How long does preeclampsia last after delivery?

Duration of Preeclampsia After Delivery

Preeclampsia typically resolves within days to weeks after delivery, with blood pressure and laboratory abnormalities expected to normalize by 3 months postpartum, though most cases resolve much sooner. 1, 2

Immediate Postpartum Period (First Week)

Blood pressure should be monitored at least every 4-6 hours for the first 3 days postpartum, as this is when hypertension commonly worsens. 1 Preeclampsia may develop de novo or worsen during this critical window, with peak worsening typically occurring between days 3-6 after delivery. 1

• Antihypertensive medications should be continued after delivery and tapered slowly only after days 3-6 postpartum unless blood pressure drops below 110/70 mmHg or the woman becomes symptomatic. 1
• Laboratory tests (hemoglobin, platelets, creatinine, liver transaminases) should be repeated the day after delivery and then every second day until stable if abnormal before delivery. 1
• Most women can be discharged by day 5 postpartum, especially when able to monitor blood pressure at home. 1

Early Postpartum Period (1-6 Weeks)

Most cases of postpartum preeclampsia occur within 7-10 days after delivery, though the condition can persist or develop de novo up to 6 weeks postpartum. 3, 4 The diagnostic window for postpartum preeclampsia extends from 48 hours to 6 weeks after delivery. 3, 4

• Women still requiring antihypertensives at discharge should be reviewed within 1 week. 1
• Eclampsia can occur postpartum, requiring continued vigilance for neurological symptoms like headache or visual disturbances. 1, 2
• While rare, late-onset postpartum eclampsia has been documented as late as 8 weeks after delivery, though cases beyond 4 weeks are exceedingly uncommon. 5, 6

Expected Resolution Timeline (3 Months)

All women with preeclampsia should be reviewed at 3 months postpartum, by which time blood pressure, urinalysis, and all laboratory tests should have normalized. 1, 2 This 3-month checkpoint serves as the definitive assessment for resolution.

• Persistent abnormalities at 3 months require further investigation for secondary causes of hypertension or underlying renal disease. 1, 2
• The condition is confirmed as preeclampsia if it resolves postpartum, distinguishing it from chronic hypertension or other disorders. 2

Critical Pitfalls to Avoid

Do not assume preeclampsia has resolved simply because delivery has occurred—the condition can worsen or develop de novo in the postpartum period. 1, 2 The first week postpartum is particularly high-risk, with days 3-6 representing the peak period for deterioration. 1

• Avoid NSAIDs for pain relief in women with preeclampsia, especially with acute kidney injury, as they can worsen hypertension. 1, 2
• Do not discontinue monitoring too early—women require assessment through at least 3 months to confirm complete resolution. 1, 2
• Be alert for atypical presentations such as dyspnea, which may indicate postpartum preeclampsia or alternative diagnoses like postpartum cardiomyopathy. 3

Long-Term Implications

Women with a history of preeclampsia require lifelong follow-up due to increased cardiovascular disease risk, even after the acute condition has resolved. 2 Annual medical review with emphasis on healthy lifestyle maintenance is recommended. 2