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Written by Dr Serena Jones, GP
Dr Serena graduated from Manchester University in 2008 (MBChB).
She also holds the MRCGP, DRCOG and DFSRH.
Pre-eclampsia is a serious condition that can affect pregnant women, after 20 weeks of pregnancy or immediately following birth. It is characterised by high blood pressure and often includes protein in the urine, highlighting possible damage to organs such as the liver or kidneys. If it is left untreated, pre-eclampsia can escalate to eclampsia which causes seizures, stroke, or even death in severe cases for both mother and baby.
Therefore, monitoring blood pressure during pregnancy is critical for early detection and intervention to prevent complications.
What Causes Pre-eclampsia?
The exact cause of pre-eclampsia is unknown, it’s thought to be linked to problems with the placenta, and potentially autoimmune disorders [1].
Risk factors include:
- A history of pre-eclampsia,
- chronic hypertension,
- first pregnancy or over 10 years since last pregnancy,
- multiple pregnancies,
- obesity,
- conditions such as diabetes, chronic kidney disease or autoimmune disorders,
- genetic predispositions and maternal age (both younger than 20 or older than 40) can also increase the risk.
Signs and Symptoms of Pre-eclampsia
In its early stages pre-eclampsia often has no symptoms at all; but some warning signs include:
- Persistent high blood pressure (above 140/90 mmHg)
- Severe headaches
- Blurred vision or light sensitivity
- Swelling of the hands, feet, or face
- Sudden weight gain
- Abdominal pain, particularly in the upper right area
- Vomiting
Monitoring blood pressure can help detect pre-eclampsia before these symptoms appear, which is why regular check-ups are essential.
How is Pre-eclampsia Diagnosed?
Having a blood pressure over 140mmHg systolic or 90mmHg diastolic after 20 weeks of pregnancy and one of the following:
- Protein in your urine, or
- Other symptoms:
- Kidney disturbance – raised creatinine.
- Liver involvement – elevated liver enzymes transaminases with or without right upper quadrant or upper central abdominal pain.
- Neurological complications such as fits, altered mental status, blindness, stroke, severe headaches or persistent visual disturbance.
- Haematological complications such as a low platelet count or problems with clotting.
- Placenta problems such as foetal growth restriction or stillbirth [2].
Management
The NHS in the UK has clear guidelines for managing pre-eclampsia. Women with high blood pressure or signs of pre-eclampsia are referred for further testing, including blood tests, ultrasound scans, and urine tests.
Women that are high risk from pre-eclampsia should be prescribed 75-150mg of Aspirin daily from 12 weeks until birth unless contra-indicated.
Depending on the severity of the condition, treatment may include:
- Close monitoring,
- lifestyle advice (having adequate rest periods, exercising regularly and keeping weight stable),
- medication such as labetalol or nifedipine, or
- early delivery of the baby if necessary (which is the only definitive treatment for pre-eclampsia). Early delivery is usually planned for around 37 weeks but is done sooner if maternal or foetal health is at risk.
Postpartum (after birth) monitoring is essential to manage any ongoing hypertension.
Conclusion
Pre-eclampsia is a potentially life-threatening condition, but it can be managed effectively with early detection and proper care. In the UK, monitoring blood pressure during pregnancy is a routine part of antenatal care. Blood pressure checks are typically conducted at each appointment, allowing healthcare professionals to identify signs of pre-eclampsia early on.
Women identified as being at high risk for pre-eclampsia may be asked to monitor their blood pressure at home. This empowers pregnant women to stay vigilant and alert healthcare providers to any abnormal readings between visits. Simple lifestyle adjustments, medication, and sometimes early delivery can manage the condition and protect both the mother and baby.
Discover our Smart Blood Pressure Monitor, designed for safe and effective use during pregnancy here.
References:
- Brown M.A., Magee L.A., Kenny L.C., Karumanchi S.A., McCarthy F.P., Saito S., Hall D.R., Warren C.E., Adoyi G., Ishaku S. Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice. 2018;72:24–43. doi: 10.1161/HYPERTENSIONAHA.117.10803
- NICE CKS: https://cks.nice.org.uk/topics/hypertension-in-pregnancy/management/pre-eclampsia/
