Preeclampsia During Pregnancy: Know Symptoms And Warning Signs

Preeclampsia during pregnancy is a condition involving high blood pressure that requires early detection and careful monitoring to protect both mother and baby.

Pregnancy involves many routine check-ups, blood tests, and health assessments.

While these appointments can sometimes feel repetitive, each test serves an important purpose.

One condition that healthcare providers carefully monitor for throughout pregnancy is preeclampsia.

Preeclampsia is a serious pregnancy complication characterised by high blood pressure and signs of organ dysfunction, most commonly affecting the kidneys and liver.

Because preeclampsia can develop gradually and sometimes without obvious symptoms, regular screening and testing during pregnancy are essential.

Many expectant mothers ask:

“How do doctors test for preeclampsia?”

“Can preeclampsia be detected early?”

“What tests will I need?”

“Will my baby need extra monitoring?”

As a women’s health physiotherapist,

I often reassure expectant mothers that routine screening for preeclampsia is designed to identify concerns early and support the healthiest possible outcome for both mother and baby.

Understanding how preeclampsia is tested can help you feel more informed and confident throughout pregnancy.

What Is Preeclampsia?

Preeclampsia is a pregnancy-specific disorder that usually develops after 20 weeks of gestation. (Cleveland Clinic)

The condition is characterised by:

• High blood pressure.
• Protein in the urine, or
• Evidence of organ dysfunction.

Preeclampsia can affect:

• The kidneys.
• Liver.
• Brain.
• Blood clotting system.
• Placenta.

Why Is Early Detection Important?

Early diagnosis allows healthcare providers to:

• Monitor maternal health closely.
• Assess fetal well-being.
• Prevent complications.
• Determine the safest timing for delivery.

Untreated preeclampsia may increase the risk of:

• Preterm birth.
• Placental abruption.
• Fetal growth restriction.
• Seizures (eclampsia).
• Maternal organ injury.

Research has shown that timely diagnosis and appropriate surveillance significantly improve pregnancy outcomes (Olagunju et al. 2025)

Blood Pressure Measurement

Checking blood pressure is the cornerstone of preeclampsia screening.

Blood pressure is measured at every antenatal appointment.

Preeclampsia is generally diagnosed when:

• Systolic blood pressure is 140 mmHg or higher, or
• Diastolic blood pressure is 90 mmHg or higher

on two separate occasions at least four hours apart.

Very high blood pressure readings require urgent evaluation.

Because preeclampsia can sometimes develop without noticeable symptoms, routine blood pressure assessment remains extremely important.

Urine Testing for Protein

Healthcare providers often test urine samples during pregnancy.

Traditionally, preeclampsia was diagnosed when elevated blood pressure occurred together with significant protein loss in the urine.

Urine testing may include:

Dipstick Urine Test

A quick screening test performed during routine antenatal visits.

Protein-to-Creatinine Ratio (PCR)

This laboratory test measures the amount of protein in relation to creatinine and is commonly used to confirm significant proteinuria.

24-Hour Urine Collection

In selected cases, healthcare providers may request collection of urine over a 24-hour period to quantify protein loss.

According to (Stephen et al. 2024), proteinuria remains an important diagnostic criterion, although preeclampsia may also occur in the absence of proteinuria if other organ dysfunction is present.

Blood Tests for Preeclampsia

Blood tests help evaluate whether preeclampsia is affecting maternal organs.

Common laboratory tests include:

Complete Blood Count (CBC)

Assesses:

• Platelet count.
• Haemoglobin levels.

Low platelet counts may indicate severe disease.

Liver Function Tests

Measures enzymes such as:

• AST.
• ALT.

Elevated liver enzymes may suggest liver involvement.

Kidney Function Tests

These tests assess:

• Creatinine levels.
• Kidney function.

Abnormal kidney function can occur in preeclampsia.

Lactate Dehydrogenase (LDH)

LDH may increase in severe disease and in conditions such as HELLP syndrome.

HELLP syndrome is a serious complication characterised by:

• Hemolysis.
• Elevated Liver enzymes.
• Low Platelet count.

Assessment of Symptoms

Not every woman with preeclampsia experiences symptoms.

However, healthcare providers routinely ask about warning signs.

Symptoms that warrant immediate medical review include:

• Severe headache.
• Visual disturbances.
• Blurred vision.
• Flashing lights.
• Severe upper abdominal pain.
• Sudden swelling of the face or hands.
• Shortness of breath.

The absence of symptoms does not exclude preeclampsia.

This is why regular antenatal appointments remain essential.

Can Preeclampsia Be Predicted Early?

Researchers continue to investigate methods for identifying women at increased risk before symptoms develop.

Several factors increase risk, including:

• Previous preeclampsia.
• Chronic hypertension.
• Diabetes.
• Kidney disease.
• Multiple pregnancy.
• Autoimmune disorders.

In some healthcare settings, first-trimester screening combines:

• Maternal history.
• Blood pressure measurements.
• Ultrasound assessment.
• Blood biomarkers.

Research by (Kane et al. 2016) demonstrated that combined first-trimester screening can identify women at increased risk of preterm preeclampsia

Ultrasound Assessment in Preeclampsia

Because preeclampsia affects placental function, babies may require additional surveillance.

Ultrasound examinations may assess:

• Fetal growth.
• Amniotic fluid volume.
• Placental appearance.
• Fetal movements.

Babies affected by preeclampsia are at increased risk of fetal growth restriction.

Consequently, serial growth scans are frequently recommended.

Doppler Ultrasound Studies

Doppler ultrasound evaluates blood flow between the placenta and fetus.

Common assessments include:

• Umbilical artery Doppler.
• Middle cerebral artery Doppler.
• Uterine artery Doppler.

Abnormal Doppler findings may indicate placental insufficiency.

A Cochrane review concluded that Doppler ultrasound improves outcomes in high-risk pregnancies by facilitating earlier identification of placental dysfunction (Alfirevic Z et al. 2017).

A Physiotherapist’s Perspective: Why Routine Appointments Matter

As a women’s health physiotherapist, I frequently meet women who feel perfectly well despite developing preeclampsia.

This highlights an important message:

Never skip antenatal appointments simply because you feel fine.

Many cases of preeclampsia are initially identified through routine blood pressure measurements and laboratory tests before symptoms appear.

Regular prenatal care remains one of the most effective strategies for early detection.

Non-Stress Test (NST)

If preeclampsia is diagnosed or suspected, healthcare providers may recommend a Non-Stress Test (NST) to assess fetal well-being.

An NST monitors:

• Fetal heart rate.
• Heart rate accelerations.
• Fetal movements.

A healthy fetus typically demonstrates temporary increases in heart rate during movement.

The test is:

• Painless.
• Non-invasive.
• Usually completed within 20 to 40 minutes.

NSTs may be performed weekly or more frequently depending on:

• Severity of preeclampsia.
• Gestational age.
• Fetal growth.
• Maternal condition.

Biophysical Profile (BPP)

A Biophysical Profile (BPP) provides a more comprehensive assessment of fetal well-being.

The BPP combines:

• Ultrasound examination.
• Non-Stress Test.

Five components are evaluated:

1. Fetal breathing movements.
2. Gross body movements.
3. Fetal muscle tone.
4. Amniotic fluid volume.
5. Fetal heart rate reactivity.

Each component receives a score.

Lower scores may indicate that the baby requires closer monitoring or, in some cases, delivery.

Manning FA and colleagues demonstrated that BPP scoring is an effective tool for evaluating fetal well-being in high-risk pregnancies (Manning et al., 1990).

How Often Will Testing Be Performed?

The frequency of testing varies significantly from one pregnancy to another.

Healthcare providers consider:

• Severity of preeclampsia.
• Blood pressure readings.
• Maternal symptoms.
• Laboratory results.
• Gestational age.
• Fetal growth.

Women with mild disease may undergo:

• Weekly blood pressure checks.
• Periodic laboratory testing.
• Regular fetal surveillance.

Women with severe preeclampsia often require:

• Frequent monitoring.
• Hospital admission.
• Daily maternal and fetal assessments.

Hospital Monitoring for Preeclampsia

Some women with preeclampsia require hospital admission.

Reasons may include:

• Severely elevated blood pressure.
• Severe headache.
• Visual disturbances.
• Abnormal laboratory results.
• Reduced fetal movements.
• Severe fetal growth restriction.

During admission, monitoring may include:

Frequent Blood Pressure Assessment

Blood pressure may be checked several times each day.

Repeated Blood Tests

Healthcare providers may monitor:

• Platelets.
• Liver function.
• Kidney function.

Fetal Surveillance

Babies may undergo:

• NSTs.
• Ultrasound examinations.
• Doppler studies.
• BPP assessments.

Hospital monitoring allows healthcare teams to respond rapidly if maternal or fetal conditions change.

What Happens If Test Results Are Abnormal?

Abnormal findings do not always mean that immediate delivery is necessary.

Instead, healthcare providers evaluate:

• Maternal health.
• Gestational age.
• Fetal condition.
• Disease severity.

Possible management strategies include:

• Increased monitoring.
• Medication to control blood pressure.
• Corticosteroids to support fetal lung maturation if preterm delivery is anticipated.
• Hospital admission.
• Delivery when risks of continuing pregnancy outweigh benefits.

According to the International Society for the Study of Hypertension in Pregnancy (ISSHP), management decisions should balance maternal and fetal risks while considering gestational age (Brown et al. 2018).

Does Preeclampsia Always Mean Early Delivery?

No.

Many women with mild preeclampsia continue their pregnancies safely with close monitoring.

However, delivery remains the only definitive treatment for preeclampsia.

The timing of delivery depends on:

• Severity of disease.
• Maternal symptoms.
• Fetal well-being.
• Gestational age.

Women with severe disease may require earlier delivery to protect both mother and baby.

Can Preeclampsia Affect the Baby?

Yes.

Preeclampsia can affect placental function, which may reduce the delivery of oxygen and nutrients to the baby.

Possible fetal complications include:

• Fetal growth restriction.
• Preterm birth.
• Low birth weight.
• Reduced amniotic fluid.

Fortunately, modern fetal surveillance techniques allow healthcare providers to identify many complications early.

Limitations of Preeclampsia Testing

Although testing has improved considerably, no single test can perfectly predict the course of preeclampsia.

Testing cannot:

• Predict exactly when symptoms will worsen.
• Prevent all complications.
• Guarantee a complication-free pregnancy.

This is why repeated assessments are often necessary.

Healthcare providers interpret results within the broader clinical picture rather than relying on one isolated finding.

A Physiotherapist’s Perspective: Listen to Your Body

As a women’s health physiotherapist, I encourage expectant mothers to pay close attention to their bodies.

Seek urgent medical review if you experience:

• Severe headache.
• Sudden swelling.
• Visual disturbances.
• Severe upper abdominal pain.
• Shortness of breath.
• Reduced fetal movements.

Trusting your instincts and seeking timely medical advice can make an important difference.

Questions You May Want to Ask Your Doctor

Consider asking:

• How severe is my preeclampsia?
• How often will I need monitoring?
• Will my baby need additional surveillance?
• What symptoms should prompt urgent review?
• Could I require hospital admission?
• When might delivery be recommended?

Preparing questions before appointments can improve understanding and reduce anxiety.

Conclusion

Testing for preeclampsia plays a critical role in modern prenatal care.

Through regular blood pressure checks, laboratory testing, and fetal surveillance, healthcare providers can identify complications early and support safer pregnancy outcomes.

Although a diagnosis of preeclampsia can feel overwhelming, many women have healthy pregnancies and babies with appropriate monitoring and timely management.

As a women’s health physiotherapist, I encourage expectant mothers to attend all antenatal appointments, remain aware of warning signs, and communicate openly with their healthcare team.

Frequently Asked Questions (FAQs)

1. How is preeclampsia diagnosed during pregnancy?

Preeclampsia is usually diagnosed through blood pressure measurements, urine protein testing, blood tests, and assessment of maternal symptoms after 20 weeks of pregnancy.

2. Can preeclampsia be detected before symptoms appear?

Yes. Routine antenatal appointments often detect elevated blood pressure or abnormal test results before symptoms develop.

3. What blood tests are performed for preeclampsia?

Common blood tests include complete blood count, liver function tests, kidney function tests, and platelet count assessments.

4. Will my baby need additional monitoring if I have preeclampsia?

Yes. Additional fetal monitoring such as growth scans, Doppler studies, NSTs, and BPPs may be recommended.

5. Does preeclampsia always require early delivery?

No. Many women with mild preeclampsia continue pregnancy safely with close monitoring. However, severe disease may require earlier delivery.

6. What symptoms should prompt urgent medical attention?

Severe headache, blurred vision, severe abdominal pain, sudden swelling, shortness of breath, or reduced fetal movements require urgent medical assessment.

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Medical Disclaimer!

This article has been reviewed and written under the guidance of our Head Physiotherapist, Dr. Kruti Raj (PT, MUHS,CPT,CMPT). The information shared is intended for educational purposes only and should not be considered a substitute for personalized medical advice, diagnosis, or treatment.

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