What Are the First Signs of Preeclampsia? 9 Signs

Medically Reviewed on 1/6/2022
What Are the First Signs of Preeclampsia
The first sign of preeclampsia is typically high blood pressure, which makes monitoring your blood pressure an important part of prenatal care

Preeclampsia is a serious pregnancy complication that typically develops after 20 weeks of pregnancy or, in rare cases, after delivery. Many of the signs of preeclampsia are silent, and others are mistaken for normal pregnancy symptoms. This can be especially dangerous if prenatal checkups are missed.

The first sign of preeclampsia is typically high blood pressure, which makes monitoring your blood pressure an important part of prenatal care. Other symptoms may include:

How serious is preeclampsia?

If left untreated, preeclampsia can lead to eclampsia and even death. Eclampsia is a serious condition that occurs when preeclampsia is followed by seizures, posing a risk of coma and a threat to the health of both mother and baby.

Preeclampsia affects about 5%-8% percent of all pregnancies in the United States.

9 signs of preeclampsia

1. High blood pressure

Blood pressure that increases to 140/90 mmHg or higher during pregnancy, measured on two separate occasions at least 4 hours apart, could indicate preeclampsia. If your diastolic increases 15 points or more and your systolic increases 30 points or more, this could be cause for concern.

Keep note of your blood pressure readings before pregnancy and during each hospital visit. You can also monitor your blood pressure at home using a kit, although home kits may not provide the most reliable and accurate readings. 

Some physicians may recommend bed rest to limit the risk of elevating blood pressure. Some also claim that lying on your left side may help release restrictions on certain veins that contribute to increased blood pressure. While there isn’t enough evidence to support these claims, there is certainly no harm in trying these methods.

2. Proteinuria (protein in the urine)

Proteinuria is another vital sign of preeclampsia, and occurs when protein in the blood spills into urine when the kidneys fail to filter it out. This is because preeclampsia temporarily affects the kidney’s filtering abilities.

Urine dipstick tests can screen for proteinuria. Readings show +1 or greater could indicate the onset of preeclampsia. At this stage, your blood pressure readings may or may not be higher than 140/90 mmHg.

A reading of +2 is a serious cause for concern, and your doctors should be made aware immediately.

3. Swelling (edema)

Swelling here and there is not a major cause of concern during pregnancy. However, you should contact a doctor immediately if you notice the accumulation of excess fluid in the face, around the eyes, or in the hands. Signs include discoloration around the site of edema, or an indentation that remains on the skin for a few seconds when pressed.

4. Headaches

Preeclampsia headaches are characterized by dull, severe, or throbbing pain similar to migraine pain. Some of the characteristics of headache and other symptoms associated with preeclampsia include:

5. Nausea or vomiting

Nausea and vomiting typically occurs during your first trimester and should go away by the time you reach your second trimester. However, sudden onset of nausea or vomiting mid-pregnancy may be linked to preeclampsia. If you notice this symptom, you should check your blood pressure and monitor for protein in your urine.

6. Pain in the abdomen, shoulder, or lower back

Abdominal pain from preeclampsia originates in the upper right quadrant, just below the ribs. It may be confused for heartburn, gallbladder problems, flu, indigestion, or pain caused by the baby’s kicks.

Shoulder pain from preeclampsia may feel like a deep pinch along the bra strap or your neck and usually radiates from the liver under the right ribs. These pain symptoms could indicate HELLP syndrome (a potentially life-threatening situation characterized by hemolysis, elevated liver enzymes, and low platelet count) or a related problem in the liver.

If you experience lower back pain along with other signs of preeclampsia, you should immediately consult your physician.

7. Sudden weight gain

If you notice that you are gaining weight very quickly, i.e. 3-5 pounds in a week, it could indicate preeclampsia. 

Staying hydrated, eating healthy, and performing light to moderate exercises can go a long way in boosting your health during pregnancy and lower the chances of developing preeclampsia

8. Changes in vision

Blurred vision, sensations of flashing light, auras, and light sensitivity are potential symptoms of preeclampsia and could indicate a central nervous system irritation or swelling of the brain. 

9. Shortness of breath

Other associated symptoms of preeclampsia include:

These symptoms may indicate high blood pressure or pulmonary edema (fluid accumulation in the lungs). If you have experienced these symptoms before pregnancy, inform your doctor so they can monitor them more closely.


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What are the symptoms of severe preeclampsia?

In severe preeclampsia, you may have symptoms of mild preeclampsia along with:

  • High blood pressure (160/110 mmHg or higher)
  • Signs of kidney or liver damage (seen on lab tests)
  • Low platelet count
  • Fluid accumulation in the lungs
  • Decreased urine output

What are the complications of preeclampsia?

Preeclampsia, if left untreated, can pose a risk to the mother and fetus:

  • Premature birth
  • Low birth weight
  • Placental abruption (early separation of the placenta from the uterus before the baby is born)
  • HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count)

Postpartum complications of preeclampsia may include:

Can preeclampsia be prevented?

While you may not be able to prevent preeclampsia, following these tips can have a positive effect on both mother and fetus:

  • Never miss your doctor’s appointments
  • Monitor your weight, check your blood pressure, and test your urine regularly
  • Eat a healthy prenatal diet full of vitamins and minerals
  • Reduce consumption of processed food, refined sugar, and caffeine
  • Avoid alcohol and nonprescription medications
  • Consult your physician before taking any nutritional or herbal supplements
Medically Reviewed on 1/6/2022
Image Source: iStock Images

Preeclampsia Foundation. Signs & symptoms. https://www.preeclampsia.org/signs-and-symptoms

Cleveland Clinic. Preeclampsia. https://my.clevelandclinic.org/health/diseases/17952-preeclampsia