Pregnancy is one of the most transformative journeys in a woman's life. But it can also bring unexpected complications — and preeclampsia is one of the most serious. As a fetal medicine specialist practising at NESA Institute of Fetal Medicine in Kolkata, I see cases of preeclampsia every week. The good news: when diagnosed early and managed carefully, most mothers and babies go home healthy.

This guide is written specifically for expecting mothers and their families. My goal is simple — to give you clear, honest, medically accurate information so you know exactly what to watch for, when to seek help, and what to expect if you are diagnosed with preeclampsia.

1. What Is Preeclampsia?

Preeclampsia is a pregnancy complication characterised by high blood pressure (hypertension) and signs of damage to other organ systems — most commonly the liver and kidneys. It typically develops after the 20th week of pregnancy, although it can sometimes appear earlier or even after delivery (postpartum preeclampsia).

In India, preeclampsia affects approximately 5–8% of all pregnancies and remains one of the leading causes of maternal and fetal complications. In Kolkata and West Bengal, it is among the top reasons for preterm birth and maternal hospitalisation.

The condition is not just "high blood pressure." When blood pressure rises during pregnancy, it can deprive the placenta of adequate blood flow — reducing the oxygen and nutrients that reach your baby. This is why fetal medicine specialists play such a critical role in monitoring and managing this condition.

2. Symptoms & Warning Signs of Preeclampsia

One of the biggest challenges with preeclampsia is that it can be silent in its early stages. Many women feel completely normal, which is why regular antenatal check-ups — including blood pressure monitoring and urine testing — are so important.

However, as the condition progresses, the following warning signs may appear:

3. What Causes Preeclampsia?

The exact cause of preeclampsia is not fully understood, but research strongly points to the placenta as the starting point. In a normal pregnancy, blood vessels in the uterus remodel during early pregnancy to deliver enough blood to the placenta. In preeclampsia, this remodelling doesn't happen properly — and this triggers a cascade of problems throughout the mother's body.

The role of the placenta

When the placenta is poorly perfused (under-supplied with blood), it releases substances into the mother's bloodstream that cause her blood vessels to constrict — raising blood pressure. These same substances can damage the lining of blood vessels in the kidneys, liver, brain, and lungs, leading to multi-organ involvement.

Immune and genetic factors

Preeclampsia is also thought to involve an abnormal immune response to the placenta. Women whose mothers or sisters had preeclampsia are at significantly higher risk themselves, suggesting a strong genetic component.

4. Who Is at Risk? Risk Factors Explained

While any pregnant woman can develop preeclampsia, certain factors significantly increase the risk. Understanding your personal risk profile is one of the most important reasons to see a fetal medicine specialist early in pregnancy — ideally at the first trimester screening (11–13 weeks).

5. How Is Preeclampsia Diagnosed?

Diagnosing preeclampsia requires a combination of clinical assessment and investigations. At NESA Institute of Fetal Medicine in Kolkata, we use a comprehensive, evidence-based approach.

Blood pressure monitoring

A sustained reading of 140/90 mmHg or higher on two separate occasions, at least 4 hours apart, is the cornerstone of diagnosis. Severe preeclampsia is defined by blood pressure of 160/110 mmHg or above.

Urine tests

Proteinuria (protein in urine) of 300 mg or more in a 24-hour urine sample, or a protein-to-creatinine ratio of ≥0.3, confirms kidney involvement. A simple urine dipstick (+1 or more protein) during your antenatal visit is often the first clue.

Blood tests

We check a full blood count (platelet levels), liver enzymes (ALT, AST), kidney function (creatinine, urea), and clotting studies. These help us understand how severely the organs are affected.

First trimester screening (11–13 weeks)

By combining the mother's blood pressure, uterine artery Doppler ultrasound, and blood markers (PAPP-A, PlGF), we can identify women at high risk of preeclampsia as early as 11–13 weeks of pregnancy. This allows us to start preventive treatment — low-dose aspirin — before the condition develops.

Doppler ultrasound

Uterine artery Doppler and fetal Doppler studies help us assess blood flow to and from the placenta, and monitor fetal wellbeing — essential tools in the management of established preeclampsia.

6. Risks & Complications if Untreated

Preeclampsia is a condition that must never be ignored or self-managed. Without proper medical care, it can escalate rapidly and cause life-threatening complications for both mother and baby.

For the mother

• Eclampsia — seizures caused by brain involvement; a true obstetric emergency
• HELLP syndrome — Haemolysis, Elevated Liver enzymes, Low Platelets; can be fatal
• Stroke — due to dangerously high blood pressure
• Acute kidney failure
• Pulmonary oedema — fluid in the lungs causing respiratory failure
• Placental abruption — premature separation of the placenta from the uterus
• Long-term cardiovascular risk — women who have had preeclampsia are at higher lifetime risk of heart disease and stroke

For the baby

• Fetal growth restriction (FGR) — the baby doesn't grow adequately due to poor placental blood flow
• Preterm birth — early delivery is often necessary to protect both mother and baby
• Low birth weight
• Stillbirth — in severe, unmanaged cases
• Neonatal intensive care admission

7. Treatment & Management of Preeclampsia

The only definitive cure for preeclampsia is delivery of the baby and placenta. However, the timing and approach to delivery depend entirely on how severe the condition is and how mature the baby is.

Mild preeclampsia (before 37 weeks)

If you are less than 37 weeks pregnant and the condition is mild, we often manage it with close monitoring — frequent blood pressure checks, regular blood and urine tests, and Doppler ultrasound to assess fetal wellbeing.

Severe preeclampsia

Severe preeclampsia requires hospitalisation. Treatment includes:

• Antihypertensive medicines — to bring blood pressure down to a safe range (labetalol, nifedipine, or methyldopa)
• Magnesium sulphate — to prevent seizures (eclampsia)
• Corticosteroids (if before 34 weeks) — to mature the baby's lungs in preparation for preterm delivery
• Delivery — when the risks to the mother outweigh the risks of prematurity

Prevention — low-dose aspirin

For women identified as high-risk in the first trimester, we recommend starting low-dose aspirin (150 mg) at night from 12–16 weeks of pregnancy until 36 weeks. Clinical trials have shown this reduces the risk of early-onset preeclampsia by more than 60%.

8. Preeclampsia After Delivery

Many women are surprised to learn that preeclampsia doesn't always resolve immediately after delivery. Blood pressure can remain elevated or even worsen in the first 48–72 hours postpartum. In some cases, preeclampsia develops for the first time after delivery — this is called postpartum preeclampsia.

It is essential that all women who had preeclampsia continue to monitor their blood pressure closely for at least 6 weeks after delivery. If you experience severe headaches, vision changes, or shortness of breath after giving birth, seek medical attention immediately.

9. Frequently Asked Questions

10. A Message from Dr. Khurshid Alam

Preeclampsia can be a frightening diagnosis. But I want every patient and family reading this to know: with the right expertise, the right monitoring, and timely intervention, the vast majority of women with preeclampsia deliver healthy babies and recover fully.

At NESA Institute of Fetal Medicine in Kolkata, we are equipped with the latest ultrasound technology, evidence-based screening protocols, and the specialist expertise to guide you safely through every stage of your pregnancy. If you have any concerns — whether you are currently pregnant, planning a pregnancy, or have had preeclampsia before — please come and speak with us.