Preeclampsia With Twins: What to Know From Twin Moms Who’ve Been There

Last updated on December 23rd, 2025 at 11:40 am

Pregnant with twins and worried about developing preeclampsia? Or already been told by your doctor that you have it and wondering what’s next? Here’s what other twin moms experienced and what you can expect if you have preeclampsia with twins.

In many ways, expecting twins can be an exhilarating experience. From that first holy-sh*t moment of seeing two babies on the ultrasound screen to picking out names and clothes for two tiny humans instead of just one, there’s a special enchantment to it all. 

At the same time, twin pregnancy can also feel riddled with unexpected complications–like the dreaded P word: preeclampsia. 

Since preeclampsia is common complication of twin pregnancy, we wanted to fill you in on what it is, signs to look for, and what to expect if you have it. We’ll also share what other twin moms went through in having preeclampsia with twins.

What is preeclampsia, and why is it so dangerous?

Preeclampsia is a type of hypertensive disorder. The main two tell-tale factors are high blood pressure and protein in the urine. 

In most cases, it develops after 32 weeks gestation, but it can appear as early as 20 weeks. It’s important to know the signs of this complication because too high a blood pressure in pregnancy puts extra strain on the mother’s organs–like the liver and kidneys. It can also be harmful to your babies since it can cause growth restrictions or require a premature birth. 

Thankfully, preeclampsia can be treated with frequent monitoring or early delivery (if necessary). But if left untreated, preeclampsia can develop into a more severe complication called eclampsia which is marked by seizures. It’s believed this is due to a poor lack of blood flow between the mother and the placenta, and it can be life-threatening. 

How do I know if I have preeclampsia? What signs should I watch for?

Here are some of the most common symptoms that point to preeclampsia:

• High blood pressure (140/90 or higher)
• The presence of protein in your urine (300 mg of protein in 24 hours or a urinary protein vs. creatinine ratio of 0.3 or greater)
• Severe headaches
• Changes in vision such as seeing flashing lights, blurriness, or general sensitivity to lights
• Shortness of breath caused by pulmonary edema (fluid accumulation in the lungs)
• Vomiting 
• Nausea
• Sudden sharp pain in the upper right abdomen
• Swelling (especially in your hands, feet, face, or legs). This is a tricky one since swelling is common in pregnancy in general. So if the swelling seems to come on quickly or is worse than usual, that’s a red flag. 

If you notice any of these signs–even on their own–especially after 20 weeks, it’s always best to be cautious and tell your doctor right away. If it happens to be after hours, call or go into your local emergency department so you can get medical assistance. 

Chances of preeclampsia in twin pregnancy?

There is a much higher risk of developing preeclampsia when you’re pregnant with twins. One study found that 9.5% of twin pregnancies end up developing preeclampsia. 

To put this into perspective, that’s nearly 1 in every 10 twin pregnancies that will experience this complication. And compared to singleton pregnancies, the risk is about 2 to 3 times higher. 

What to expect with preeclampsia?

If you end up developing preeclampsia, try not to panic. Keep in mind that there are varying degrees of severity so as long as you are keeping on top of your prenatal appointments and monitoring your symptoms, chances are you will catch it earlier on. 

Here’s what will likely happen next:

• You’ll probably have more frequent appointments with your doctor to check your blood pressure, urine protein levels, and fetal movement.
• You may be prescribed medication to take to manage the high blood pressure
• You may need to stay overnight in the hospital or even for a few days until your blood pressure goes down.
• If symptoms worsen, early delivery may be necessary.
• After delivery, you’ll probably be given a magnesium sulfate drip which helps to lower your blood pressure (but it can cause you to feel sick). 
• You may need to continue taking blood pressure medication after delivery or you’ll be instructed to monitor your blood pressure closely at home. 

We recently asked our twin parent community:

For those who developed preeclampsia in their twin pregnancy, how far along were you when you had it? Did you have to have an emergency delivery? How was your recovery?

Here’s what twin parents had to say:

“Started at 29 weeks. Still made it to my 36+3 planned C-section, but I was hospitalized 3 times, on meds, and very well-monitored with NSTs twice a week and ultrasound weekly by the end.” 

“36 weeks!” 

“Didn’t have it until the day I got induced. Was allowed to proceed/deliver vaginally.” 

“35 weeks. Delivered at 35 and 6. Emergency c-section. The first 5 days were brutal.” 

“37 and 5. Was induced for a vaginal delivery. All was fine.” 

“At 35 + 6, they induced me once they caught it. Vaginal delivery. I was very weak for about a week following delivery. And the blood pressure meds made me sick.” 

“Monitored from 30 weeks, hospitalized at 34 weeks, babies born at 35 weeks.” 

“I got it officially during labor, but it resolved by the time I left the hospital.” 

“36 weeks, c-section. I’ve had worse recoveries. This was by far the smoothest one.” 

“32 weeks delivered via urgent c-section at 33 weeks 6 days. I was discharged in 3 days and babies spent 9 days in the NICU.” 

“I developed it AFTER delivery which I didn’t even know could happen!”

“Diagnosed at 34 weeks, delivered at 35 weeks, 4 day with di/di twin girls.” 

“C-section and it was bad with having ER trips AFTER.” 

“Induced at 38 weeks 2 days. I developed severe preeclampsia and HELLP. Emergency c-section and 2 return trips.” 

“Developed it postpartum though I had symptoms for a week ahead. Quick recovery in hospital.”

“33 weeks and 6 days. Emergency, intubated. Recovery was horrific.” 

“29 weeks when admitted. C-section was 27 hours later. Put on 2 BP meds 6x a day after birth.”

“31 weeks. We were able to manage it until 34 weeks.”

“33 weeks. Emergency c-section. 14 and 15 day NICU stays.”

“At 33 weeks my blood pressure spiked. In and out of hospital and scheduled c-section at 37 weeks.” 

“25 – 30 weeks. C-section but not an emergency in week 37.”

“37 weeks it started. Made it to 37 + 6 and had a c-section.” 

“Severe preeclampsia, had my boys at 34 weeks via emergency c-section. Boys spent time in the NICU.”

“At 33 weeks they started monitoring my blood pressure and at 34 weeks they did a c-section. It was not an emergency due to a wonderful team of doctors.” 

“Emergency c-section at 35 weeks. Signs started at 6 months.”

“35 weeks + 1 day! I was committed to having a vaginal birth…didn’t go over so well.”

“C-section. Always planned (they were breach). And recovery was the hardest part.” 

“35.5 weeks, delivered at 36.5 weeks.” 

“I was diagnosed at 33 weeks 4 days. Emergency c-section was at exactly 34 weeks.” 

“32 weeks it started. I went into labor at 36 weeks 6 days and had a c-section. Blood pressure spiked postpartum and I had to take meds for about a month.” 

“C-section at 36 weeks.” 

A twin mom’s preeclampsia birth story (learn from my mistakes!)

My twin pregnancy was riddled with all sorts of complications including gestational diabetes, a congenital lung defect for Twin A, borderline blood pressure readings, and a Covid-19 diagnosis. 

Due to Twin A’s condition, I had regular doctor’s appointments 1 – 2 times a week ever since I reached 20 weeks. Even with all that monitoring, preeclampsia still took me by surprise. I was so focused on my twins that I forgot to pay close attention to my own body. 

Once I hit 34 weeks, my blood pressure was rather high at one appointment, and I had to stay overnight in the hospital for monitoring. The next morning (a Friday, and my hubby’s birthday), it had gone down enough that they discharged me since I had a c-section scheduled for the following Wednesday, only 5 more days away. 

But things took a turn for the worse over the weekend. It happened to be Super Bowl weekend, and as a last hurrah, we decided to have a couple friends (like 4 people) over. 

Instead of resting and staying off of my feet, I spent that weekend making some food for our guests and putting some final touches on the nursery. My mom had also flown in that weekend from out-of-town so she could be there to help out the week of the twins’ birth. 

Thank goodness she was there! The day after the Super Bowl, my husband went into work, and my mom was at the house with me. She was the voice of reason when it all went down.

When I woke up that morning (at 34 weeks, 5 days), I noticed my hands and feet were super itchy. No rash, no bumps, just pure itchiness for seemingly no reason. This was red flag 1 (later found out it was from intrahepatic cholestasis of pregnancy, which can increase your risk of preeclampsia). 

A few hours into the day came red flag #2. My mom and I were watching TV together, and I began to have weird things happen with my vision. When I would look at my phone, it was a little blurry and I had trouble reading the words on the screen. I also felt like I had bright and dark patches constantly that made it just slightly off when I would look anywhere. 

Yet, I was still in denial. It was mid-February and we had snow on the ground outside, so I told myself the it was just the glare from the bright sun against the snow that was making it hard to see. But when I told my mom this, she basically said, “Okay, that’s enough. Call your doctor, you need to go in.” 

Even still, I fought against this at first. I didn’t feel ready to deliver, and I wanted my husband to be able to have his last two days at work (since he had just started a new position). 

Thanks to my mom’s urging though, she drove me to the hospital (an hour away since it was a specialized children’s hospital where my Twin A needed to be delivered). And lo and behold, all the test results pointed to preeclampsia. The numbers were bad enough that I needed to deliver as soon as my husband was able to get there. So while they waited for him to make the hour drive, they started prepping the OR and gave me a quick run-down of what to expect. 

We delivered our twins via C-section that night on Valentine’s Day—our little Valentwins. 

Moral of the story with preeclampsia with twins…

This was certainly not how I imagined delivering my twins, but looking back, I wish I would have been more educated about preeclampsia. And I wish I would have listened to my body and what it was telling me more carefully. 

So if you’re a pregnant twin mama reading this, take it easy on your body in those later days of twin pregnancy, and pay careful attention to your symptoms. If anything feels even slightly off, trust your gut and tell your doctor ASAP. It’s better to ask and have it be nothing than to not ask and have it be something dangerous to you or your babies’ health. 

All content on this website, including medical opinions and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Want to learn more about twin pregnancy complications and how to cope with them? Check out these articles too:

• Postpartum Eclampsia Almost Took My Life
• Cholestasis of Pregnancy With a Twin Pregnancy
• What Are Common Complications of Twin Pregnancy?
• Your Guide to Coping With Twin Pregnancy Complications
• The Glucose Test and Gestational Diabetes With Twins

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