If you have preeclampsia, your blood pressure rises to dangerous levels during pregnancy, and the condition can affect your kidneys, liver, brain, and blood. It develops after 20 weeks of pregnancy, and the only cure is delivering the baby. How it plays out depends heavily on when it starts, how severe it becomes, and how quickly it’s caught.
Why Preeclampsia Happens
During a normal pregnancy, blood vessels in the uterus remodel themselves to deliver a high volume of blood to the placenta at low pressure. In preeclampsia, this remodeling fails. The placenta doesn’t get enough blood flow, becomes stressed, and starts releasing proteins into your bloodstream that damage the lining of blood vessels throughout your body. That widespread blood vessel damage is what drives the high blood pressure, organ stress, and other problems that define the condition.
How It’s Diagnosed
The diagnosis centers on two things: high blood pressure (140/90 mmHg or higher) and signs that your organs are under strain. Protein in your urine used to be required for a diagnosis, but current guidelines recognize that preeclampsia can damage the kidneys, liver, brain, or blood without showing up in a urine test. That’s why your provider checks blood work and asks about symptoms like headaches and vision changes, not just blood pressure and urine.
Preeclampsia is classified as early-onset when it develops before 34 weeks and late-onset after that point. Early-onset cases tend to be more severe and carry higher risks for both mother and baby.
What It Feels Like
Some women feel completely normal when preeclampsia is first detected at a routine appointment. Others notice symptoms that build over days or appear suddenly. The most common warning signs include a persistent headache that doesn’t respond to pain relievers, visual disturbances like blurriness or seeing spots, pain in the upper right abdomen near the ribs, sudden swelling in the face and hands, and nausea or vomiting that appears late in pregnancy when morning sickness should be long gone.
Rapid weight gain over just a few days, sometimes several pounds in a week, can signal fluid retention tied to preeclampsia. Shortness of breath and decreased urination are also red flags that the condition is progressing.
What Happens to Your Body
Preeclampsia forces your blood vessels to constrict, raising blood pressure and reducing blood flow to your organs. Your kidneys may start leaking protein. Your liver can become inflamed, causing that characteristic rib pain. Your platelet count, the blood cells responsible for clotting, may drop, making bleeding harder to control.
About 20% of women with preeclampsia develop HELLP syndrome, a serious escalation where red blood cells break apart, liver enzymes spike, and platelet counts plummet. HELLP can cause internal bleeding and liver damage, and it often requires emergency delivery regardless of how far along the pregnancy is.
Without treatment, preeclampsia can also progress to eclampsia, which means seizures. Medication given through an IV reduces the risk of seizures by more than 50% in women with severe preeclampsia, which is one reason hospital monitoring is so important once the diagnosis is made.
How It Affects the Baby
Because the placenta isn’t getting adequate blood flow, the baby may not get enough oxygen and nutrients. This leads to fetal growth restriction, where the baby measures smaller than expected for gestational age. In early-onset preeclampsia (before 34 weeks), about 40% of babies are growth-restricted. In late-onset cases, that number drops to around 10%.
If the condition is severe or worsening, early delivery becomes necessary, which means the baby may be premature. Babies born before 34 weeks often need time in the NICU to support breathing, feeding, and temperature regulation. The timing of delivery is always a balancing act: keeping the baby in longer helps development, but waiting too long puts both mother and baby at risk.
How It’s Managed
There is no medication that reverses preeclampsia. Treatment focuses on controlling blood pressure, preventing seizures, and deciding when to deliver. If you’re diagnosed before 37 weeks with mild preeclampsia, your provider may try to buy time with close monitoring, including frequent blood pressure checks, blood work, and fetal heart rate assessments. You may be admitted to the hospital or monitored at home with very frequent visits.
If you develop severe features, or if you’re past 37 weeks, delivery is typically recommended. For many women this means induction of labor, though a cesarean section may be needed depending on the circumstances. During labor and for 24 to 48 hours afterward, you’ll likely receive IV medication to prevent seizures.
It Can Start After Delivery
Preeclampsia doesn’t always end when the baby arrives. Postpartum preeclampsia can develop anytime in the six weeks after birth, though it’s most common within the first 48 hours. This catches many women off guard, especially those who had normal blood pressure throughout pregnancy.
The warning signs after delivery are the same: severe headaches, vision changes, upper abdominal pain, swelling, chest pain, and shortness of breath. If you notice any of these in the days or weeks after giving birth, it warrants urgent evaluation. Postpartum preeclampsia carries the same risks of seizures and organ damage as the prenatal form.
Long-Term Health Effects
Preeclampsia is not just a pregnancy complication. It signals an elevated risk of cardiovascular disease later in life. Women who’ve had preeclampsia face a two- to four-fold higher risk of developing chronic high blood pressure, heart disease, and stroke compared to women with uncomplicated pregnancies. Research published in the American Heart Association’s journal Hypertension found a dose-response relationship: each additional day between diagnosis and delivery was associated with a 1% to 2% higher risk of cardiovascular disease before age 55.
This doesn’t mean heart disease is inevitable. It means your pregnancy history is a valuable piece of health information. Staying on top of blood pressure monitoring, maintaining a healthy weight, exercising, and managing cholesterol in the years after a preeclamptic pregnancy can significantly lower that risk.
Who’s at Higher Risk and Prevention
Certain factors increase the likelihood of developing preeclampsia: a history of preeclampsia in a previous pregnancy, carrying multiples, chronic high blood pressure, type 1 or type 2 diabetes, kidney disease, and certain autoimmune conditions. First pregnancies also carry higher risk, as do pregnancies in women over 35 or those with obesity.
For women with at least one of these risk factors, the U.S. Preventive Services Task Force recommends low-dose aspirin (81 mg daily) starting after 12 weeks of pregnancy. This simple intervention has been shown to reduce preeclampsia risk, particularly in high-risk groups. It’s not effective if started later in pregnancy, so early prenatal care matters.