from mild to severe. In mild cases, pregnant people might not notice any symptoms at all and only learn about the condition during routine prenatal care. In severe cases, the condition can become life-threatening for both the pregnant person and the baby. According to the National Institutes of Health, preeclampsia contributes to approximately 15% of premature births in the United States.

The exact cause of preeclampsia remains unclear, but researchers believe it involves problems with how the placenta develops and functions. It may also relate to immune system changes during pregnancy and genetic factors. Some cases develop gradually, while others appear without warning. This unpredictability underscores why knowing the warning signs matters.

Preeclampsia cannot be prevented, but it can be managed with proper medical monitoring. Regular prenatal visits allow healthcare providers to detect early signs through blood pressure checks and urine tests. Understanding the warning signs helps pregnant people and their families recognize when something may need medical attention between scheduled appointments.

Practical Takeaway: Preeclampsia is a real medical condition that affects a small percentage of pregnancies. Learning its warning signs helps you know when to contact your healthcare provider, even outside regular appointment times.

Common Warning Signs You Should Know

Several warning signs may indicate preeclampsia is developing. It's important to understand that having one or more of these signs doesn't mean you definitely have preeclampsia, but it does mean you should contact your healthcare provider to be evaluated. Your doctor or midwife can perform tests to confirm whether preeclampsia is present.

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High blood pressure is the primary indicator, but many people cannot feel when their blood pressure rises. This is why regular monitoring during prenatal visits is crucial. However, if you have a home blood pressure monitor, sudden increases from your baseline readings should be reported to your healthcare provider. A normal blood pressure is generally below 120/80 mmHg. Preeclampsia is typically diagnosed when blood pressure reaches 140/90 mmHg or higher on two separate occasions at least four hours apart.

Swelling in the face, hands, and feet is common during normal pregnancy, but sudden or severe swelling may signal preeclampsia. Swelling that appears puffy or leaves indentations when you press on it warrants medical attention. Pay special attention to facial swelling and swelling in your hands and upper arms, which are less common in normal pregnancies. Some pregnant people with preeclampsia also notice their rings or bracelets suddenly fitting tightly.

Headaches during pregnancy can be normal, but persistent headaches that don't improve with rest or pain relief medication may be concerning. These headaches are often described as throbbing and may be severe. They sometimes occur alongside vision changes such as blurred vision, seeing spots or flashes of light, or temporary vision loss. Any vision changes during pregnancy warrant immediate medical evaluation.

Upper abdominal pain or right shoulder pain can occur with preeclampsia, particularly in severe cases. This pain feels different from typical pregnancy discomfort and doesn't resolve with position changes or rest. Some people describe it as sharp or persistent. Nausea and vomiting in the second or third trimester, especially if these symptoms are new or severe, may also indicate preeclampsia rather than typical morning sickness.

Practical Takeaway: Keep a mental note of sudden swelling, persistent headaches, vision changes, or upper abdominal pain. These warrant a call to your healthcare provider, even if your next appointment is weeks away.

Who Is at Higher Risk for Preeclampsia

While preeclampsia can develop in any pregnancy, certain factors increase the risk. Understanding whether you have any risk factors helps you stay alert and engage more actively in your prenatal care. Your healthcare provider can discuss your individual risk level and may recommend more frequent monitoring.

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Age plays a role in preeclampsia risk. Pregnant people under age 18 and those over age 35 have higher rates of preeclampsia. First-time pregnancies carry higher risk than subsequent pregnancies, though previous preeclampsia significantly increases the risk of it recurring. According to the American College of Obstetricians and Gynecologists, about 25% of people who had preeclampsia in a previous pregnancy will experience it again in a future pregnancy.

Certain medical conditions increase preeclampsia risk substantially. People with chronic high blood pressure are at increased risk. Those with type 1 or type 2 diabetes have significantly higher risk, as do those with kidney disease or autoimmune conditions such as systemic lupus erythematosus or antiphospholipid syndrome. If you have any of these conditions, your healthcare provider likely has already discussed increased monitoring.

Obesity affects preeclampsia risk as well. People with a body mass index (BMI) of 30 or higher before pregnancy have approximately double the risk of developing preeclampsia compared to those with a normal BMI. Similarly, pregnancy after assisted reproductive technology like in vitro fertilization carries slightly higher risk. Multiple gestations—carrying twins, triplets, or more—significantly increase preeclampsia risk because the placenta works much harder to support multiple babies.

Family history matters too. If your mother or sister had preeclampsia, your risk increases. Racial and ethnic factors also play a role; Black pregnant people in the United States experience preeclampsia at nearly twice the rate of white pregnant people. This disparity relates to complex factors including healthcare access, chronic stress, and biological factors. Hispanic and Indigenous pregnant people also experience preeclampsia at elevated rates.

Being informed about your risk factors allows you to take your prenatal care seriously and report warning signs promptly. Even with multiple risk factors, many pregnancies progress without preeclampsia. However, awareness supports better outcomes.

Practical Takeaway: If you have risk factors such as chronic high blood pressure, diabetes, obesity, or a family history of preeclampsia, discuss these with your healthcare provider early in pregnancy so they can plan appropriate monitoring.

When to Contact Your Healthcare Provider

Knowing when to contact your healthcare provider is as important as knowing the warning signs themselves. Some situations require a phone call during business hours, while others need immediate emergency care. Understanding the difference helps ensure you get the right level of attention.

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Call your healthcare provider during regular office hours if you notice sudden swelling in your face, hands, or feet; experience a new and persistent headache that doesn't respond to rest or over-the-counter pain relief; have blurred vision or see spots or flashes of light; or experience upper abdominal pain that feels different from normal pregnancy discomfort. Also contact your provider if you notice decreased fetal movement, though this can indicate other conditions besides preeclampsia. If you have a home blood pressure monitor and notice sustained readings of 140/90 mmHg or higher, report this to your provider even if you feel fine.

Seek immediate medical attention by going to an emergency room or calling 911 if you experience severe headaches accompanied by vision changes; sudden severe swelling; right-sided abdominal pain that is intense; chest pain or difficulty breathing; loss of consciousness; seizures; or vaginal bleeding. You should also seek emergency care for signs of severe preeclampsia such as very high blood pressure readings combined with concerning symptoms. Don't wait for an appointment if you experience these symptoms—go directly to the emergency room.

When you contact your healthcare provider, describe your symptoms clearly and mention any recent changes you've noticed. If possible, have your blood pressure reading available if you took one at home. Explain the timing of symptoms—whether they developed suddenly or gradually, and whether they're getting worse. This information helps your provider determine whether