World Pre-Eclampsia Day: Recognising the signs and knowing when to act

What is pre-eclampsia?

Pre-eclampsia is a condition linked to high blood pressure during pregnancy. It can also affect organs like the kidneys, liver, brain, and placenta.

It usually develops after 20 weeks of pregnancy, but it can also occur during labour or in the days and weeks after birth. In some cases, it develops gradually. In others, it can progress very quickly.

Some women have a higher risk of developing pre-eclampsia, including those who:

• are over 35
• are pregnant for the first time
• are carrying twins
• have pre-existing high blood pressure or conditions like diabetes
• have had pre-eclampsia before

However, many women who develop pre-eclampsia have no clear risk factors. It can occur in otherwise healthy pregnancies.

This was also the experience of a colleague, medical negligence lawyer Ivana Pajic, who shared her story for this article:

"I had a completely normal pregnancy with no warning signs or symptoms. At around 38 weeks, I developed blurred vision. I thought it might be the start of a migraine, and when it went away, I didn’t think much of it."

What are the warning signs of pre-eclampsia?

Pre‑eclampsia is not always easy to spot. Some women feel completely fine, while others may dismiss symptoms as part of a normal pregnancy. Symptoms of pre-eclampsia may include:

• protein in your urine
• persistent or severe headaches

• changes in vision, such as blurring or flashing lights
• swelling of your face, hands, or feet
• pain under your ribs or in your upper abdomen
• shortness of breath or chest tightness
• feeling suddenly very unwell

Ivana describes her continued symptoms and the steps she took:

“A few days later, the blurred vision happened again while I was driving to an appointment. I mentioned it to my midwife, and my blood pressure was elevated. I was sent for tests and admitted for 24-hour monitoring, then sent home.

Over the next few days, after further tests and foetal monitoring, my doctor became concerned I was developing pre-eclampsia and recommended induction of labour as soon as possible. Within a week of my first symptoms, my baby was safely born. Thankfully, my symptoms resolved after birth.”

Sometimes, the first signs don’t appear until labour. That’s why regular antenatal checks and taking symptoms seriously are so important.

How is pre-eclampsia diagnosed and managed?

During pregnancy, your midwife or doctor should regularly check your blood pressure. If they are concerned, you may have:

• blood tests to assess organ function
• urine tests to check for protein
• ultrasound scans to monitor your baby’s growth
• heart rate monitoring for your baby

Because pre-eclampsia can worsen quickly, keeping up with appointments is essential. If it’s diagnosed during pregnancy, management will depend on how severe it is and how far along you are.

In some cases, the safest option is for the baby to be born. If possible, your care team may try to prolong the pregnancy with close monitoring and medication.

If your condition becomes more serious, you might need hospital care or an earlier birth, which may involve induction or caesarean section. 

Risks to mothers and babies

Severe pre-eclampsia can have serious consequences. For mothers, risks include:

• kidney or liver failure
• heavy bleeding
• seizures
• stroke
• HELLP syndrome, a life-threatening condition affecting the liver and blood clotting

For babies, reduced blood flow through the placenta can limit oxygen and nutrients. This can:

• slow growth
• cause distress during pregnancy or labour
• increase the risk of brain injury, developmental disability, or cerebral palsy

Amber’s story

For Amber and her parents, pre-eclampsia had life-changing consequences. Her mother, Rebecca, had a normal, healthy pregnancy with no warning signs. At 41 weeks, she went to the hospital for an induction of labour.

That morning, tests showed elevated blood pressure and high levels of protein in her urine, both signs of pre-eclampsia. Rebecca and her partner, Phil, didn’t realise how serious this was for Amber at the time.

It was recommended that Rebecca continue with the induction of labour, as originally planned. Labour was slow. Her blood pressure continued to rise, and a repeat urine test in the afternoon showed even higher traces of protein. Despite these telling signs, there were long periods where Amber’s heart rate wasn’t monitored, and no treatment was given to control Rebecca’s blood pressure, now reaching severe levels.

The decision was eventually made to deliver Amber by caesarean section. But there was a delay of almost two hours before Rebecca was taken to the theatre.

Just after she arrived at the theatre, Rebecca went into active labour and delivered naturally. But by the time Amber was born, she had been deprived of oxygen. She required urgent resuscitation. Later scans confirmed severe, permanent brain injury.

Amber is now an adult and lives with cerebral palsy. She requires full-time care, which her parents continue to provide. This will be a lifelong need.

Her story shows how quickly pre-eclampsia can escalate, and how important careful monitoring and timely care can be. Sometimes the safest option can be an earlier birth.

What you can do to protect yourself and your baby

Pre-eclampsia can develop quickly, but knowing what to look for and acting on it can help keep you and your baby safe.

Practical steps you can take:

• if you’ve had pre‑eclampsia before, ask early in pregnancy about extra monitoring
• attend every antenatal appointment, even when you feel well
• make sure your blood pressure is checked regularly
• seek medical advice if you notice any symptoms, even mild ones
• call emergency services if symptoms are severe, such as chest pain, breathing difficulties, or seizures
• keep follow-up appointments after birth and monitor any new symptoms

When care falls short

Most women with pre‑eclampsia go on to have healthy babies. But when signs are missed or not acted on, the condition can be devastating.

Knowing the signs, attending your appointments and speaking up early can make all the difference. If you’re pregnant or have recently had a baby, trust your instincts and seek help if something doesn’t feel right.

If medical errors have contributed to an adverse outcome during pregnancy or childbirth, it may be considered medical negligence. If you’d like to understand your legal options, you can get in touch for a free, no-obligation conversation with our team.