The risks of pre-eclampsia: What you need to know

Pre-eclampsia is a condition that can develop during pregnancy, usually after 20 weeks. It affects about 1 in 10 pregnancies in the UK and can become serious if not detected and managed early. It’s most commonly spotted by high blood pressure and signs of strain on the kidneys or liver. With early detection and proper care, most complications can be prevented - protecting both you and your baby.

 

 

What causes pre-eclampsia?

 

Pre-eclampsia begins in the placenta, which feeds your baby. In some cases, the blood vessels that support the placenta don’t form properly. This can reduce blood flow and trigger high blood pressure and organ stress in the mother. The exact cause isn’t fully known, but some people are at higher risk than others.

 

 

What groups are most at risk of developing pre-eclampsia?

 

Pre-eclampsia can happen to anyone, even if you’ve never had blood pressure problems before. However, the following increase your risk:

• First pregnancy
• Age over 40
• Expecting twins or more
• A BMI over 30
• Family history of pre-eclampsia
• Health conditions like high blood pressure, diabetes, kidney disease, or autoimmune conditions like lupus

 

 

What are the symptoms of pre-eclampsia?

 

Early on, there may be no symptoms - which is why routine checks are so important. But as it progresses, you might experience:

• Severe headaches
• Blurred vision or seeing flashing lights
• Pain under the ribs
• Swelling in your face, hands, or feet
• Feeling sick in late pregnancy
• Reduced baby movements

 

If you notice any of these signs, contact your midwife or doctor straight away.

 

 

Why it matters

 

Without the right monitoring and treatment, pre-eclampsia can lead to serious health problems:

For mothers:

• Seizures (eclampsia)
• Liver damage and blood problems (HELLP syndrome)
• Stroke
• Organ failure
• Placental separation (abruption)

 

For babies:

• Premature birth
• Low birth weight
• Growth problems
• Stillbirth in severe cases

 

 

How is pre-eclampsia treated?

 

Treatment depends on how far along you are and how severe the condition is. This may include:

• Regular blood pressure and urine checks
• Extra scans to monitor your baby’s growth
• Blood pressure medication
• Hospital stays if needed
• Early delivery if the condition worsens

 

The only true 'cure' is delivering the baby and placenta. Decisions around delivery balance the safety of both mum and baby.

 

 

Can we predict it earlier? Yes - and here's how:

 

A major breakthrough in recent years is the first-trimester screening test for pre-eclampsia, developed by the Fetal Medicine Foundation (FMF).

 

This test combines several things:

• Your medical and family history
• Your blood pressure
• A special Doppler scan of blood flow to the womb
• Two blood markers (called PlGF and PAPP-A)

 

What does it do?

The test can identify women at risk of pre-eclampsia very early in pregnancy - before symptoms even begin:

• It detects about 2 out of 3 cases of preterm pre-eclampsia (before 37 weeks)
• It detects over 3 out of 4 cases of early-onset pre-eclampsia (before 34 weeks)
• It has a low false alarm rate, so most women won’t be wrongly told they’re high-risk

 

Why is this important?

If you are found to be at high risk, taking low-dose aspirin before 16 weeks can dramatically reduce your chances of developing pre-eclampsia - by up to 80 per cent in some cases. Early action can save lives.

 

What should you do?

Ask your obstetrician or midwife whether this screening test is available at your hospital or clinic. It’s usually done between 11 and 14 weeks of pregnancy, and can be performed at the same time as your dating scan.

 

 

In summary

 

Pre-eclampsia is a serious but manageable condition when caught early. Thanks to new screening tools, we can now predict and prevent many cases before they even start.

 

Talk to your care provider about whether this test is available to you - it could make a big difference to your pregnancy journey.