From the Guidelines
Pre-eclampsia signs include high blood pressure (140/90 mmHg or higher) and protein in the urine (proteinuria) after 20 weeks of pregnancy, as well as other symptoms such as severe headaches, vision changes, and upper abdominal pain, which can be identified through regular prenatal care and blood pressure monitoring, as recommended by the most recent guidelines 1. The diagnosis of pre-eclampsia is based on the presence of new-onset hypertension and proteinuria, or other signs of maternal organ dysfunction, such as acute kidney injury, liver involvement, or neurological complications, after 20 weeks of gestation 1. Key signs to watch for include:
- Severe headaches
- Vision changes like blurriness or seeing spots
- Upper abdominal pain (typically under the ribs on the right side)
- Nausea and vomiting
- Decreased urination
- Shortness of breath
- Sudden weight gain with significant swelling (edema) in the face, hands, and feet Laboratory findings may show elevated liver enzymes, low platelet counts, and kidney dysfunction, which can indicate the severity of the condition and the need for urgent medical attention 1. It is essential to note that pre-eclampsia can rapidly progress to life-threatening conditions, such as eclampsia (seizures) or HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), emphasizing the importance of prompt recognition and management of the condition 1. Regular prenatal care with blood pressure monitoring is crucial for early detection, and women with pre-eclampsia should be assessed in hospital when first diagnosed, with subsequent management depending on the severity of the condition and the presence of other complications 1.
From the Research
Signs of Preeclampsia
The signs of preeclampsia include:
- Hypertension, defined as a systolic blood pressure (SBP) of at least 140 mmHg and/or a diastolic blood pressure (DBP) of at least 90 mmHg 2, 3, 4, 5, 6
- Proteinuria, defined as the presence of protein in the urine, typically greater than 300 mg/24 hours 2, 3, 4, 5, 6
- Renal impairment 2, 4
- Thrombocytopenia, defined as a low platelet count, typically less than 100,000/μL 2
- Epigastric pain 2, 4
- Liver dysfunction 2, 4
- Hemolysis-elevated liver enzymes-low platelet count (HELLP) syndrome 2, 3
- Visual disturbances 2
- Headache 2
- Seizures, which can occur in severe cases, known as eclampsia 2, 3, 4, 5, 6
Severe Preeclampsia
Severe preeclampsia is characterized by:
- Severe hypertension, defined as a SBP of at least 160 mmHg and/or a DBP of at least 110 mmHg 2
- Thrombocytopenia less than 100,000/μL 2
- Liver transaminases above twice the normal values 2
- HELLP syndrome 2
- Renal failure 2
- Persistent epigastric or right upper quadrant pain 2
- Visual or neurologic symptoms 2
- Acute pulmonary edema 2