A 35‑year‑old bank employee from Kochi walked into her routine antenatal check‑up expecting nothing more than the usual blood pressure reading and a quick chat with her doctor. She felt perfectly fine—no headaches, no swelling, no warning signs. Yet her blood pressure was unexpectedly high, and a urine test showed protein. Within minutes, her calm morning turned into a flurry of monitoring, scans, and urgent discussions. She had developed pre‑eclampsia, a condition she had barely heard of, but one that would shape the rest of her pregnancy.
Her story is far more common than most people realise.
What exactly is pre‑eclampsia?
Pre‑eclampsia is a pregnancy‑related condition that usually appears after 20 weeks. It’s primarily identified by high blood pressure and protein in the urine, but it can also affect organs like the liver, kidneys, and the blood’s ability to clot.
It affects 1–5 out of every 100 pregnant women, especially first‑time mothers. Most cases are mild, but a small number can become severe and even life‑threatening if not monitored closely.
The tricky part? Many women feel completely normal until a routine check‑up reveals the problem.
How do you know you have it?
Often, you don’t. Pre‑eclampsia can be silent. But when symptoms do appear, they may include:
• Persistent severe headache
• Blurred vision or flashing lights
• Pain below the ribs
• Sudden swelling of the face, hands, or feet
• Nausea or vomiting
• Feeling unusually unwell
These symptoms should never be ignored. They can signal worsening disease and require immediate medical attention.
Why pre‑eclampsia matters for mothers
In severe cases, pre‑eclampsia can affect vital organs. Rarely, it can lead to eclampsia, a condition where the mother has seizures. Although uncommon—about 1 in 3000 pregnancies—it is a medical emergency.
The condition can also increase a woman’s long‑term risk of high blood pressure, stroke, and heart disease later in life. Pregnancy, in this sense, becomes a window into future health.
Why it matters for babies
Pre‑eclampsia affects how well the placenta works. If the placenta doesn’t function properly, the baby may:
• Grow more slowly
• Become distressed
• Need to be delivered early
• Require care in a neonatal unit
In severe cases, the placenta may fail completely, leading to stillbirth. This is why monitoring is so crucial.
Who is more likely to get pre‑eclampsia?
Pre‑eclampsia can happen to anyone, but the risk is higher if:
• You had high blood pressure before pregnancy
• You had pre‑eclampsia in a previous pregnancy
• You have kidney disease, diabetes, or autoimmune conditions like lupus
• You are pregnant for the first time
• You are over 40
• Your last pregnancy was over 10 years ago
• You have a BMI over 35
• Your mother or sister had pre‑eclampsia
• You are carrying twins or triplets
Women with higher risk are often advised to take low‑dose aspirin (75–150 mg) from 12 to 36 weeks to reduce the chance of developing the condition.
How doctors monitor pre‑eclampsia
Once diagnosed, your care becomes more personalised. Monitoring may include:
• Frequent blood pressure checks
• Regular blood tests
• Ultrasound scans every 2 weeks to track baby’s growth
• Medication to control blood pressure
• Hospital admission if the condition becomes severe
Most women can be monitored as outpatients; Few may need daily reviews or hospital stays.
When will the baby be delivered?
Pre‑eclampsia doesn’t truly improve until the baby is born.
If you reach 37-39 weeks, doctors may usually consider delivery, but this is very individualised, with the exact timing based on blood pressure, response to medications, amount of protein in urine, symptoms, baby aspects, etc. If you or your baby become unwell earlier, delivery may be advised even before 37 weeks. This is a careful decision balancing the risks of prematurity against the risks of continuing the pregnancy.
Birth options may include:
• Mostly induction of labour, aiming for vaginal delivery
• Rarely a planned caesarean section, depending on your condition and your baby’s wellbeing
What happens if it becomes severe?
Severe pre‑eclampsia requires hospital care. Treatment may include:
• Strong medication to control blood pressure
• Magnesium sulphate to prevent seizures
• Continuous monitoring of mother and baby
• Delivery of the baby once the condition stabilised
The timing of delivery becomes a critical decision made by a specialist team.
After the baby is born
Pre‑eclampsia usually resolves after delivery, but the first few days remain risky. You may need:
• Close monitoring
• Blood pressure checks for several weeks
• Medication that is safe for breastfeeding
• Support if your baby is in the neonatal unit
A follow‑up appointment at 6–8 weeks is essential. If blood pressure or protein in the urine remains high, further evaluation may be needed.
Emotional recovery matters too
A complicated pregnancy can be frightening. Many women feel anxious, overwhelmed, or low in mood afterwards. If this happens, speaking to your health care provider can help you access support early.
Will it happen again?
The chance of recurrence depends on how early the baby was delivered:
• 1 in 3 if the baby was born between 28–34 weeks
• 1 in 4 if born between 34–37 weeks
• 1 in 6 if born after 37 weeks
Women with a history of pre‑eclampsia are usually advised to take low‑dose aspirin in future pregnancies and to book early with their healthcare team.
Long‑term health: What you can do
Since pre‑eclampsia increases the risk of future heart disease, simple lifestyle steps can make a difference:
• Avoid smoking
• Maintain a healthy weight
• Stay physically active
• Eat a balanced diet
Pregnancy may end, but your health journey continues. Pre‑eclampsia is a common but often silent pregnancy complication that can affect both mother and baby. Regular antenatal check‑ups, early detection, and careful monitoring are key to keeping pregnancy safe. While the condition resolves after birth, its emotional and long‑term health effects deserve attention. With awareness, timely care, and healthy habits, women can navigate pre‑eclampsia confidently and protect their future wellbeing.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
