1. What is pre-eclampsia (PE)?

Pre-eclampsia is a pregnancy-specific hypertensive disorder that usually occurs after 20 weeks of gestation. It is diagnosed when a pregnant woman develops new high blood pressure together with protein in the urine or with specific signs of organ dysfunction (such as problems with the liver, kidneys, blood clotting, brain, or vision), even if proteinuria is absent. If untreated, it can progress to eclampsia (seizures), which is life-threatening for both mother and baby. 

2. What causes pre-eclampsia?

The exact cause isn’t fully understood. Pre-eclampsia is linked to abnormal development of the placenta, leading to poor blood flow and imbalance in placental and maternal blood vessel function. This sets off a cascade of immune, vascular, and metabolic changes. Risk factors include first pregnancies, multiple pregnancies (twins or more), chronic high blood pressure, kidney disease, diabetes, obesity, family history of pre-eclampsia, older maternal age, and certain autoimmune conditions.

3. How can pre-eclampsia be treated?

The only definitive cure is delivery of the baby and placenta. Management depends on gestational age and severity:

• Close monitoring (blood pressure, urine, labs, ultrasound) if mild and early.
• Antihypertensives to control blood pressure.
• Magnesium sulphate to prevent seizures (eclampsia).
• Corticosteroids if preterm delivery is anticipated, to help the baby’s lungs mature.
• Timely delivery if the condition is severe or worsens.

4. Can pre-eclampsia be prevented?

• There is no guaranteed prevention, but evidence-based strategies reduce risk:
• Low-dose aspirin for women at increased risk  
• Calcium supplementation where dietary calcium intake is low.
• Managing underlying conditions (hypertension, diabetes), maintaining a healthy weight, and regular antenatal care.

5. What are the symptoms of pre-eclampsia?

Some women have no symptoms, which is why regular antenatal checks are vital. Possible warning signs include:

• Severe headache
• Vision problems (blurred vision, flashing lights)
• Swelling of the face, hands, or sudden weight gain
• Pain in the upper right abdomen
• Nausea, vomiting, or generally feeling unwell
• Pre-eclampsia can also appear after delivery (postpartum pre-eclampsia).

6. What is the impact of pre-eclampsia on mothers?

Pre-eclampsia may cause:

• Organ injury (kidneys, liver, brain)
• Seizures (eclampsia)
• Stroke or blood clotting problems
• Long-term increased risk of heart disease, hypertension, and stroke later in life
• In severe cases, it can be fatal without prompt treatment.

7. What is the impact of pre-eclampsia on babies?

Pre-eclampsia reduces blood flow to the placenta, which can result in:

• Restricted growth (low birth weight)
• Preterm birth (sometimes induced for safety)
• Stillbirth in severe cases
• Preterm babies may also face breathing and developmental complications.

8. What is placental growth factor (PlGF)?

PlGF is a protein produced by the placenta that promotes blood vessel growth. In pre-eclampsia, PlGF levels are usually low. In women with suspected preterm pre-eclampsia, PlGF-based tests or the sFlt-1/PlGF ratio can help rule in or rule out the condition in the short term and guide management. In early pregnancy, combined screening (maternal risk factors + blood pressure + uterine artery Doppler + PlGF) can identify women at high risk of preterm pre-eclampsia, so preventive aspirin can be offered.

9. Who is at risk of pre-eclampsia?

Higher risk is seen in women who are:

• Pregnant for the first time
• Carrying twins or more
• Over age 35
• With obesity, chronic hypertension, kidney disease, or diabetes
• With a family history of pre-eclampsia
• With autoimmune disorders (e.g., lupus, antiphospholipid syndrome)

10. Does pre-eclampsia happen again in future pregnancies?

Yes, women who’ve had pre-eclampsia are at higher risk in later pregnancies, although not all will develop it again. Preventive strategies (e.g. aspirin, calcium where appropriate) and closer monitoring can reduce risks.

11. Is pre-eclampsia the same as eclampsia?

No. Pre-eclampsia is the condition before seizures occur. Eclampsia is the progression to seizures, which can be fatal if untreated.