Pre-eclampsia: symptoms, causes and which doctor to see

For pre-eclampsia you can first see: Obstetrics & Gynecology or Perinatology (Maternal-Fetal Medicine). In large hospitals, the Perinatology unit also deals with this. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: blood pressure of 140/90 or higher; a persistent severe headache; blurred vision or flashing lights; pain in the upper right abdomen or upper stomach; sudden swelling of the face and hands and rapid weight gain; new nausea and vomiting in later pregnancy. Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

Do not suppress a headache with painkillers thinking it is “normal in pregnancy”; have your blood pressure checked first.

The most common causes: problems in the development and blood flow of the placenta; first pregnancy and multiple pregnancy; high blood pressure, diabetes or kidney disease before pregnancy; pre-eclampsia in a previous pregnancy; obesity and pregnancy over 35. Only a doctor’s examination can determine the exact cause.

The definitive treatment of pre-eclampsia is delivery of the baby and placenta. The timing depends on the week of pregnancy and severity; meanwhile blood pressure is controlled and treatment to prevent seizures is given. Symptoms usually improve in the days to weeks after birth.

It is more common in: women pregnant for the first time; those who had pre-eclampsia in a previous pregnancy; twin or triplet pregnancies; women with chronic high blood pressure, diabetes, kidney disease or lupus; pregnant women over 35 and those with obesity.

Blood pressure is measured and urine checked for protein at every antenatal visit. If pre-eclampsia is suspected, a blood count (platelets), liver and kidney tests, 24-hour urine protein and Doppler ultrasound of the baby are done.

In high-risk pregnancies, the doctor may recommend a preventive treatment started in early pregnancy; be sure to discuss this with your doctor. Regular antenatal check-ups are the most important way to detect it early.

Ankle swelling that gets worse in the evening is common in pregnancy and usually harmless. Sudden swelling of the face and hands, rapid weight gain and high blood pressure should be checked for pre-eclampsia.

Yes, rarely it can start in the first weeks after birth. See a doctor immediately for a severe headache and high blood pressure after giving birth.

If the answer to any of these questions is yes, call 112 without delay: “Has there been a seizure or confusion?” “Is a severe headache accompanied by vision problems?” “Is there breathlessness or a marked drop in the baby’s movements?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: the same day if blood pressure is 140/90 or higher in pregnancy; if sudden swelling of the face and hands has started; immediately for a persistent headache or vision problems.