World Pre-eclampsia Day 2026

Pre‑eclampsia is a condition that can develop during pregnancy or after birth. It is associated with raised blood pressure and can progress rapidly to life-threatening complications for both mothers and babies.[1]

On World Pre‑eclampsia Day, we reflect on learning from maternity and newborn safety investigations to better understand where care can be improved and how harm can be prevented.

Why pre‑eclampsia remains a safety challenge

Pre-eclampsia does not always present in a straightforward way, as symptoms such as headache, swelling, and abdominal pain may initially be absent, mild, or differ between individuals,[2] making early recognition challenging.

Insights from MNSI investigations

Analysis of maternal death investigations involving pre‑eclampsia between 2020 and 2026 across England, identified several themes that offer important safety learning.

Recognising deterioration and evolving risk

In several investigations, mothers had clear risk factors or early signs of pre‑eclampsia and the diagnosis was delayed. This included situations where raised blood pressure or abnormal test results were not escalated or followed up in line with guidance.

Investigations also found that pre‑eclampsia was sometimes not considered in the absence of proteinuria, despite current guidance[3] recognising that the condition can be diagnosed based on other signs such as organ dysfunction or placental insufficiency in addition to raised blood pressure. This reflects the need for ongoing awareness of evolving diagnostic criteria and ensuring this knowledge is embedded in frontline care.

Monitoring, investigations, and follow‑up

Consistent monitoring is central to safe care. Investigations identified gaps in routine assessments, including inconsistent blood pressure measurement and urinalysis. In some investigations, abnormal results did not trigger urgent review, and opportunities to repeat laboratory tests were missed.

We also saw challenges in systems for reviewing test results, particularly in busy triage environments where multiple demands and mixed paper and electronic systems could contribute to delays or limited oversight. Without robust processes, important clinical information may not inform timely decision making.

Communication and involvement of mothers and families

Clear communication with mothers and their families is essential. In several investigations, there was limited documentation of discussions about the signs and symptoms of pre‑eclampsia, particularly at discharge. This meant that mothers may not have been aware of when to seek help, even when symptoms persisted or worsened.

Investigations also highlighted that families were sometimes unaware of a mother’s diagnosis of pre-eclampsia, which affected their ability to provide important information when she became acutely unwell. Supporting mothers to understand their condition and what to look out for is a key component of safe care.

Multidisciplinary working and continuity of care

Pre‑eclampsia often requires input from multiple teams, particularly when mothers become critically unwell. Investigations identified occasions where coordination between obstetric and non‑obstetric teams was limited, and where maternity-specific considerations were not always recognised in non-maternity settings.

Effective multidisciplinary communication and clear clinical leadership are essential to ensure that care is coordinated and responsive to changing needs.

System pressures and environment

Many of the factors identified in investigations occurred in the context of busy clinical environments. Pressures within maternity triage, limited capacity, and competing demands sometimes contributed to decisions to discharge mothers before results were reviewed or without senior input.

These system factors can make it more difficult for staff to deliver consistent, guideline-based care, particularly when processes for escalation or follow‑up are not clearly defined.

What supports safer care?

What our investigations tell us is clear: improving outcomes in pre‑eclampsia relies on early recognition, consistent monitoring, timely escalation, and effective communication.

This includes:

• Supporting staff with clear, accessible guidance and training on the diagnosis of pre-eclampsia—not only emergency management
• Ensuring robust systems to review and act on laboratory investigation results
• Providing mothers with clear, consistent information about symptoms and when to seek help
• Strengthening multidisciplinary working across all care settings

A shared commitment to learning

The majority of mothers with pre‑eclampsia receive safe care, and many examples of good practice were identified within MNSI investigations. By learning from safety investigations, we can continue to strengthen systems and support staff to recognise and respond to this condition effectively.