Pre-eclampsia, or toxemia, is a condition which only occurs during pregnancy or very soon after birth, almost always after week 20 and usually after week 30. It's main characteristics are high blood pressure and protein in urine and there are several other symptoms, including severe swelling in the hands, feet and face and bad headaches. However, many women with pre-eclampsia can feel perfectly well, particularly in the early stages of the illness. This is unfortunate as if left untreated, the condition can pose a serious risk to both mother and baby. But a simple urine test can pick up the condition and proper pre-natal care can prevent more serious complications developing, so it's important to be alert to the warning signs and attend all your pre-natal checks.

What is pre-eclampsia?
Pre-eclampsia prevents the placenta from working properly, limiting the supply of food and oxygen to baby and may also affect the mother's kidneys, liver, lungs, brain and blood clotting system. As the name suggests, pre-eclampsia may develop into full eclampsia, leading to fits and coma, and may be fatal, but this is thankfully very rare.

Before you start to panic, you should be aware that these days most women with pre-eclampsia go on to deliver healthy babies. The majority of cases occur in the final weeks of pregnancy and the more serious complications are avoided. The key to limiting the risks, however, is in timely diagnosis and good health care.

What are the signs of pre-eclampsia?
As some women can experience no obvious symptoms of pre-eclampsia, it's essential to go to your regular pregnancy health checks to have your blood pressure and urine checked. There are other reasons why you may have high blood pressure or protein in your urine, so having one of these symptoms doesn't mean that you have pre-eclampsia. Up to 10% of pregnant women develop high blood pressure during pregnancy, which is known as gestational hypertension. If you're diagnosed with high blood pressure then your doctor should keep a close watch on you and conduct more frequent urine tests for protein.

If you do have other signs they may include:

  • Swelling in hands, feet and face, particularly if sudden
  • Severe headaches
  • Flashing lights or spots before the eyes
  • Frequent nausea and vomiting
  • Pain in the upper part of the abdomen

Any one of these signs can be present without pre-eclampsia and, in particular, some swelling is to be expected during pregnancy and some pregnant women are more prone to headaches. Even so, it's still sensible to report any of these symptoms to your doctor as soon as you can.

How is it treated?
Mother and baby will be closely monitored to see how the condition is affecting them both. Milder cases may be treatable from home, and mothers with mild pre-eclampsia will be advised to cut down their activities to a minimum, but hospitalisation and complete bed-rest may also be necessary. Drugs may be prescribed to control blood pressure but the only proper cure for pre-eclampsia is the birth of the baby, so depending on how serious the condition is for mother and baby, an early delivery in the last weeks of pregnancy by induction or by caesarian section is quite likely. In a few cases where pre-eclampsia develops early and poses a significant risk to mother and baby, premature delivery may be the only option.

Following delivery all symptoms should disappear within two weeks.

What are the risks of re-occurrence?
If you've had pre-eclampsia in an earlier pregnancy you do have a higher risk of developing the condition again, but there's also a very good chance that you'll have a healthy, uncomplicated pregnancy.

With each subsequent pre-eclampsia pregnancy the risk of a repeat in the next pregnancy increased, but it doesn't necessarily follow that you will suffer again.