Preeclampsia symptoms

By trimester

Weeks 1–13

1st trimester

Preeclampsia criteria apply after 20 weeks, so this isn't typically on the radar yet in the first trimester. If you have chronic high blood pressure or other risk factors, your provider may start low-dose aspirin in the first trimester specifically to lower your chance of developing preeclampsia later.

Weeks 14–27

2nd trimester

The 20-week mark falls in the second trimester, which is when preeclampsia can first be identified. Routine blood pressure and urine protein checks at every prenatal visit from this point on are how most cases are caught early.

Weeks 28–birth

3rd trimester

Preeclampsia is most often identified in the third trimester, often near term. Because it can move from mild to severe quickly, report new headache, vision changes, swelling, or upper right belly pain the same day rather than waiting for your next scheduled visit.

What does the evidence show for preeclampsia symptoms?

• Preeclampsia meets clinical criteria when blood pressure reaches 140/90 mmHg or higher after 20 weeks of pregnancy in someone whose blood pressure was previously normal, usually along with protein showing up in the urine. 1
• Beyond blood pressure and protein in the urine, preeclampsia can also cause swelling in the face and hands, headache, blurred vision, and pain in the upper right side of the belly, and it can occur alongside HELLP syndrome, in which a woman might bleed or bruise easily and feel extreme fatigue. 2
• Severe features of preeclampsia include a blood pressure of 160/110 mmHg or higher, a platelet count under 100,000, kidney or liver function changes, fluid in the lungs, or a new headache with or without vision changes, and any of these can show up with or without protein in the urine. 3
• Protein in the urine is confirmed with a reading of 300 mg or more over 24 hours, a urine protein-to-creatinine ratio of 0.3 or higher, or a dipstick reading of 2+ or higher when lab testing isn't immediately available. 3
• Preeclampsia is usually mild, but it can progress from mild to severe, or to full eclampsia, in a matter of days, and globally preeclampsia and eclampsia cause about 14% of maternal deaths, roughly 50,000 to 75,000 women each year. 4

When should I call my provider about preeclampsia symptoms?

A blood pressure reading of 140/90 mmHg or higher after 20 weeks of pregnancy, especially alongside protein in the urine, a severe or new headache, vision changes, swelling in your face or hands, or pain in the upper right side of your belly, are the signs that separate preeclampsia from ordinary pregnancy discomfort and are worth reporting to your provider the same day. Severe-range blood pressure of 160/110 mmHg or higher, easy bruising or bleeding, extreme fatigue, or a low platelet count on bloodwork can point to HELLP syndrome, a more serious complication that needs prompt evaluation. Because preeclampsia can move from mild to severe within days, new or worsening symptoms on this list are not something to wait out. If you are ever unsure which side of the line you are on, make the call. Obstetric teams handle these check-ins as routine, not as overreacting.