notamedik

Pre-eclampsia Diagnostic Criteria

Blood pressure

On two occasions at least 4 hours apart, in a woman previously normotensive. Severe-range readings may be confirmed within minutes to allow prompt treatment.

After 20 weeks?
Proteinuria

Proteinuria: ≥ 300 mg per 24-hour collection, protein/creatinine ratio ≥ 0.3, or dipstick 2+ where quantitative methods are unavailable.

Severe features

Criteria not met

Pre-eclampsia requires hypertension. Without it these criteria do not apply, whatever else is present.

Notes on the criteria

Proteinuria is not required. Hypertension after 20 weeks plus any one severe feature is pre-eclampsia. Waiting for proteinuria before making the diagnosis is the older, superseded approach.

Severe-range blood pressure alone is enough. Gestational hypertension with a systolic ≥ 160 or diastolic ≥ 110 is diagnosed as pre-eclampsia with severe features, with nothing else needed.

Gestational hypertension is not the benign end of a spectrum. The bulletin is explicit that treating it as intrinsically less concerning is incorrect; it requires the same enhanced surveillance and can progress.

The platelet threshold here is < 100 × 10⁹/L (< 100,000/µL). The bulletin itself prints “100,000 × 10⁹/L”, which is a units slip — that figure is a thousand times any real platelet count and could never be met.

Headache is a weak criterion on its own. The bulletin notes it is unreliable and non-specific, and calls for a circumspect approach when other corroborating signs are absent.