Recognize the risks and symptoms of this high blood pressure condition
Pregnancy often brings to mind images of baby showers, bassinets, and breathing classes. While preparation is key for ensuring the baby has all they need when they are born, it’s important that parents prepare themselves for what can happen during pregnancy.
We talked to Dr. Kelly O. Elmore, an OB/GYN who has made it her mission to transform women’s health care. She shared her insights on a little-known but common condition called preeclampsia (toxemia), which occurs in 2–8% of all pregnancies.
Dr. Elmore shared the 5 Ws – what, who, when, why, where – of preeclampsia in the hopes that education can help save the lives of more parents and their babies.
What is preeclampsia?
Preeclampsia is a high blood pressure condition that occurs during and after pregnancy. It’s often coupled with higher-than-normal protein levels in urine. There may not be any initial symptoms of preeclampsia. That’s why Dr. Elmore stresses the importance of regular prenatal visits. She notes that providers can take blood pressure, noting any changes over time. Expecting parents can also monitor their blood pressure at home and share updates with their providers. Providers might also test urine and blood to check for sudden changes that may indicate preeclampsia.
Other symptoms of preeclampsia parents should look for include:
- Severe headaches
- Changes in vision
- Difficulty breathing
- Upper belly pain, especially under the right side of ribs
- Persistent nausea and/or vomiting
If left untreated, preeclampsia can lead to premature birth, urgent cesarean delivery, organ failure, and even maternal death.
Who is at risk for preeclampsia?
While anyone who can get pregnant may develop the condition, some people are at greater risk than others. Risk factors can include:
- Previous personal or family history of preeclampsia
- First pregnancy
- Multiple-birth pregnancy (twins, triplets, etc.)
- Use of in vitro fertilization
- Chronic high blood pressure
- Diabetes
- Kidney disease
- Autoimmune disorder, such as lupus
- Body mass index (BMI) higher than 30
- Being older than 35
- Other health conditions, such as blood clots or fibroids
Dr. Elmore also notes that preeclampsia disproportionally affects those who are Black/African American, as well as Indigenous peoples. In fact, Black/African American pregnant people are 60% more likely (PDF, 178 KB) to have preeclampsia and to develop severe cases. Research suggests this is not necessarily rooted in genetics but in social and healthcare inequities.
That’s why Dr. Elmore strongly advocates for these populations to track their symptoms and speak up if something doesn’t feel right. Finding a doctor that provides culturally competent care is also another way to support a healthy pregnancy.
When does preeclampsia usually start?
Preeclampsia often occurs after the first 20 weeks of a pregnancy. Those who are pregnant may notice a sudden increase in blood pressure after this time. However, people with high blood pressure can also develop preeclampsia. So it’s important to monitor any fluctuations in blood pressure throughout pregnancy.
Dr. Elmore also notes that people should still monitor their symptoms even after pregnancy. That’s because preeclampsia can still happen after birth – a condition known as postpartum preeclampsia. Postpartum preeclampsia often occurs within 48 hours of delivery. However, it can still occur up to 6 weeks after the baby is born.
Why does preeclampsia occur?
While there is no single cause for the condition, there are a series of common factors that can lead to preeclampsia. The main issue starts in the placenta, the organ that feeds the baby during pregnancy. When blood vessels don’t form properly in the placenta, that can impact blood flow and increase blood pressure. Gestational hypertension – that is, high blood pressure that occurs due to pregnancy – can also develop into preeclampsia.
As mentioned before, preeclampsia can affect anyone who is pregnant. But Dr. Elmore highlights that socioeconomic and environmental factors can increase risk and severity of preeclampsia. These factors include stress, lack of access to health care, and conditions like diabetes and hypertension.
Where should someone seek treatment for preeclampsia?
As Dr. Elmore stressed above, early and regular prenatal visits are essential for helping to reduce the risk of and manage preeclampsia. Based on the results of screenings and tests, a doctor might suggest preventive strategies, such as:
- Optimizing nutrition
- Increasing water intake
- Exercising and resting regularly
- Elevating feet several times a day
- Eliminating alcohol or caffeine
- Taking prenatal vitamins
- Taking low-dose aspirin (if at moderate to higher risk)
If someone already is diagnosed with preeclampsia, scheduling a delivery sooner might also be considered when the parent is nearing their due date.
Dr. Elmore also recommends seeking immediate emergency care if any of the symptoms of preeclampsia occur suddenly and severely. These can include blurred vision, shortness of breath, and sudden swelling. If seizures also occur, this can indicate eclampsia. Eclampsia is a medical emergency defined by the onset of seizures and/or coma. Dr. Elmore also wants to remind people to look for signs of both preeclampsia and eclampsia after delivery, when close medical supervision often wanes.
While preeclampsia may not be as well-known as many other pregnancy conditions, it is still quite common. Dr. Elmore hopes that knowing the signs and symptoms – and knowing how and where to seek care – can help save the lives of more parents and their babies.
About Dr. Elmore
Dr. Kelly O. Elmore is a board-certified OB/GYN, retired U.S. Navy Captain, and founder of KOE Medical Consulting, Inc.
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Blue Shield of California does not provide medical or dental advice. This information is for informational purposes only.
Y0118_25_012A_MAR_C 06092025
H2819_25_012A_MAR_C Accepted 06142025
