How is pre-eclampsia diagnosed?

Posted On: January 19, 2016 By Andrei Rebarber, MD

The traditional concept of diagnosing pre-eclampsia includes the elevation of blood pressure, clinical diagnosis of peripheral hands, feet, and/or face swelling, and proteinuria (ie. when the urine has abnormal quantities of protein). The later issue is an indication of a problem with the kidneys. Recently, with new diagnostic criteria, for diagnosis of pre-eclampsia does not require the mother to have proteinuria.

Pre-eclampsia is generally associated with elevation of blood pressure greater than or equal to 140/90 in a sitting position, during two separate occasions about 4-6 hours apart. In the absence of proteinuria, pre-eclampsia patients may have a nuance of hypertension, thrombocytopenia (ie. Low platelets), renal insufficiency (Ie. Poor output of urine), impaired liver function (ie elevated liver enzyme blood tests), pulmonary edema (ie. Fluid in the lungs) or visual changes (signs of central nervous system involvement). The most important part of this is that proteinuria is no longer necessary for a patient to be properly diagnosed.

It is necessary to state that these are clinical definitions that have been obtained through expert opinion and consensus documents and there is no absolute criteria regarding blood pressure, proteinuria, or other findings that diagnosis the disease. The diagnoses is mainly based on the experience clinician’s examination and overview of patient’s clinical status as the manifestations can be quite varied.

In most cases when the criteria isn’t sufficient enough to diagnose pre-eclampsia, doctors generally view it as an evolving issue and simply may diagnose gestational hypertension. Since pre-eclampsia is developed over time and can become severe quite quickly, regular screening is necessary to determine the timing of this potential transition. It is unfortunate that pre-eclampsia can’t be predicted well yet, but Maternal Fetal Medicine physicians can monitor women at risk attempt improve the overall outcome for infants and mothers with timely diagnosis and interventions.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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