clinical features

Last reviewed 10/2022

Symptoms of pre-eclampsia:

  • generally asymptomatic and can only be detected by routine screening
  • if present, the most frequent symptoms are headache, visual disturbance (commonly 'flashing lights'), epigastric pain, vomiting, oedema (especially facial oedema) - these symptoms in conjunction with raised blood pressure should indicate immediate referral for obstetric review
  • women may rarely present with a convulsion - if a first fit occurs in the second part of pregnancy with no other known cause this is a strong indication of pre-eclampsia

Additional signs which may be used to recognise this condition include, in the mother:

  • excessive weight gain - more than 1.0 Kg per week
  • ascites
  • hyperuricaemia*
  • hypocalciruia
  • reduced plasma concentrations of von Willebrand factor, cellular fibronectin, and antithrombin III
  • thrombocytopenia
  • increased packed cell volume
  • increased blood concentration of liver enzymes

And in the fetus:

  • intrauterine growth retardation
  • intrauterine hypoxaemia

* a systematic review concluded that serum uric acid is a poor predictor of maternal and fetal complications in women with pre-eclampsia (1)


  1. Thangaratinam S et al. Accuracy of serum uric acid in predicting complications of pre-eclampsia: a systematic review.BJOG. 2006 Apr;113(4):369-78.
  2. Ramsey LE et al Guidelines for the management of hypertension: report of the third working party of the British Hypertension Society, 1999. J Hum Hypertens;13: 569-92.