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If you have preeclampsia, you probably won't know it. That's because it doesn't usually cause symptoms unless it gets serious. But early signs of preeclampsia can be picked up during the regular checkups that you have while you are pregnant.

The first signs of preeclampsia may show up in you, your baby, or both of you some time after 20 weeks of pregnancy.

There are two main signs of preeclampsia in you (the mother).¹

• High blood pressure, with a bottom (diastolic) number of at least 90. High blood pressure doesn't always mean preeclampsia. But half of all women who get high blood pressure before 32 weeks of pregnancy go on to get preeclampsia. Your blood pressure should be checked at every checkup. For more, see Blood pressure during pregnancy.
• Protein in your urine. Normally, you have only a tiny bit of protein in your urine. If you have more, it can mean preeclampsia. For more, see Urine checks for protein.

You can also get swelling in your hands, feet or face with preeclampsia. But swelling is not a reliable sign. That's because it can also happen if your pregnancy is normal.²

The main sign of preeclampsia in your unborn baby is that he or she grows more slowly than normal. Doctors can see this on an ultrasound scan. For more, see Checks on your baby's health.

If you have just the early signs of preeclampsia (high blood pressure and protein in your urine), you will probably feel fine. If you do start to feel sick, this probably means the preeclampsia is getting worse. These are the symptoms to watch out for:³

• A bad, throbbing headache that is not helped by normal painkillers, such as acetaminophen (brand name Tylenol)
• Changes in your vision, such as blurred vision, double vision or flashing lights before your eyes
• Severe pain just under your ribs, probably on your right side
• Throwing up.

If you get any of these symptoms, see your doctor right away.

Even if you haven't had any signs of preeclampsia, see your doctor or midwife right away if you feel sick between your checkups. This could be the first sign that something is wrong.

Preeclampsia doesn't get better until after your baby is born. In fact, it usually it gets worse. Once you have symptoms, you may need to have your baby in the next few days.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.