Epigastric Pain in Preeclampsia

May 22, 2023

epigastric pain in preeclampsia, hand to hold

by Jenna Maxfield

High blood pressure, protein in the urine, swelling and headaches and some of the most commonly-reported symptoms of preeclampsia. But there’s one lesser-known symptom that can often get overlooked: epigastric pain – pain in the upper right quadrant of the abdomen.

It’s possible that preeclampsia can develop with no symptoms. Often, when symptoms do present, they’re variable and atypical. This can sometimes make it difficult for doctors to diagnose the condition. Commonly, a rise in blood pressure is the first sign of preeclampsia, and many other symptoms, such as headaches, vision issues, or difficulty urinating are also sometimes reported. Of course, all of these symptoms can be attributed to other causes, making it even more difficult for a diagnosis.

An often overlooked but widely reported symptom of preeclampsia is epigastric pain. This type of pain will usually present in the upper right quadrant of the abdomen, under the ribs, and may feel like indigestion. However, other women have reported the pain is sharper and more like a “stabbing.” Because it’s so common for pregnant women to suffer from indigestion and acid reflux, a doctor may assume that’s the cause of pain felt just under the ribs. However, if you experience this pain, especially after your 20th week of pregnancy, it’s important to ask your doctor to measure your blood pressure and test your urine for protein. If your blood pressure is normal and no protein presents in the urine, it’s possible the pain could be from acid reflux. If the pain persists, however, another doctor’s appointment will be necessary.

Preeclampsia can create abnormalities in the liver, such as liver hypertrophy, or enlargement of the liver, which is what causes the epigastric pain. In some cases, women’s blood pressure and urine tests come back normal, but doctors find elevated liver enzymes. If you have this type of pain, it’s important to ask your doctor about these tests in order to rule out preeclampsia. If you do have the condition, timeliness in treatment is vital for both the baby’s and mother’s health. Therefore, don’t discount epigastric pain as a normal symptom of pregnancy. Ask your doctor to perform the necessary tests and never be afraid to ask more questions.

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