Pre-eclampsia is a multisystem disorder of pregnancy, defined by new hypertension after 20 weeks’ gestation together with proteinuria or other maternal organ dysfunction. It remains a major cause of maternal and perinatal morbidity worldwide.
Who is at risk?
Major risk factors:
- Pre-eclampsia in a previous pregnancy
- Chronic hypertension, kidney disease or diabetes
- Autoimmune disease such as lupus or antiphospholipid syndrome
- Multiple pregnancy
Prevention with low-dose aspirin
For women at high risk, low-dose aspirin started before 16 weeks’ gestation and continued until late pregnancy reduces the risk of preterm pre-eclampsia. The ASPRE trial used 150 mg nightly; recommended doses vary between national guidelines.
Recognition and management
Warning symptoms include severe headache, visual disturbance, epigastric pain and sudden swelling. Management includes blood pressure control, magnesium sulfate to prevent eclamptic seizures in severe disease, and planned delivery, which remains the only definitive treatment.
“Every antenatal blood pressure check is a screening test.”
Ultrasound surveillance of fetal growth and Doppler studies help time delivery safely.
This article is for education only and does not replace clinical judgement or local guidelines.
