What is preeclampsia?

Preeclampsia is a hypertensive disorder of pregnancy — defined by new-onset high blood pressure (≥140/90 mmHg) after 20 weeks of gestation, plus at least one sign of organ damage (protein in urine, liver or kidney dysfunction, severe headache, visual disturbance, low platelets). It affects 2-8% of pregnancies and is caused by abnormal placental development in early pregnancy, causing systemic maternal endothelial dysfunction.

What causes preeclampsia?

Preeclampsia is fundamentally a placental disease — caused by failure of normal placental trophoblast invasion into maternal spiral arteries in early pregnancy. This leads to a poorly perfused, stressed placenta that releases soluble factors (including sFlt-1 — an anti-angiogenic factor) into maternal circulation, causing systemic endothelial damage, hypertension, kidney dysfunction and the other manifestations. Risk factors: nulliparity (first pregnancy); previous preeclampsia; chronic hypertension; pre-existing diabetes; kidney disease; multiple pregnancy; obesity; family history.

What is the difference between preeclampsia and eclampsia?

Preeclampsia is the hypertensive disorder of pregnancy without seizures. Eclampsia is the occurrence of tonic-clonic seizures in a woman with preeclampsia — a medical emergency. Eclampsia was historically the major cause of maternal death; magnesium sulfate (reducing eclampsia risk by 59%) and better blood pressure control have dramatically reduced its incidence in high-income countries. In LMICs, where access to magnesium sulfate and monitoring is limited, eclampsia remains a major killer.

How can preeclampsia be prevented?

Calcium supplementation (1.5-2g/day) for pregnant women with low dietary calcium reduces preeclampsia risk by approximately 50% — a critical intervention in LMICs where calcium intake is often inadequate. Low-dose aspirin (75-150mg/day started before 16 weeks) reduces preeclampsia risk by 10-24% in high-risk women. First-trimester screening (maternal factors + blood pressure + uterine artery Doppler + PlGF) identifies high-risk women for aspirin prophylaxis.

How is preeclampsia treated?

The only cure is delivery — the placenta is the source of the disease. Management balances maternal risk (of continued preeclampsia) against fetal risk (prematurity from early delivery). Key treatments: antihypertensives for severe hypertension (labetalol, nifedipine, hydralazine); magnesium sulfate for seizure prevention; corticosteroids for fetal lung maturation if preterm delivery planned; and close monitoring of mother and fetus. Delivery by induction or caesarean is the definitive treatment.

What is HELLP syndrome?

HELLP syndrome — Haemolysis (red blood cell destruction), Elevated Liver enzymes and Low Platelets — is a severe preeclampsia complication causing right upper quadrant pain, nausea, and potentially liver rupture, disseminated intravascular coagulation and maternal death. It requires immediate delivery regardless of gestational age and intensive multidisciplinary care.

Why do most preeclampsia deaths occur in LMICs?

76% of preeclampsia maternal deaths occur in LMICs — because: antenatal care is inadequate (blood pressure not measured, proteinuria not tested); magnesium sulfate is unavailable in many health facilities; healthcare workers are not trained to recognise and respond to severe preeclampsia; and women present late (at eclampsia or HELLP stage). Access to IV magnesium sulfate in all health facilities is a priority — it costs less than $1 per treatment.

What are the long-term consequences of preeclampsia?

Women who have had preeclampsia have significantly increased lifetime cardiovascular risk: 2-fold increased risk of heart disease and stroke; 3-4 fold increased hypertension risk; and doubled risk of type 2 diabetes in later life. Preeclampsia reveals pre-existing susceptibility to cardiovascular disease. Post-pregnancy cardiovascular risk screening is recommended for all women with a history of preeclampsia or gestational hypertension.

How is preeclampsia being researched?

Key research areas: PlGF-based tests for early preeclampsia detection (now entering practice); sFlt-1/PlGF ratio for risk stratification; novel treatments targeting placental ischemia (NO donors, proton pump inhibitors); aspirin dose optimisation; and better understanding of the placental biology underlying the disease. The ASPRE trial established first-trimester screening and aspirin as the primary prevention strategy for preterm preeclampsia.

How does GMJ News cover preeclampsia?

GMJ News covers WHO preeclampsia data, calcium and aspirin prevention evidence, magnesium sulfate access advocacy, maternal mortality reduction targets and long-term cardiovascular consequences. Preeclampsia management is a direct PHIG healthcare quality priority, with Accreditation Canada standards addressing hypertensive disorders of pregnancy in Georgian hospitals.

Home › Topics › Preeclampsia and Eclampsia

Preeclampsia and Eclampsia

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Preeclampsia — a hypertensive disorder of pregnancy characterised by high blood pressure and organ damage — affects 2-8% of pregnancies globally and causes approximately 40,000-70,000 maternal deaths per year, making it one of the leading causes of maternal mortality alongside haemorrhage and sepsis (WHO). Eclampsia — the seizure complication of preeclampsia — kills thousands more and causes devastating fetal consequences including prematurity and growth restriction. Two interventions have transformed the landscape: low-dose aspirin (for high-risk women from 12 weeks) reduces preeclampsia risk by 10-24%, and calcium supplementation reduces incidence by 50% in low-calcium settings.

Key messages

Leading cause of maternal mortality

Preeclampsia and eclampsia cause approximately 40,000-70,000 maternal deaths per year, making hypertensive disorders of pregnancy one of the three leading causes of maternal mortality globally alongside haemorrhage and sepsis (WHO).

2-8% of pregnancies

Preeclampsia affects 2-8% of all pregnancies globally — more commonly in first pregnancies, multiple gestations, women with pre-existing hypertension, diabetes or kidney disease, and in LMICs where access to antenatal monitoring is limited.

Calcium supplementation — a major prevention

WHO recommends calcium supplementation (1.5-2g/day) for all pregnant women in populations with low calcium intake — reducing preeclampsia risk by approximately 50%. This simple, cheap intervention is severely underprovided in high-risk LMICs.

Low-dose aspirin

Low-dose aspirin (75-150mg/day) started before 16 weeks reduces preeclampsia risk by 10-24% in high-risk women. WHO and NICE recommend aspirin for women with risk factors including prior preeclampsia, chronic hypertension, diabetes, kidney disease and multiple pregnancy.

Magnesium sulfate prevents eclampsia

IV magnesium sulfate is the essential treatment for preventing eclamptic seizures in women with severe preeclampsia, and for treating eclampsia. It reduces maternal death and severe morbidity by approximately 50%.

Only delivery cures

The only definitive cure for preeclampsia is delivery of the baby and placenta. Management balances the risks of continued pregnancy (maternal deterioration) against risks of prematurity to the baby.

Key statistics

40-70K

maternal deaths from preeclampsia/year

WHO

2-8%

of all pregnancies affected

WHO

500K

perinatal deaths associated/year

WHO/Lancet

50%

preeclampsia reduction with calcium

WHO Cochrane

10-24%

preeclampsia reduction with aspirin

ASPRE trial/WHO

76%

of deaths in LMICs

WHO

Preeclampsia incidence (% of pregnancies) by region — WHO global survey

Source: WHO Global Survey on Maternal and Perinatal Health. LMICs have higher incidence and much worse outcomes.

Glossary of key terms

Preeclampsia
WHO/ISSHPA pregnancy-specific disorder defined as new-onset hypertension (≥140/90 mmHg) at ≥20 weeks of gestation plus at least one of: proteinuria; other maternal organ dysfunction (kidney, liver, neurological, haematological); or uteroplacental dysfunction (fetal growth restriction).

Eclampsia
WHOThe occurrence of tonic-clonic seizures (convulsions) in a woman with preeclampsia — a life-threatening obstetric emergency. Treated with IV magnesium sulfate (first-line), urgent delivery, and intensive monitoring.

HELLP syndrome
WHO/ACOGA severe complication of preeclampsia: Haemolysis + Elevated Liver enzymes + Low Platelets. A life-threatening multisystem disorder requiring immediate delivery regardless of gestational age.

Magnesium sulfate (MgSO4)
WHO EMLThe essential medicine for eclampsia prevention and treatment. Given IV/IM to women with severe preeclampsia or eclampsia. Reduces eclampsia risk by 59% (Magpie trial). Included on WHO Essential Medicines List — but unavailable in many LMICs.

Placental growth factor (PlGF)
WHO/researchA novel biomarker for preeclampsia prediction and diagnosis. Low PlGF in the first trimester (combined with blood pressure, uterine artery Doppler and maternal characteristics) identifies women at highest risk. PlGF-based tests are now entering clinical practice.

Antihypertensive therapy
WHOLabetalol, nifedipine or hydralazine are recommended to control severe hypertension (≥160/110) in preeclampsia — reducing stroke risk. Blood pressure control does not treat preeclampsia (which is a placental disease) but prevents maternal vascular complications.