Preeclampsia Symptoms: The Warning Signs I Almost Missed

Before I developed severe preeclampsia and HELLP syndrome at 33 weeks, I knew preeclampsia was something doctors watched for during pregnancy. What I did not understand was how it could actually feel when it was happening to me.

I expected one obvious moment when something was clearly wrong. Instead, several of my symptoms could easily have been explained away as normal third-trimester pregnancy. I was swollen. I did not feel great. My blood pressure started creeping up. Eventually I developed a headache that became much more concerning.

Within a few days, I went from expecting seven more weeks to prepare for my baby to being hospitalized and delivering my daughter at 33 weeks.

This is my personal experience and not medical advice. Preeclampsia can be serious and symptoms vary. If you are pregnant or postpartum and concerned about new symptoms, contact your OB-GYN or medical provider rather than using my story to decide whether you have preeclampsia.

The short answer

Preeclampsia is a pregnancy complication involving high blood pressure that usually develops after 20 weeks. It can show up as swelling of the face or hands, a headache that will not go away, vision changes, upper abdominal pain, nausea or vomiting, sudden weight gain, or trouble breathing. Some people have no noticeable symptoms at all, which is why routine blood pressure checks matter. If something feels wrong, call your provider.

What is preeclampsia?

Preeclampsia is a pregnancy-related high blood pressure disorder that can affect organs throughout the body. It typically develops after 20 weeks of pregnancy, and it can also involve protein in the urine or other signs that organs are being affected. You do not necessarily need protein in your urine to be diagnosed with preeclampsia.

My first warning signs

My pregnancy was normal until my 32-week appointment. By then, my face, hands and feet had become extremely swollen. I had been pregnant before, and this did not feel like my body's normal swelling. I remember looking at my face and barely recognizing myself.

My blood pressure was 141/93. Before this pregnancy, I never thought much about blood pressure. Suddenly it was one of the most important numbers in my life. The CDC defines high blood pressure in pregnancy as 140/90 or higher on two readings at least four hours apart, and severe high blood pressure as 160/110 or higher.

One thing I learned is that you can feel relatively normal and still have high blood pressure. That is part of why prenatal appointments matter so much.

Because of my blood pressure and swelling, my doctor ordered bloodwork and a urine test. The next day, my urine protein was elevated and I was told I had mild preeclampsia. I was sent to labor and delivery for monitoring, then discharged.

Preeclampsia symptoms to watch for

Preeclampsia does not feel the same for everyone, and some people have few noticeable symptoms at all. High blood pressure or protein in the urine may be the first sign.

According to the American College of Obstetricians and Gynecologists (ACOG), symptoms can include:

- Swelling of the face or hands

- A headache that does not go away

- Changes in vision

- Pain in the upper abdomen or shoulder

- Nausea or vomiting during the second half of pregnancy

- Sudden weight gain

- Difficulty breathing

The CDC also lists urgent maternal warning signs to take seriously, including a severe or worsening headache, significant vision changes, extreme swelling of the hands or face, severe belly pain, severe nausea and vomiting, trouble breathing, chest pain, and decreased fetal movement.

The headache was the symptom that scared me most

I had dealt with headaches earlier in this pregnancy, but they faded during my second trimester. Once I developed high blood pressure, my doctors specifically told me to come in if I got a bad headache. Then I did.

A persistent or worsening headache can be a warning sign, especially alongside elevated blood pressure. Because I had already been told to watch for it, I knew I could not simply take something and assume it would pass.

Can preeclampsia feel like the flu?

This was the part of my experience that surprised me most. The night my condition became severe, I felt like I had the flu. My entire body ached. I was throwing up and had diarrhea. I developed a terrible headache, and I thought I might be feeling pain near my right ribs or liver, although I was not sure.

I did not think my preeclampsia was getting worse. I thought I was genuinely sick. Sudden nausea and vomiting in the second half of pregnancy can be associated with preeclampsia, and upper-right abdominal pain can be associated with severe preeclampsia or HELLP syndrome. That does not mean flu-like symptoms mean preeclampsia. But in my case, what felt like an illness was happening as my condition was becoming significantly more serious.

How quickly preeclampsia can progress

I was diagnosed with mild preeclampsia on a Tuesday. By Friday, I was preparing to deliver my baby at 33 weeks.

After my first hospital evaluation on Tuesday, I was told my delivery would probably move up to around 37 weeks. On Wednesday I felt okay. Thursday morning I woke up lightheaded and off. I went back to the hospital around lunchtime, where my protein had increased dramatically. I was sent home with a 24-hour urine collection kit. On Thursday night, everything changed.

Even though I felt terrible, I did not want to go back again. I had already been evaluated several times that week, and I felt embarrassed, almost like the "boy who cried wolf." So I tried to sleep it off. An hour later I woke up feeling even worse. My husband and sister pushed me to go in, and I am incredibly grateful that I did.

When mild preeclampsia became severe preeclampsia and HELLP

At the hospital, my bloodwork showed my liver enzymes rising and my platelet count falling rapidly. I had progressed from preeclampsia without severe features to severe preeclampsia with HELLP syndrome.

HELLP stands for hemolysis, elevated liver enzymes, and low platelet count. It is a serious pregnancy complication associated with preeclampsia and is considered a medical emergency.

A high-risk doctor told me I would have my baby by the end of the weekend. Then another set of labs came back, and things were progressing so quickly that I was in an emergency C-section within hours. My platelets were dropping fast enough that there was even concern I might need general anesthesia. Thankfully, that did not happen. My daughter was born at 33 weeks and spent just under two and a half weeks in the NICU.

For me, HELLP felt like getting very sick very quickly: a severe headache, nausea, vomiting, diarrhea, body aches, and possible upper-right abdominal pain. More than anything, I remember feeling incredibly unwell. Some of those overlap with recognized warning signs of HELLP, and some could easily be attributed to a stomach bug or the flu. If I had not already been diagnosed with preeclampsia, I could easily have assumed I had caught something.

Can you have preeclampsia without symptoms?

Yes. Some people with preeclampsia have no noticeable symptoms at all. That is why regular prenatal appointments matter, because your provider can catch elevated blood pressure even when you feel fine. I would never wait until you feel sick enough before mentioning something unusual to your doctor.

Preeclampsia after delivery

Preeclampsia can also develop after childbirth. The CDC notes that postpartum preeclampsia is usually diagnosed within 48 hours of delivery but can occur up to six weeks postpartum. New or concerning postpartum symptoms such as a severe headache, vision changes, or trouble breathing should be discussed with a medical provider promptly. Do not dismiss something simply because your pregnancy is over.

When to call your doctor

If you are pregnant or postpartum and experiencing a new or severe headache, vision changes, significant swelling, severe abdominal pain, trouble breathing, or other concerning symptoms, contact your healthcare provider promptly. The CDC advises seeking immediate medical care for urgent maternal warning signs, because some can indicate potentially life-threatening pregnancy complications.

Follow any specific instructions your provider has given you for monitoring your blood pressure or symptoms, since your thresholds and care plan may differ based on your history. And if something simply feels wrong, tell your provider. You do not need to figure out the diagnosis yourself before asking to be evaluated.

The bottom line

I share my story not to scare anyone who is pregnant, but because I had never heard of HELLP syndrome before it happened to me, I did not know severe preeclampsia could feel like the flu, and I did not expect my condition to change so dramatically over a few days.

Preeclampsia does not necessarily announce itself with one unmistakable symptom. For me, it was a collection of things: elevated blood pressure, swelling, protein in my urine, a concerning headache, and feeling sick. I would much rather make an unnecessary phone call than ignore something important.

If you are worried about something during pregnancy, call your doctor. If your symptoms change or get worse, call again. And if you are told which warning signs to watch for, take them seriously, even if you are not sure what you are feeling "counts."

Frequently Asked Questions About Preeclampsia Symptoms

What are the first signs of preeclampsia?

High blood pressure may be one of the first signs of preeclampsia, and some people don't experience obvious symptoms. Other possible symptoms include swelling of the face or hands, a persistent headache, vision changes, upper abdominal or shoulder pain, nausea or vomiting later in pregnancy and difficulty breathing. My first noticeable signs were swelling and elevated blood pressure at my 32-week appointment.

What does preeclampsia feel like?

Preeclampsia can feel different from person to person, and some people may not feel sick at all. In my case, the early stage didn't make me feel dramatically ill. When my condition became severe, however, I developed a terrible headache, vomiting, diarrhea, body aches and generally felt like I had the flu.

Can preeclampsia feel like the flu?

Some symptoms associated with severe preeclampsia and HELLP syndrome, including nausea, vomiting, headache and upper abdominal pain, can overlap with symptoms people may attribute to illnesses such as the flu. That is what happened to me. Flu-like symptoms by themselves do not mean you have preeclampsia, so contact your medical provider if you're pregnant and concerned about new symptoms.

Can preeclampsia develop suddenly?

Preeclampsia can worsen and develop severe features. In my experience, the progression happened extremely quickly. I went from being diagnosed with mild preeclampsia to severe preeclampsia with HELLP syndrome and delivering my daughter within a few days.

What does a preeclampsia headache feel like?

A headache that won't go away is a recognized warning sign of preeclampsia. My headache became severe the night my condition progressed. Because headaches can have many causes during pregnancy, your medical provider is the right person to determine whether yours requires evaluation.

Can you have preeclampsia without protein in your urine?

Yes. Although protein in the urine is associated with preeclampsia, it is not required in every case. Preeclampsia can also be diagnosed when new high blood pressure comes with certain other signs of organ involvement.

Can preeclampsia happen after delivery?

Yes. Postpartum preeclampsia can occur after you have given birth, including in people who did not have it during pregnancy. Contact your provider about new or concerning symptoms such as a severe headache, vision changes, or trouble breathing.

What Came Next

My preeclampsia and HELLP syndrome story didn't end with delivery. Because my daughter was born at 33 weeks, we suddenly found ourselves navigating the NICU and learning an entirely new world of premature babies, feeding, corrected age and eventually bringing a preemie home. If you're going through something similar, you can read more about my experience having a baby at 33 weeks, what I wish I knew before bringing my preemie home from the NICU, what I learned about preemie bottle feeding, and how corrected age works for premature babies.

A note from Mom 411

This article shares my personal experience with severe preeclampsia and HELLP syndrome and is for informational purposes only. It is not medical advice and should not replace guidance from your OB-GYN or other healthcare provider. If you are pregnant or postpartum and experiencing concerning symptoms, contact your medical provider. For severe or emergency symptoms, seek immediate medical care.