Preeclampsia

Preeclampsia is a pregnancy problem where new high blood pressure starts after 20 weeks and there are signs that the mother’s organs are under stress (like the kidneys, liver, brain, blood, or lungs). Doctors used to require protein in the urine to make the diagnosis. Today, it’s accepted that protein is not required if there is high blood pressure plus any sign of organ trouble (for example, low platelets, rising creatinine, high liver enzymes, lung fluid, or new brain/eye symptoms). This is important because it lets doctors diagnose earlier and treat faster. preeclampsia.orgpreeclampsia.orgNICE

Preeclampsia is a pregnancy-related condition where blood pressure becomes high after 20 weeks and the body shows signs of organ stress or damage (for example, protein leaking into urine, low platelets, liver or kidney problems, lung fluid, severe headache, or vision changes). It can also appear after birth (postpartum), usually within 6 weeks. Preeclampsia can progress quickly and, without proper treatment, can lead to seizures (eclampsia), stroke, organ failure, preterm birth, or danger to the mother and baby. The only “complete cure” is delivery of the placenta, but careful monitoring and treatment can protect you and your baby and buy time if you’re not yet at term. preeclampsia.org

Preeclampsia matters because it can worsen quickly and harm both mother and baby. “Severe features” include very high blood pressure (≥160/110 mm Hg), bad headache, vision changes, pain under the right ribs, shortness of breath from lung fluid, platelets under 100,000, creatinine above ~1.1 mg/dL or doubling from baseline, or liver enzymes twice normal. These red flags push doctors to act urgently and often to plan delivery depending on the week of pregnancy and mother/baby status. preeclampsia.orgNICE

---

Types

These labels help guide monitoring and timing of delivery. The words are technical, but the ideas are simple.

1. Preeclampsia without severe features
   This means high blood pressure after 20 weeks plus protein in the urine or a mild sign of organ stress, but none of the severe warning signs. The mother and fetus still need close checks. preeclampsia.org

2. Preeclampsia with severe features
   This means high blood pressure after 20 weeks with any severe warning (very high BP, severe headache, vision changes, lung fluid, low platelets, rising creatinine, or very abnormal liver tests). This form needs hospital-level care and prompt delivery planning. preeclampsia.org

3. Early-onset preeclampsia (<34 weeks)
   This form tends to be more serious and is strongly linked to placental problems and fetal growth restriction. It often needs specialized care in a hospital with maternal-fetal medicine and a NICU. preeclampsia.org

4. Late-onset preeclampsia (≥34 weeks)
   This is more common and often has milder placental issues, yet it can still progress to a severe state and must be watched closely. preeclampsia.org

5. Superimposed preeclampsia on chronic hypertension
   Here, a person already had high blood pressure before pregnancy or before 20 weeks, and then develops new protein in urine or organ stress later in pregnancy. This is harder to spot and needs careful trend tracking. preeclampsia.org

6. HELLP syndrome
   This is a dangerous variant with Hemolysis (red cells break), Elevated Liver enzymes, and Low Platelets. RUQ pain, nausea, and malaise are common. It can exist with or without very high blood pressure. Urgent care is required. preeclampsia.org

7. Postpartum preeclampsia
   Sometimes preeclampsia starts after delivery, most often in the first week, but it can happen up to 6 weeks postpartum. New headache, vision changes, or shortness of breath after birth should prompt immediate evaluation. preeclampsia.org

8. Atypical preeclampsia
   This label is used when the timing or lab pattern is not classic (for example, no protein in urine but clear organ injury with new hypertension). The aim is to treat the condition, not just the textbook picture. preeclampsia.org

9. Preeclampsia with fetal growth restriction
   Here the baby is smaller than expected because the placenta is not working well. Doctors add fetal growth scans and Doppler checks to guide timing of delivery. NICE

10. Gestational hypertension that evolves into preeclampsia
    Some people start with just high blood pressure after 20 weeks (no protein, no organ stress). If protein or organ trouble later appears, it becomes preeclampsia. This is why repeat testing matters. preeclampsia.org

In early pregnancy, the placenta should remodel the mother’s uterine arteries so blood flows easily to the baby. In preeclampsia, this remodeling is shallow or incomplete. The placenta then releases signals that make the mother’s blood vessels tight and “leaky.” The result is high blood pressure and organ stress (kidneys spill protein, liver gets irritated, the brain swells causing headache or vision problems, the lungs fill with fluid). This problem is multi-factorial: genes, immune mismatch, and health conditions all play a part. preeclampsia.org

---

Common causes

These are things that raise the chance of preeclampsia. Many people who get preeclampsia have no risk factors, and many people with risk factors do not get it. Risk helps with prevention plans (like low-dose aspirin) and closer follow-up. USPSTFACOGUpToDate

1. First pregnancy — The immune system is meeting the placenta for the first time, and the risk is higher.

2. Past preeclampsia — If you had it before, your chance is higher in a later pregnancy.

3. Family history — If your mother or sister had it, your personal risk rises.

4. Carrying twins or more — More placental tissue raises the strain on the circulation.

5. Chronic high blood pressure — If BP was high before pregnancy or before 20 weeks, risk is higher.

6. Type 1 or Type 2 diabetes — Vessels can already be stressed, which adds risk.

7. Kidney disease — Kidneys are central in preeclampsia; prior kidney issues increase risk.

8. Autoimmune disease (for example, lupus or antiphospholipid syndrome) — These conditions affect blood vessels and clotting.

9. Obesity (BMI ≥30) — Extra inflammation and vascular strain raise risk.

10. Age 35 or older — Vessels are less flexible, and comorbidities are more common.

11. Long gap since the last pregnancy (about 10 years or more) — The immune system “forgets” the partner’s antigens, and risk rises.

12. In-vitro fertilization or egg donation — Immune mismatch and placental factors play a role.

13. New partner (compared to prior pregnancies) — New paternal antigens may increase risk modestly.

14. High blood pressure early in pregnancy (before 20 weeks) — Suggests underlying vascular stress.

15. Thrombophilias (tendency to clot) — May disturb placental blood flow.

16. Sleep apnea — Repeated low oxygen and BP swings stress vessels.

17. PCOS or metabolic syndrome — Insulin resistance and inflammation add risk.

18. Low calcium intake — In some settings this links to higher risk; calcium supplements can help where intake is low.

19. Low socioeconomic resources / barriers to care — Not a biological cause, but less access to early prenatal care increases harm; structural inequities matter.

20. Black patients (as a proxy for the effects of racism and inequity) — The higher observed risk reflects structural factors, not biology; better access and respectful care reduce harm. ACOG+1

---

Symptoms

If any of these appear during pregnancy or up to 6 weeks after birth, seek care the same day. If severe, go to emergency care immediately. preeclampsia.org

1. Severe or persistent headache — A pounding or constant head pain can mean brain irritation.

2. Vision changes — Blurry vision, flashing lights, spots, or temporary loss of vision come from swelling in the visual pathways.

3. Pain under the right ribs or in the upper belly — The liver capsule can stretch and hurt.

4. Nausea or vomiting after mid-pregnancy — When new or worsening, this can reflect liver irritation.

5. Sudden swelling of the face or hands — Fluid leaks from vessels into tissues.

6. Fast weight gain over a few days — This can be fluid build-up rather than body fat.

7. Shortness of breath — Fluid in the lungs (pulmonary edema) makes breathing hard.

8. Chest pain or pressure — High BP and lung fluid can strain the heart and lungs.

9. Little urine (oliguria) — Kidneys may be struggling.

10. Blood in the urine — Damaged kidneys can leak red cells (less common, but urgent).

11. Confusion, agitation, or feeling “not right” — The brain does not like high BP and swelling.

12. Overactive reflexes or muscle jerks — The nervous system is irritable in severe disease.

13. Seizure (eclampsia) — This is an emergency; call for help immediately.

14. Dizziness or fainting — The brain may be getting less steady blood flow.

15. Decreased baby movements — The baby may be under stress; call your care team.

---

Diagnostic tests

Below are 20 tests grouped into Physical Exam, Manual Tests, Lab/Path, Electrodiagnostic, and Imaging. Not every person needs all tests. Your team chooses based on symptoms, gestational age, and severity. Thresholds and use come from major guidelines. preeclampsia.orgNICEpreeclampsia.org

A) Physical exam

1. Standardized blood pressure checks
   BP is measured after 5 minutes of rest, sitting upright, with the right cuff size on the bare arm, and readings are repeated. Two values ≥140/90, 4 hours apart (or one value ≥160/110 confirmed sooner) after 20 weeks support the diagnosis. Method matters because false readings can mislead care. NICE

2. Orthostatic BP and pulse
   Readings lying, sitting, and standing check for volume status and help explain dizziness.

3. Deep tendon reflexes and clonus
   Brisk reflexes and ankle clonus show brain and spinal cord irritability and warn of seizure risk.

4. Eye (fundus) exam
   Looking at the back of the eye can show retinal vessel spasm or swelling, which mirrors brain vessel stress.

5. Edema and pitting scale
   Grading swelling in shins, hands, and face tracks fluid leakage from blood vessels.

B) Manual / bedside tests

6. Urine dipstick for protein
   A simple strip test gives a quick estimate of urine protein. It is not perfect and can be affected by hydration, so it is backed up by lab quantification when possible. preeclampsia.org

7. Fundal height tape measurement
   A tape measure from pubic bone to top of the uterus tracks baby’s growth between ultrasounds; a lag may signal placental insufficiency.

8. Fetal movement “kick counts”
   Parents track baby movements daily. Fewer kicks than usual can point to fetal stress, prompting further testing.

C) Lab and pathological tests

9. Complete blood count (with platelets)
   Platelets under 100,000/µL suggest a severe form or HELLP. Falling platelets along with hemolysis mark microangiopathy. preeclampsia.org

10. Liver enzymes (AST, ALT) and bilirubin
    Values twice the upper limit show liver injury. RUQ pain plus high enzymes points toward severe disease or HELLP. preeclampsia.org

11. LDH and haptoglobin
    High LDH with low haptoglobin supports hemolysis, a key part of HELLP. preeclampsia.org

12. Serum creatinine, BUN, and electrolytes
    A creatinine >1.1 mg/dL or doubling from baseline shows kidney injury and counts as a severe feature. preeclampsia.org

13. Spot urine protein-to-creatinine ratio (PCR)
    A PCR ≥0.3 roughly matches ≥300 mg/day proteinuria. It is quicker than a 24-hour collection and widely used. NICE

14. 24-hour urine protein
    This gold-standard total shows how much protein is lost in a day; ≥300 mg/day supports the diagnosis when needed. NICE

15. Placental growth factor (PlGF) or sFlt-1/PlGF ratio
    Low PlGF or a high sFlt-1/PlGF ratio supports placental dysfunction and helps rule in or out disease in some healthcare systems, especially before 35 weeks. NICE includes PlGF-based testing pathways for suspected preeclampsia. NICE

D) Electrodiagnostic tests

16. Cardiotocography (non-stress test)
    Electronic sensors track the baby’s heart rate and your contractions. Healthy variability and accelerations reassure; late decelerations or reduced variability suggest placental insufficiency and guide delivery timing. NICE

17. Electrocardiogram (ECG)
    If there is chest pain, shortness of breath, very high BP, or concern for heart strain, an ECG helps check the heart rhythm and ischemia.

E) Imaging tests

18. Obstetric ultrasound for growth and amniotic fluid
    Serial scans check estimated fetal weight, growth trend, and amniotic fluid. Growth restriction and low fluid support placental insufficiency. NICE

19. Umbilical artery Doppler velocimetry
    This ultrasound studies blood flow from placenta to baby. High resistance or absent/reversed end-diastolic flow signals severe placental disease and pushes toward earlier delivery in some cases. NICE

20. Targeted maternal imaging when indicated
    A kidney ultrasound can look for other causes of kidney injury. Head CT/MRI may be used if there are seizures, focal neurologic signs, or concern for bleeding/posterior reversible encephalopathy. Imaging is chosen only when benefits outweigh risks. preeclampsia.org

Non-pharmacological treatments (therapies & supportive care)

Important: Non-drug care helps support you and your baby. Delivery remains the only cure. Items marked “not recommended” are included to explain why they’re avoided.

1. Close prenatal follow-up
   Purpose: catch problems early.
   What it does: regular BPs, urine checks, symptoms review; labs and ultrasound when needed to watch mother’s organs and baby’s growth/placenta. preeclampsia.org

2. Home blood-pressure (BP) monitoring
   Purpose: spot dangerous spikes early.
   What it does: you check BP at home (correct cuff size, seated, arm at heart level). Call right away for ≥140/90 (two readings) or any single ≥160/110. ACOG

3. Fetal well-being testing (NST/BPP/Dopplers) when indicated
   Purpose: make sure baby is doing well.
   What it does: tracks baby’s heart rate patterns, movements, and blood flow to guide timing of delivery. preeclampsia.org

4. Hospital observation or admission (for severe features)
   Purpose: rapid treatment if BP or symptoms worsen.
   What it does: continuous BP checks, IV access, labs, fetal monitoring, and preparation for delivery if needed. millionhearts.hhs.gov

5. Seizure precautions & quiet, low-stimulus environment
   Purpose: lower seizure risk in severe disease and eclampsia.
   What it does: dim lights, minimize noise, position safely, prepare magnesium sulfate if indicated. millionhearts.hhs.gov

6. Left-side (lateral) rest when lying
   Purpose: improve blood return and uterine blood flow.
   What it does: reduces pressure on major vessels; may help symptoms like shortness of breath. (Not a cure.)

7. Fluid management (careful IVs, watch urine)
   Purpose: avoid fluid overload and lung edema while preventing dehydration.
   What it does: balanced IV fluids; monitor urine output; treat pulmonary edema promptly. preeclampsia.org

8. Oxygen if there’s breathing trouble
   Purpose: protect mother’s organs and baby if oxygen levels drop.
   What it does: nasal cannula or mask in clinically indicated cases. millionhearts.hhs.gov

9. Early corticosteroids for fetal lungs if <34 weeks and delivery likely
   Purpose: help baby’s lungs mature.
   What it does: two doses (betamethasone or dexamethasone) improve preterm outcomes. (This is a medication but used for the baby’s benefit as part of “supportive” planning before delivery.) preeclampsia.org

10. Individualized birth planning
    Purpose: choose induction vs C-section timing and mode based on mother/baby status and cervix.
    What it does: plans the safest route and timing; delivery is the definitive treatment. preeclampsia.org

11. Education on “red-flag” symptoms
    Purpose: get urgent help fast.
    What it does: teaches warning signs—persistent severe headache, vision changes, severe upper-belly pain, shortness of breath, heavy swelling, nausea/vomiting after mid-pregnancy, or any seizure. ACOGpreeclampsia.org

12. Postpartum BP checks & follow-up
    Purpose: catch postpartum preeclampsia and manage BP safely while breastfeeding.
    What it does: home BP and clinic follow-up; safe postpartum BP meds (e.g., nifedipine, amlodipine, enalapril) if needed. Ahm Journals

13. Healthy movement (as your clinician allows)
    Purpose: in general, regular pregnancy-safe activity lowers the risk of hypertensive disorders and supports mood and sleep.
    What it does: walking, pregnancy yoga, or light aerobic exercise—customized to your condition. ACOGPMC

14. Weight, diabetes, and sleep-apnea management (pre-pregnancy or early pregnancy)
    Purpose: lower baseline risk.
    What it does: healthy weight, glucose control, and treatment of sleep apnea reduce strain on vessels. preeclampsia.org

15. Calcium-rich diet (and supplements if intake is low)
    Purpose: in low-calcium-intake settings, calcium reduces preeclampsia risk.
    What it does: 1.5–2 g/day elemental calcium in divided doses where dietary calcium is low (per WHO). World Health Organization

16. Low-dose aspirin (preventive, for high-risk patients)
    Purpose: reduces risk of developing preeclampsia when started in early second trimester if you’re high risk.
    What it does: 81 mg/day in the U.S. (75–150 mg in some countries), ideally before 16 weeks and by 12–28 weeks at the latest, taken nightly. (This is a medication, included here because it’s a cornerstone of non-delivery prevention planning.) PMCACOGNICE

17. Oral health (treat periodontal disease)
    Purpose: gum disease is associated with higher preeclampsia risk.
    What it does: dental cleaning and treatment during pregnancy; good daily oral hygiene. PMC

18. Smoking and substance cessation
    Purpose: protect blood vessels and placenta.
    What it does: counseling and support programs.

19. Telemedicine / remote monitoring when appropriate
    Purpose: faster response to abnormal readings; fewer unnecessary trips.
    What it does: shares home BP and symptoms with the care team in real time. SpringerLink

20. What not to do: “bed rest”
    Purpose: avoid harms (blood clots, weakness).
    What it does: guidelines do not recommend routine bed rest for hypertension in pregnancy. Light activity as advised is preferable. NICE

---

Drug treatments

Doses below reflect common guideline ranges; your clinician will tailor therapy to your blood pressure, symptoms, labs, and gestational age.

1. Magnesium sulfate (anti-seizure prophylaxis/treatment)
   Class: anticonvulsant (OB use).
   When: severe preeclampsia/eclampsia; sometimes during labor and 24 hrs postpartum.
   Dose (typical): 4–6 g IV loading over 20–30 min, then 1–2 g/hour infusion; IM alternative exists.
   Purpose: prevents and treats seizures.
   Mechanism: stabilizes nerve-muscle activity and dilates cerebral vessels.
   Side effects: flushing, nausea, drowsiness; rare toxicity (loss of reflexes, breathing depression)—careful monitoring needed. obgconnect.com

2. Labetalol (IV for emergency; oral for maintenance)
   Class: alpha/beta-blocker.
   When: acute severe BP (≥160/110); oral for ongoing control.
   Dose (acute IV): 20 mg IV, then 20–80 mg every 10–30 min (max ~300 mg), or infusion 1–2 mg/min.
   Purpose: quickly lower dangerous BP spikes.
   Mechanism: blocks adrenaline effects on heart/vessels.
   Side effects: low HR, dizziness; avoid with asthma/heart block. The ObG Project

3. Hydralazine (IV)
   Class: direct vasodilator.
   When: acute severe BP if labetalol/nifedipine unsuitable or inadequate.
   Dose: 5–10 mg IV, repeat q20–30 min; infusion in ICU settings.
   Purpose: lower severe BP.
   Mechanism: relaxes arterial smooth muscle.
   Side effects: headache, flushing, fast heart rate. PMC

4. Nifedipine (immediate-release oral for emergency; extended-release for maintenance)
   Class: calcium-channel blocker.
   When: acute severe BP (oral 10 mg capsule; may repeat); daily control with ER tablets.
   Purpose: reduce BP quickly (immediate) or smoothly (ER).
   Mechanism: relaxes arterial muscle.
   Side effects: flushing, headache; avoid taking with magnesium bolus at the same instant (team coordinates timing). PMC

5. Methyldopa (oral)
   Class: central alpha-agonist.
   When: non-severe maintenance when others unsuitable (less used now).
   Purpose: lower BP.
   Mechanism: reduces sympathetic tone from brain.
   Side effects: fatigue, dry mouth.

6. Nicardipine (IV infusion in ICU settings)
   Class: calcium-channel blocker.
   When: refractory severe BP when continuous titration is needed.
   Purpose: controlled BP reduction with infusion pump.
   Mechanism/side effects: like nifedipine; used in critical care protocols. millionhearts.hhs.gov

7. Nitroglycerin (IV) for pulmonary edema or refractory hypertension
   Class: vasodilator.
   When: severe cases with lung fluid or tight BP despite first-line therapy.
   Purpose: unload the heart and improve breathing.
   Mechanism: releases nitric oxide; dilates veins/arteries.
   Side effects: headache, low BP—ICU monitoring.

8. Furosemide (diuretic), mainly postpartum or if pulmonary edema
   Class: loop diuretic.
   When: fluid overload or postpartum BP spikes (not routine during pregnancy).
   Purpose: remove excess fluid; improve breathing.
   Side effects: electrolyte shifts; careful dosing. SpringerLink

9. Antenatal corticosteroids (betamethasone or dexamethasone)
   Class: steroid for fetal lung maturation.
   When: likely delivery <34 weeks.
   Purpose: reduce neonatal breathing problems and complications.
   Mechanism: speeds type II pneumocyte maturation.
   Side effects: temporary blood-sugar rise; timing coordinated by team. preeclampsia.org

10. Low-dose aspirin (prevention in high-risk patients)
    Class: antiplatelet.
    When: begin 12–16 weeks (no later than 28), continue until near delivery (per your clinician).
    Dose: 81 mg nightly in the U.S. (75–150 mg in some regions).
    Purpose: lower the chance of developing preeclampsia (especially preterm preeclampsia) if you’re high risk.
    Mechanism: shifts placental thromboxane/prostacyclin balance; improves placental perfusion.
    Side effects: bruising/heartburn; avoid if aspirin allergy or bleeding risks. PMC+1

Timing matters: For acute severe BP (≥160/110), treatment should start within 30–60 minutes of confirmation to prevent stroke and other complications. SMFM Publicationsilpqc.org

---

Dietary “molecular” supplements

Supplements do not treat active preeclampsia. They’re used for general nutrition or risk reduction in specific situations. Always ask your obstetric team before starting anything.

1. Calcium
   Dose: 1.5–2.0 g elemental calcium/day in low-calcium-intake populations (split doses ≤500 mg at a time).
   Function: reduces risk of preeclampsia where dietary calcium is low.
   Mechanism: calms vascular smooth muscle and hormonal pathways that raise BP. World Health Organization

2. Vitamin D (if deficient)
   Dose: typically 1,000–2,000 IU/day; higher only if prescribed.
   Function: corrects deficiency, supports bone/immune health.
   Mechanism: modulates inflammation and endothelial function; evidence for preeclampsia prevention is mixed. preeclampsia.org

3. L-arginine
   Dose used in studies: often 3–6 g/day (sometimes via medical nutrition bars).
   Function: may reduce risk in high-risk women when combined with other care.
   Mechanism: precursor to nitric oxide, which relaxes vessels. Evidence suggests benefit in certain contexts. PMC

4. Omega-3 fatty acids (DHA/EPA)
   Dose: ≥200–300 mg DHA/day from low-mercury fish or supplements.
   Function: supports fetal brain/eye development; BP effects are modest.
   Mechanism: anti-inflammatory lipid mediators; mixed data for preeclampsia prevention. U.S. Food and Drug Administration

5. Folate (folic acid)
   Dose: 400–800 mcg/day (standard prenatal dose).
   Function: prevents neural-tube defects; may help homocysteine balance.
   Mechanism: methylation pathways; not a proven preeclampsia preventive but essential for pregnancy.

6. Probiotics (e.g., Lactobacillus, Bifidobacterium strains)
   Dose: product-specific (follow clinician guidance).
   Function: may modestly reduce some pregnancy complications; evidence for preeclampsia is inconsistent.
   Mechanism: gut–immune modulation affecting inflammation and metabolism.

7. Magnesium (dietary supplement, not MgSO₄ drug)
   Dose: 350–400 mg/day (from diet/supplement as needed).
   Function: general support for muscle and nerve function.
   Mechanism: vascular relaxation; does not replace magnesium sulfate therapy.

8. Coenzyme Q10
   Dose in small studies: ~200 mg/day.
   Function: antioxidant support; limited early research suggested possible benefit, but evidence is small and not definitive.
   Mechanism: mitochondrial electron transport and antioxidation; discuss before use.

9. Myo-inositol
   Dose: commonly 2 g twice daily in metabolic studies.
   Function: improves insulin signaling; helps with gestational diabetes risk; effect on preeclampsia risk is uncertain.
   Mechanism: second-messenger pathways.

10. Dietary nitrate sources (e.g., beetroot)
    Dose: food-based; concentrate doses vary.
    Function: may modestly lower BP in non-pregnant adults; pregnancy-specific evidence is limited.
    Mechanism: nitrate→nitrite→nitric oxide pathway; use food sources rather than high-dose concentrates unless advised.

---

Regenerative or stem-cell drugs

There are no approved immune-boosting, regenerative, or stem-cell drugs to treat preeclampsia. Some ideas are being studied—pravastatin, metformin, mesenchymal stem-cell/exosome therapies, complement inhibitors (eculizumab) in different conditions like pregnancy-associated thrombotic microangiopathy—not for routine preeclampsia care. Results are mixed or negative, and these approaches should be used only in clinical trials or for other diagnoses under specialist care. I can’t responsibly list dosages because they’re not recommended for preeclampsia outside trials. PubMedBioMed CentralBioMed CentralPMC

---

Procedures / surgeries

1. Induction of labor
   Why: once you or your baby will be safer outside the womb (e.g., at or near term, or earlier if severe disease).
   What happens: cervical ripening (balloon or medication), then oxytocin and/or membrane rupture to start labor. Delivery ends the disease because the placenta is removed. preeclampsia.org

2. Cesarean delivery
   Why: if labor would be too slow or risky (non-reassuring fetal status, severe maternal disease with an unfavorable cervix, or other obstetric reasons).
   What happens: surgical birth to expedite safe delivery. preeclampsia.org

3. Therapeutic plasma exchange (TPE) – rare, rescue use
   Why: in refractory postpartum HELLP (a severe preeclampsia variant) or when the picture overlaps with other thrombotic microangiopathies.
   What happens: machine removes plasma and replaces it to clear harmful factors; done in ICU by specialists. (Not routine for preeclampsia; selected severe cases only.) PMC

4. Surgical/Interventional control of liver hemorrhage or rupture (very rare)
   Why: in life-threatening liver bleeding with HELLP.
   What happens: options include laparotomy with liver packing or interventional radiology embolization, depending on stability and anatomy. BioMed Central

5. Dialysis catheter placement and temporary dialysis (if acute kidney failure occurs)
   Why: severe, temporary kidney injury from the disease.
   What happens: a catheter is placed; dialysis supports the body until kidneys recover; uncommon but lifesaving in selected cases. Ash Publications

---

Prevention strategies

1. Know your risk & start care early (especially with prior preeclampsia, chronic hypertension, diabetes, kidney disease, autoimmune disease, twins, or IVF). preeclampsia.org

2. Low-dose aspirin if you’re high risk—start at 12–16 weeks, continue as advised. PMC

3. Calcium supplementation where dietary calcium is low. World Health Organization

4. Healthy weight before pregnancy; manage weight gain during pregnancy with clinician guidance. ACOG

5. Stay active safely (unless your clinician restricts activity). ACOG

6. Control chronic conditions (blood pressure, diabetes, kidney disease, lupus/APS). preeclampsia.org

7. Treat sleep apnea if present (mask therapy helps blood pressure). preeclampsia.org

8. Oral health care (treat periodontal disease). PMC

9. Avoid smoking, alcohol, and illicit drugs.

10. Follow a balanced diet emphasizing calcium sources and adequate protein; limit excessive sodium and ultra-processed foods.

---

When to see a doctor

Call or go now if you have any of these during pregnancy or within 6 weeks after birth:

• BP ≥160/110 mm Hg even once, or ≥140/90 twice—especially with symptoms;

• Severe or persistent headache, blurry vision/seeing spots, trouble breathing, chest pain, confusion, severe upper-right belly pain, nausea/vomiting after mid-pregnancy, sudden face/hand swelling, or seizure;

• Marked decrease in baby’s movements. ACOGMayo Clinic

---

What to eat” and “what to avoid

Eat more of:

• Calcium-rich foods: milk/yogurt/cheese, small-bone fish (sardines), tofu with calcium, green leafy veg. (Supplements if your dietary intake is low—ask your clinician.) World Health Organization

• Protein with meals: eggs, fish (low-mercury choices), beans, lentils.

• Colorful vegetables & fruits for fiber and antioxidants.

• Whole grains for steady energy and bowel regularity.

• Healthy fats (olive oil, avocados, nuts) and low-mercury fish 2–3 times/week for DHA. U.S. Food and Drug Administration

Limit/avoid:

• High-mercury fish (shark, swordfish, king mackerel, bigeye tuna, tilefish, marlin, orange roughy). Choose low-mercury fish instead. ACOG

• Unpasteurized dairy, undercooked meats, and raw seafood (food-borne infection risk). Mayo Clinic

• Alcohol (avoid completely).

• Caffeine: keep <200 mg/day (about one 12-oz coffee). ACOG

• Highly salted, ultra-processed foods—OK occasionally, but don’t overdo sodium.

• Herbal supplements not approved by your obstetric team (unknown safety).

---

FAQs

1) Can preeclampsia be cured without delivery?
No. Medicines protect you and buy time, but the disease resolves only after the placenta is delivered. preeclampsia.org

2) What BP is dangerous in pregnancy?
160/110 mm Hg or higher is an emergency and should be treated quickly (within 30–60 minutes). SMFM Publications

3) Do I need a C-section if I have preeclampsia?
Not always. Many patients deliver vaginally if mother and baby are stable and the cervix is favorable; C-section is chosen when it’s safer or faster. preeclampsia.org

4) Why is magnesium sulfate used?
To prevent seizures and protect the brain in severe disease. It’s different from over-the-counter magnesium supplements. obgconnect.com

5) I’ve heard about an “angiogenic” blood test—what is it?
In hospitals, a sFlt-1/PlGF ratio test can help doctors decide how likely preeclampsia is and how closely to monitor you when they’re concerned. It’s not a home test. NICE

6) Does low-dose aspirin really help?
Yes—if you’re high risk and start it in early second trimester. It lowers the chance of preterm preeclampsia. Ask your clinician if you qualify. PMC+1

7) Can I breastfeed while on BP medicines?
Usually yes. Nifedipine, amlodipine, and enalapril are commonly used postpartum and considered compatible with breastfeeding; your team will individualize therapy. Ahm Journals

8) What about bed rest?
Routine bed rest is not recommended because risks outweigh benefits. NICE

9) Will it come back in my next pregnancy?
Risk is higher if you’ve had preeclampsia, especially if it was early or severe. Preconception counseling, aspirin when indicated, and early prenatal care help. preeclampsia.org

10) Can exercise help?
Pregnancy-appropriate activity is safe for most and is linked with lower risk of hypertensive disorders. Follow your clinician’s advice. ACOGPMC

11) Do vitamins C and E prevent preeclampsia?
Large trials did not show benefit; they’re not recommended for this purpose.

12) I live where dairy intake is low. Should I take calcium?
Yes—WHO recommends 1.5–2 g/day elemental calcium in low-intake settings to reduce risk. World Health Organization

13) Can preeclampsia happen after delivery?
Yes—postpartum preeclampsia can appear up to 6 weeks after birth. Keep checking your BP and call for warning symptoms. Mayo Clinic

14) Does stress cause preeclampsia?
Stress alone doesn’t cause it; it’s mainly a placental blood-vessel problem. Reducing stress still helps overall health.

15) What’s the long-term outlook for me?
After recovery, lifetime heart-disease risk is higher. Plan heart-healthy habits and follow-up with your primary-care clinician. PMC

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 22, 2025.