Severe Features of Preeclampsia

HealthCare

In a woman with preeclampsia, the presence of one or more of the following features indicates a diagnosis of “preeclampsia with severe features”
Organ systems affected are: CNS; Lungs,  Liver; Kidney, Lungs, as well as Cardiovascular system (low platelets, and elevated pressures)
    1. SBP of ≥ 160 mm Hg, or DBP of ≥ 110 mm Hg on two occasions at least 4 hours apart while the patient is on bed rest (unless antihypertensive therapy is initiated before this time, in which case the patient meets the criteria with just one set of BP)
    2. Thrombocytopenia (platelet count less than 100,000/microliter)
    3. Impaired liver function as indicated by abnormally elevated blood concentrations of liver enzymes (to twice normal concentration), severe persistent right upper quadrant or epigastric pain unresponsive to medication and not accounted for by alternative diagnoses, or both
    4. Progressive renal insufficiency (serum creatinine concentration greater than 1.1 mg/dL or a doubling of the serum creatinine concentration in the absence of other renal disease)
    5. Pulmonary edema.
    6. New-onset cerebral or visual disturbances. 
      1. Symptoms of new-onset cerebral disturbance include 1) Altered Mental Status; 2) Severe headaches (ie, incapacitating, “the worst headache I’ve ever had”) or headaches that persists and progresses despite analgesic therapy.
      2. Visual disturbances include scotomata, photopsia, etc.

 

Photopsias are flashes of light that are usually brief and intermittent.
A scotoma is a spot in the visual field in which vision is absent or deficient

Reference
Obstet Gynecol. 2013 Nov;122(5):1122-31. https://www.ncbi.nlm.nih.gov/pubmed?term=24150027.

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