Preeclampsia usually begins after the 20th week of gestation; however, it can appear at any time during pregnancy. It occurs most frequently in the final trimester.
Mild preeclampsia includes an elevated blood pressure of 140/90 taken on two separate readings at least four to six hours apart.
A dipstick reading of 1+ or 2+ indicating protein in the urine confirms mild preeclampsia. Due to elevated blood pressure, patients can develop other end-organ dysfunction as well, including headache, vision disturbances, dyspnea, abdominal pain, edema and altered mental status.
Severe preeclampsia includes an elevated blood pressure of 160/110 taken on two separate readings within six hours.
In severe preeclampsia, patients develop progressive renal insufficiency. This is defined as a serum creatinine concentration greater than 1.1 mg/dL, or a doubling of the serum creatinine concentration in the absence of other renal disease.
Blurry vision, double vision, photophobia, or scotomas may occur as a result of retinal arterial spasms.
HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a life-threatening condition likely representing a severe form of preeclampsia, though the etiology remains unclear. It presents with more drastic symptoms and signs of liver inflammation. Patients may complain of epigastric pain or right upper quadrant pain, persistent headache, and blurred vision; symptoms that often precede eclampsia-related convulsions.
As a complication of hypertension in this disease, patients can develop pulmonary edema. This occurs as a result of increased afterload in the heart, pushing fluid into the lungs.
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