Alison Wilson

Consultant in Obstetrics
Alison Wilson

Providing continuity of care for women with complex problems is a rewarding part of my work.

Pre-eclampsia is a condition that affects some pregnant women, usually during the second half of pregnancy (from around 20 weeks) or soon after their baby is delivered.

Early signs of pre-eclampsia include having high blood pressure (hypertension) and protein in your urine (proteinuria). It is unlikely you will notice these signs, but they should be picked up during your routine antenatal appointments.

In some cases, further symptoms can develop, including:

  • swelling of the feet, ankles, face and hands caused by fluid retention (oedema)
  • severe headache
  • vision problems
  • pain just below the ribs

If you notice any symptoms of pre-eclampsia, seek medical advice immediately by calling your midwife, GP surgery or NHS 111.

Although many cases are mild, the condition can lead to serious complications for both mother and baby if it is not monitored and treated (see below). The earlier pre-eclampsia is diagnosed and monitored, the better the outlook for mother and baby.

Who is affected?

Pre-eclampsia affects up to 5% of pregnancies, and severe cases develop in about 1-2% of pregnancies.

There are a number of things that can increase your chances of developing pre-eclampsia, such as:

  • if it is your first pregnancy
  • if you developed the condition during a previous pregnancy
  • if you have a family history of the condition
  • if you are over 40 years old
  • if you are expecting multiple babies (twins or triplets)

If you are thought to be at a high risk of developing pre-eclampsia, you may be advised to take a daily dose of low-dose aspirin from the 12th week of pregnancy until your baby is delivered.

What causes pre-eclampsia?

Although the exact cause of pre-eclampsia is not known, it is thought to occur when there is a problem with the placenta (the organ that links the baby's blood supply to the mother's).

Treating pre-eclampsia

If you are diagnosed with pre-eclampsia, you should be referred for an assessment with an obstetrician at the Rosie.

While in hospital you will be monitored closely to determine how severe the condition is and whether a hospital stay is needed.

The only way to cure pre-eclampsia is to deliver the baby, so you will usually be monitored regularly until it is possible for your baby to be delivered. This will normally be at around 37-38 weeks of pregnancy, but it may be earlier in more severe cases.

At this point, labour may be started artificially (induced) or you may have a caesarean section, and medication may be recommended to lower your blood pressure while you wait for your baby to be delivered. 

If pre-eclampsia has been severe, you may need to stay in hospital for 5-7 days after your baby is born for blood pressure monitoring.

Blood pressure tablets may also be required and these may need to be taken for some time after delivery. 

Complications

Although most cases of pre-eclampsia cause no problems and improve soon after the baby is delivered, there is a risk of serious complications that can affect both the mother and her baby.

There is a risk the mother will develop fits called eclampsia. These fits can be life threatening for the mother and the baby, but they are rare.

Overall, complications of pre-eclampsia are responsible for the deaths of around six or seven women every year in the UK. About 1,000 babies die each year in the UK because of the condition, mostly because of complications of early delivery, such as severe breathing difficulties.

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