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==Diagnosis==
==Overview==
===History and Symptoms==
The previous classification of  [[preeclampsia]] into mild and severe disease is not used now because [[Preeclampsia]] may deteriorate rapidly without any specific [[signs]] and [[symptoms]]. [[Preeclampsia]] may present the first time intrapartum or early postpartum. Every [[hypertensive]] [[pregnant]] woman should be investigated for the symptoms related to organ damage, even in the absence of [[ proteinuria]]. Symptoms of [[preeclampsia]]  may include the following: [[epigastric pain]] or [[right upper quadrant pain]], [[frontal]] or [[occipital]] [[ headache]], [[visual scotoma]], [[shortness of breath]], limbs [[swelling]], [[altered mental status]], and [[photophobia]].


* According to the new guideline of ISSHP 2018, every hypertensive pregnant woman after 20 weeks, should be evaluated for preeclampsia by investigation about multiple organ involvement, even in the absence of proteinuria.  
==History and Symptoms==
*  
* The previouse classification of [[preeclampsia]] into mild and severe disease is not used now because [[Preeclampsia]] may deteriorate rapidly without any specific [[signs]] and [[symptoms]].  <ref name="BrownMagee2018">{{cite journal|last1=Brown|first1=Mark A.|last2=Magee|first2=Laura A.|last3=Kenny|first3=Louise C.|last4=Karumanchi|first4=S. Ananth|last5=McCarthy|first5=Fergus P.|last6=Saito|first6=Shigeru|last7=Hall|first7=David R.|last8=Warren|first8=Charlotte E.|last9=Adoyi|first9=Gloria|last10=Ishaku|first10=Salisu|title=Hypertensive Disorders of Pregnancy|journal=Hypertension|volume=72|issue=1|year=2018|pages=24–43|issn=0194-911X|doi=10.1161/HYPERTENSIONAHA.117.10803}}</ref>
 
* [[Preeclampsia]] may present the first time intrapartum or early postpartum.
 
* Every [[hypertensive]] [[pregnant]] woman should be investigated for the symptoms related to organ damage, even in the absence of [[proteinuria]].
 
*  Symptoms of [[preeclampsia]] may include the following:
 
:* [[Epigasteric pain]] or [[right upper quadrant pain]]
According to the concept proposed by the International Society for Studies in Gestational Hypertension, published in 2014 and reinforced in 2018 [24], every hypertensive pregnant woman should be investigated for multiple organ involvement, even if presenting negative proteinuria, in order to discard the hypothesis of preeclampsia. This approach is innovative and tends more broadly to encompass cases that are somewhat neglected by the absence of proteinuria
:* [[Frontal]] or [[oxipital]] [[ headache]]
 
:* [[Visual scotoma]]
 
:* [[Shortness of breath]]
 
:* limbs [[swelling]]
Pre-eclampsia is usually asymptomatic, hence its detection depends on signs or investigations. Nonetheless, one symptom is crucially important because it is so often misinterpreted. The epigastric pain, which reflects hepatic involvement and is typical of the [[HELLP syndrome]], may easily be confused with heartburn, a very common problem of pregnancy. However, it is not burning in quality, does not spread upwards towards the throat, is associated with hepatic tenderness, may radiate through to the back, and is not relieved by giving antacids. It is often very severe, described by sufferers as the worst pain that they have ever experienced. Affected women are not uncommonly referred to general surgeons as suffering from an acute abdomen, for example acute cholecystitis.
:* [[Altered mental status]]
 
:* [[Photophobia]]
In general, none of the signs of pre-eclampsia is specific; even convulsions in pregnancy are more likely to have causes other than [[eclampsia]] in modern practice. Diagnosis, therefore, depends on finding a coincidence of several pre-eclamptic features, the final proof being their regression after delivery.


==References==
==References==
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Latest revision as of 17:26, 24 March 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Ogheneochuko Ajari, MB.BS, MS [3]

Overview

The previous classification of preeclampsia into mild and severe disease is not used now because Preeclampsia may deteriorate rapidly without any specific signs and symptoms. Preeclampsia may present the first time intrapartum or early postpartum. Every hypertensive pregnant woman should be investigated for the symptoms related to organ damage, even in the absence of proteinuria. Symptoms of preeclampsia may include the following: epigastric pain or right upper quadrant pain, frontal or occipital headache, visual scotoma, shortness of breath, limbs swelling, altered mental status, and photophobia.

History and Symptoms

References

  1. Brown, Mark A.; Magee, Laura A.; Kenny, Louise C.; Karumanchi, S. Ananth; McCarthy, Fergus P.; Saito, Shigeru; Hall, David R.; Warren, Charlotte E.; Adoyi, Gloria; Ishaku, Salisu (2018). "Hypertensive Disorders of Pregnancy". Hypertension. 72 (1): 24–43. doi:10.1161/HYPERTENSIONAHA.117.10803. ISSN 0194-911X.