We can divide the preeclampsia signs and symptoms as those that present with a mild condition and those that come on with a severe one.
Since preeclampsia mostly sets in during the second half of the pregnancy, you will see these symptoms setting in at that time mostly after the 20 weeks of your gestation period. Most of the cases occur after 24-26 weeks and more so towards the end of pregnancy.
However, it is also seen to come on earlier, though rarely, and later too, as late as 25 weeks or even 30 weeks. The symptoms and the accompanying signs though, remain unchanged whatever be the week that preeclampsia develops.
Similarly, you will find cases that present even after birth. This is called postpartum preeclampsia and its symptoms typically are similar to those seen during pregnancy.
These symptoms shall remain throughout your pregnancy and will not go away, except for the temporary relief provided by symptomatic drugs.
The symptoms start as soon as the condition develops. However, postpartum preeclampsia symptoms develop after giving birth to the baby, either immediately or even as late as 6 weeks postpartum.
Experts believe that in such cases, preeclampsia develops during pregnancy but the symptoms set in later after giving birth to the baby.
The hallmark symptoms and signs are high blood pressure, protein in urine and swelling especially of the limbs.
Preeclampsia symptoms but no protein in urine
It can also happen that you may have the typical symptoms but no protein in the urine. This does not mean that preeclampsia is not present.
In confirming preeclampsia, experts now give more importance to the presence of high blood pressure and development of damage to the body organs as detected by blood tests.
Is it possible to have the symptoms and normal blood pressure?
Technically, this is not possible. High blood pressure is a cardinal sign and needs to be present to diagnose this condition.
You may develop this condition and its symptoms and yet have a normal blood pressure only if you have been taking antihypertensive medication for high blood pressure, which you have developed before getting pregnant.
Preeclampsia without symptoms
There is a third category as far as preeclampsia symptoms are concerned. This is the preeclampsia that comes on without causing any symptoms.
Prenatal care becomes a powerful tool in such cases to detect this silent condition. Signs such as high blood pressure, protein in urine or tests indicating organ damage are detected by your doctor and he then stamps you as a preeclampsia patient and admits you to the hospital for monitoring and further investigations.
Mild preeclampsia symptoms and signs
High blood pressure is the biggest red flag indicating the presence of this pregnancy complication. Systolic blood pressure more than 140 mm Hg but less than 160 mm Hg and diastolic more than 90 mm Hg but less than 100 mm Hg indicates that your preeclampsia is of mild nature.
The presence of protein in the urine (proteinuria) is another cardinal sign. It indicates a kidney problem. The presence of trace proteins should not be a cause of concern. Presence of +1 protein in the 24 hour urine sample signifies the onset even if your blood pressure is normal. Reading of 2+ or more on a simple dipstick test of your urine indicates that your preeclampsia is progressing and worsening. See your obn/gyn the same day. Kidney damage is also a cause of concern.
Water retention causes swelling of hands, feet, ankles and face that stays on during the day. Some amount of swelling is common during pregnancy but the swelling of preeclampsia is excessive and can be diagnosed through pitting after applying pressure on the swollen parts.
Severe preeclampsia symptoms and signs
- Severe preeclampsia necessarily shows a systolic blood pressure of 160 mm Hg or more and a diastolic pressure of 110 mm Hg or more.
- Persistent and often severe headaches set in the third trimester of pregnancy. If you begin to have severe headaches for the first time during pregnancy it could be a sign that you are developing this pregnancy complication.
- Vision disturbances are a serious symptom and include blurred or double vision. You may even see flashy lights. Visual symptoms are reported in 25 to 50 percent of the women. They are due to pathological changes in the eye, which include cortical blindness, serous retinal detachment, retinopathy, and vitreous hemorrhages. They can also be due to involvement of the central nervous system and could indicate collection of fluid in the brain (cerebral edema).
- Photophobia, which means increased sensitivity to light and inability to tolerate light.
- Nausea and vomiting are common during the first trimester of pregnancy. But, the sudden onset of nausea and vomiting after mid pregnancy is a powerful sign of this condition.
- Passing small amounts of urine
- Pain in upper right abdomen due to liver involvement. This pain can radiate to the right shoulder. Liver pain can also present as lower back pain.
- Shortness of breath due to pulmonary edema (accumulation of fluid in the lungs).
- More than normal and rapid weight gain due to water retention (5 or more pounds in one week). This is attributed to fluid retention wherein damaged blood vessels cause more fluid to leak into your body’s tissues and not pass through the kidneys to be excreted.
- Decrease in platelets in the blood causing blood clotting problems
- Impaired liver function
- Seizures indicate the onset of eclampsia and are a sign of a complication, which is found in 1% of the women with this condition. Eclampsia is a life-threatening complication for both the mother and baby. During a seizure, cerebral blood in the brain of the mother and the oxygen supply to the fetus reduce drastically.
- Fatigue, mental confusion, a heightened sense of anxiety, and a sense of impending doom are some other symptoms, which can present.
Postpartum preeclampsia symptoms
As mentioned above, preeclampsia is seen to develop even after the mother gives birth to the baby. Its symptoms are typically similar to those that develop during pregnancy and include:
- High blood pressure (hypertension)
- Severe persistent headaches
- Swelling of the limbs
- Vision changes
- Nausea and vomiting
- Liver pain under the ribs on the right side of the abdomen
- Sudden weight gain
Signs seen in fetus
The main sign of preeclampsia relating to the fetus is the restriction of its growth due to reduced blood supply to the placenta because of narrowed arteries.
If after 21 weeks your baby has stopped moving or movements have reduced for more than 24 hours, your baby may be in distress.