A health care provider will bank check a pregnant adult female'southward blood pressure and urine during each prenatal visit. If the blood pressure reading is considered high (140/ninety or college), especially afterward the 20th week of pregnancy, the health care provider volition likely perform claret tests and more extensive lab tests to wait for extra poly peptide in the urine (called proteinuria) likewise as other symptoms.

The American College of Obstetricians and Gynecologists provides the post-obit criteria for a diagnosis of gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome.

Gestational hypertension is diagnosed if a significant woman has loftier blood pressure but no protein in the urine. Gestational hypertension occurs when women whose blood pressure levels were normal before pregnancy develop high claret pressure level afterward 20 weeks of pregnancy. Gestational hypertension tin progress into preeclampsia.1

Mild preeclampsia is diagnosed when a pregnant woman has:2,3

  • Systolic blood pressure (tiptop number) of 140 mmHg or higher or diastolic blood force per unit area (lesser number) of 90 mmHg or higher and either
    • Urine with 0.3 or more grams of protein in a 24-hour specimen (a drove of every drop of urine within 24 hours) or a protein-to-creatinine ratio greater than 0.3
      or
    • Blood tests that show kidney or liver dysfunction
    • Fluid in the lungs and difficulty animate
    • Visual impairments

Severe preeclampsia occurs when a pregnant woman has any of the following:

  • Systolic blood pressure of 160 mmHg or higher or diastolic claret pressure level of 110 mmHg or higher on two occasions at least 4 hours autonomously while the patient is on bed balance
  • Urine with 5 or more grams of protein in a 24-hour specimen or 3 or more than grams of protein on 2 random urine samples collected at least 4 hours apart
  • Examination results suggesting kidney or liver damage—for instance, blood tests that reveal low numbers of platelets or high liver enzymes
  • Severe, unexplained stomach pain that does not respond to medication
  • Symptoms that include visual disturbances, difficulty breathing, or fluid buildup4

Eclampsia occurs when women with preeclampsia develop seizures. The seizures can happen before or during labor or after the baby is delivered.

HELLP syndrome is diagnosed when laboratory tests show hemolysis (burst red claret cells release hemoglobin into the blood plasma), elevated liver enzymes, and low platelets. There also may or may not be extra protein in the urine.5

Some women may besides be diagnosed with superimposed preeclampsia—a situation in which the woman develops preeclampsia on top of high claret pressure that was nowadays before she got significant. Health care providers await for an increase in blood pressure and either protein in the urine, fluid buildup, or both for a diagnosis of superimposed preeclampsia.

In addition to tests that might diagnose preeclampsia or similar issues, health intendance providers may do other tests to assess the health of the female parent and fetus, including:

  • Blood tests to run across how well the mother's liver and kidneys are working
  • Blood tests to check blood platelet levels to see how well the mother'south claret is clotting
  • Blood tests to count the total number of carmine blood cells in the mother's blood
  • A maternal weight bank check
  • An ultrasound to assess the fetus'southward size
  • A check of the fetus's middle rate
  • A concrete exam to look for swelling in the mother'due south face, hands, or legs as well as abdominal tenderness or an enlarged liver

Citations

Shut Citations

  1. Saudan, P., Brown, One thousand. A., Buddle, Chiliad. L., Jones, M. (1998). Does gestational hypertension become pre-eclampsia?British Journal of Obstetrics and Gynaecology,  105(11), 1177–1184.
  2. ACOG Committee on Practice Bulletins, Obstetrics. (2020). Gestational Hypertension and Preeclampsia: ACOG Practice Message Number 222 https://pubmed.ncbi.nlm.nih.gov/32443079/
  3. ACOG Committee on Do Bulletins, Obstetrics. (2019). Chronic Hypertension in Pregnancy: ACOG Do Message Number 203 https://pubmed.ncbi.nlm.nih.gov/30575676/
  4. Sibai, B. M. (2012). Hypertension. In Southward. Thou. Gabbe, J. R. Niebyl, J. L. Simpson, K. B. Landon, H. 50. Galan, E. R. M. Jauniaux, & D. A. Driscoll (Eds.),Obstetrics: Normal and problem pregnancies (sixth ed., pp. 631–666). Philadelphia: W. B. Saunders.
  5. Haram, M., Svendsen, E., & Abildgaard, U. (2009). The HELLP syndrome: Clinical bug and management. A review. BMC Pregnancy & Childbirth , ix, eight. Retrieved June 6, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654858/ external link

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