Pre-eclampsia is a pregnancy-specific disorder usually recognised after 20 weeks through new high blood pressure together with protein in the urine, maternal organ dysfunction, or evidence that the placenta is not supporting the pregnancy normally. It ranges from a condition managed with close outpatient surveillance to a medical emergency requiring admission and delivery.
Who is at increased risk?
Risk is higher after previous pre-eclampsia, particularly when it was early or severe; in chronic hypertension, kidney disease, diabetes, autoimmune disease, multifetal pregnancy, or certain first pregnancies. Risk assessment early in pregnancy can identify women who may benefit from preventive strategies such as low-dose aspirin, but treatment should be prescribed by the treating clinician after reviewing contraindications and timing.
What monitoring may include
Assessment can include repeated blood pressure measurement, urine protein, blood counts, liver and kidney tests, symptom review, fetal growth ultrasound, amniotic-fluid assessment, and Doppler studies. The purpose is not to repeat tests mechanically. It is to detect whether maternal disease or placental dysfunction is progressing and to decide whether continuing the pregnancy remains safer than delivery.
Warning signs
Severe or persistent headache, visual disturbance, severe pain below the ribs or in the upper abdomen, sudden marked swelling, chest pain, breathlessness, seizures, heavy bleeding, or reduced fetal movements needs urgent clinical assessment. A home blood pressure reading of 140/90 mmHg or higher should prompt contact with the maternity team; a severely elevated reading or serious symptoms requires urgent care.
The delivery decision
Delivery is the definitive way to end the pregnancy process driving pre-eclampsia, but timing depends on gestation, severity, maternal laboratory findings, blood pressure control, fetal condition, and available neonatal support. Before term, the team balances the maternal risk of waiting against the fetal consequences of prematurity. That decision is individual and can change quickly, which is why a documented escalation plan matters.
Prevention, with perspective
Can a plan change
the odds?
Sometimes, yes. But the useful answer includes who was studied, what changed, and what the finding means for you. Here is one important example.
Preterm pre-eclampsia
Affected pregnancies, % · Screen-selected high-risk singleton pregnancies · 1,620 with follow-up
Outcome: pre-eclampsia leading to delivery before 37 weeks. Trial percentages are not your personal risk or Mediclinic outcomes.
About 3 feweraffected pregnancies per 100 in this trial
The trial compared clinician-prescribed aspirin with placebo in a specific high-risk group. The difference was statistically significant.
Adjusted odds ratio (95% confidence interval): 0.38 (0.20–0.74)
Do not start, stop, or change aspirin from this chart. Your clinician should assess your history, bleeding risks, allergies, dose, and timing. Prevention does not replace monitoring.
Study details and source
ASPRE randomized 1,776 participants. The primary outcome analysis included 798 in the aspirin group and 822 in the placebo group after withdrawals and loss to follow-up. Trial regimen: 150 mg daily from 11–14 until 36 weeks. This describes the research, not a universal treatment schedule.
Rolnik et al. · NEJM 2017 · DOI: 10.1056/NEJMoa1704559Understand your baseline
Previous pregnancies, health conditions, medicines, and the current findings shape the plan.
Agree what to follow
Know which symptoms, measurements, blood tests, and scans matter in your situation.
Know when to call
Severe symptoms need urgent assessment. An online request is not an emergency service.
The essential distinctions
Mother, placenta, baby: one connected picture.
The placenta supports exchange between two separate circulations. Assessment looks at how the whole system is working.
- The placenta
Transfers oxygen and nutrients, and removes waste. Its position and function are different questions.
- The baby
Growth, movements, fluid, and Doppler help build a picture of wellbeing.
- The pregnancy
Maternal health, membranes, and gestational age shape the next decision.
Visual decision pathway
Suspected pre-eclampsia: assess, classify, act
Blood pressure is one part of the decision; symptoms, laboratory results, placental function and fetal condition complete the picture.
- ConfirmMeasure and reassess
Repeat blood pressure correctly and review gestation, history and medication.
- EvaluateLook for organ or placental dysfunction
Symptoms, urine protein, blood count, liver, kidney and fetal assessment.
- ClassifyStable or severe?
Identify severe features, progression and whether outpatient care is safe.
- BalanceTreat, monitor or deliver
Balance maternal deterioration against prematurity with a documented escalation plan.