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Pre-eclampsia and high blood pressure in pregnancy

Quick answer

Pre-eclampsia causes high blood pressure, usually with protein in the urine, after 20 weeks of pregnancy. It affects about 2 to 8 in 100 pregnancies and can become serious for mother and baby if untreated. It often has no symptoms at first, which is why your blood pressure is checked at every visit. A severe headache, vision problems, pain under the ribs or sudden swelling need urgent care.

Key facts

High blood pressure140/90 or above
Severe160/110 or above
WhenAfter 20 weeks, and up to 6 weeks after birth
Prevention if high riskLow-dose aspirin from 12 weeks, if prescribed
CureBirth of the baby and placenta

What is pre-eclampsia?

It's a problem with the placenta that affects blood vessels throughout the body. Blood pressure rises, the kidneys leak protein, and the liver, brain and baby's growth can be affected.

90140160180Top number (systolic), mmHgHigh: 140/90 or aboveSevere: 160/110 or above — get help now
Blood pressure in pregnancy. A reading of 140/90 or above is high. Pre-eclampsia is high blood pressure after 20 weeks, usually with protein in your urine.

Symptoms

  • Often none at first
  • Severe headache that doesn't go away with simple painkillers
  • Blurred vision, flashing lights or spots
  • Pain just below the ribs, especially on the right
  • Vomiting in the second half of pregnancy
  • Sudden swelling of the face, hands or feet
  • Feeling very unwell

Call your maternity unit or emergency number straight away if you have any of these after 20 weeks.

Who's at higher risk?

  • Pre-eclampsia or high blood pressure in a previous pregnancy
  • Long-term high blood pressure, kidney disease, diabetes, lupus
  • First pregnancy, age 40 or over, BMI of 35 or more
  • Twins or more
  • More than 10 years since your last pregnancy, or a family history

Can it be prevented?

If you're at higher risk, your doctor may prescribe low-dose aspirin daily from 12 weeks until birth. Don't start aspirin without advice. Where diets are low in calcium, the World Health Organization recommends calcium supplements in pregnancy.

Checking your blood pressure

If you use a home monitor, sit quietly for 5 minutes, rest your arm at heart level, and take two readings. Bring your readings to appointments.

Treatment

Treatment includes regular monitoring, blood pressure medicines that are safe in pregnancy, and sometimes a hospital stay. Magnesium sulphate may be given to prevent seizures in severe cases. Because the cure is birth, your baby may be delivered early, often by 37 weeks.

After birth

Pre-eclampsia can start or continue after birth, so keep watching for symptoms for 6 weeks. It raises your long-term risk of high blood pressure and heart disease, so have your blood pressure checked every year.

Frequently asked questions

Does salt cause pre-eclampsia?
No. Cutting salt doesn't prevent it, though a balanced diet is always good.
Will my baby be okay?
Most babies do well with good care, though some are born early or small.
Will I get it again?
The chance is higher in your next pregnancy, so tell your doctor early; aspirin may be offered.

Sources

  • NICE NG133: Hypertension in pregnancy
  • WHO: Recommendations for prevention and treatment of pre-eclampsia and eclampsia
  • ACOG Practice Bulletin 222
  • Preeclampsia Foundation

General information, not medical advice. Medical disclaimer · How we review content

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