Preeclampsia (pre-eclampsia): what it is, the warning signs and how it is treated
In this article
Pre-eclampsia, also spelled preeclampsia, is a pregnancy condition that causes high blood pressure, usually with protein in your urine. The NHS says it is most likely from 20 weeks onwards but can happen at any point, and sometimes only in the days or weeks after birth. You may feel nothing at first, which is why KKH checks your blood pressure and urine at every antenatal visit.
| What it is | High blood pressure in pregnancy, often with protein in your urine |
|---|---|
| When | Usually from 20 weeks; can start after birth |
| How common | About 4 per cent of pregnancies in Singapore, SGH says |
| Checked by | Blood pressure and a urine test at every visit |
| Cure | Delivery of the baby |
Warning signs that need same-day care
The NHS lists the symptoms: a severe headache that simple painkillers do not shift, blurred vision or flashing lights, pain just below the ribs, sudden swelling of your face, hands or feet, heartburn that antacids do not help, vomiting, and feeling very unwell. It says any of these needs checking immediately, including in the first weeks after the birth.
KKH asks you to come in for severe headaches, changes in vision or tummy pain. At KKH that is the Delivery Suite on Level 2 of the Women's Tower from 22 weeks. Do not wait for your next appointment.
How it is picked up
Most women have no symptoms at the start, so the routine checks do the work. KKH takes your blood pressure and a urine sample at every antenatal appointment. The NHS says that if pre-eclampsia is suspected you are sent to hospital for blood tests and scans of your baby's growth.
Raised blood pressure without protein in the urine is called gestational hypertension. SGH's obstetricians, writing on HealthXchange, say it is one of the risk factors for preeclampsia, so it is watched closely.
Who is at higher risk
The NHS says your risk is higher if you have diabetes, high blood pressure, kidney disease or an autoimmune condition such as lupus, or if you had pre-eclampsia before. It is also higher in a first pregnancy, from age 40, with twins or triplets, with a BMI of 35 or more, when a close relative has had it, or when 10 years or more have passed since your last pregnancy.
If you are at higher risk, the NHS says your doctor may prescribe aspirin every day from week 12 until birth. It also says not to start aspirin on your own. Ask your gynae at your first visit whether it applies to you.
Treatment, delivery and recovery
SGH's obstetricians say the only cure is delivery. If preeclampsia appears after 37 weeks, your doctor will usually plan the birth, by induction or by caesarean if there are other reasons for one. Before 37 weeks, the team tries to manage it for as long as it is safe, and the baby may still need to be born early and spend time in neonatal intensive care (see premature birth).
The NHS says you will usually get medicine to lower your blood pressure, and severe cases stay in hospital. Most cases are not severe, but it can lead to seizures (eclampsia), HELLP syndrome or stroke. SGH says blood pressure usually returns to normal within a few weeks of delivery. Our full guide to preeclampsia in Singapore covers blood pressure readings and follow-up.
Frequently asked questions
What is pre-eclampsia?
A condition of pregnancy that raises your blood pressure, often with protein in your urine. The NHS says it is most likely from 20 weeks.
Is swelling in pregnancy a sign of preeclampsia?
Not on its own. SGH's obstetricians say swelling is very common in normal pregnancies. Sudden swelling of the face, hands or feet is different, and the NHS says it needs checking straight away.
Can you get pre-eclampsia after giving birth?
Yes. The NHS says it sometimes develops in the days or weeks after the birth, so a bad headache or vision changes after delivery still need urgent care.
How common is preeclampsia in Singapore?
SGH's obstetricians put it at about 4 per cent of pregnancies here. HealthHub gives a higher figure of 10 percent. Either way, it is the reason for the blood pressure check at every visit.
Related terms
- Gestational Hypertension: New high blood pressure that starts after 20 weeks of pregnancy in someone whose blood pressure was normal before.
- Antenatal (also Prenatal): Antenatal means before birth. Antenatal care is the check-ups, scans and tests you get while you are pregnant.
- Induction of Labour: Starting labour with medical help, such as a pessary, balloon or drip, instead of waiting for it to begin.
- Preterm (Premature) Birth: A baby born alive before 37 completed weeks of pregnancy. In Singapore, about 8.5% of babies arrive this early.
- Gestational Diabetes: High blood sugar that starts in pregnancy. Singapore screens every mum-to-be with a glucose test at 24 to 28 weeks.
- C-section (Caesarean Section): An operation to deliver your baby through a cut in your tummy and womb, planned ahead or done in labour.
