eMedicine Specialties > Emergency Medicine > Obstetrics & Gynecology
Pregnancy, Preeclampsia: Differential Diagnoses & Workup
Updated: May 12, 2008
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Workup
Laboratory Studies
- CBC count
- Microangiopathic hemolytic anemia (HELLP)
- Thrombocytopenia
- Hemoconcentration may occur in severe preeclampsia.
- Liver function tests: Transaminase levels are elevated from hepatocellular injury and in HELLP syndrome.
- Serum creatinine level: levels are elevated due to decreased intravascular volume and decreased glomerular filtration rate (GFR).
- Urinalysis
- Proteinuria is one of the diagnostic criteria for preeclampsia.
- Proteinuria is defined as greater than or equal to 1+ protein on urine dipstick. Alternatively, protein concentration of 300 mg/L or more on urine dipstick.
- Proteinuria is also defined as 300 mg or more of protein in a 24-hour urine sample.
- Elevated PT, aPTT, fibrin split products, and decreased fibrinogen
- Disseminated intravascular coagulopathy testing
- Uric acid
- Uric acid levels are increased in preeclampsia.
- Serial levels may be useful to indicate disease progression.
Imaging Studies
- Head CT: This study is used to detect intracranial hemorrhage in selected patients with sudden severe headaches, focal neurologic deficits, or seizures with a prolonged post-ictal state.
- Ultrasonography: This is used for fetal assessment.
More on Pregnancy, Preeclampsia |
| Overview: Pregnancy, Preeclampsia |
 Differential Diagnoses & Workup: Pregnancy, Preeclampsia |
| Treatment & Medication: Pregnancy, Preeclampsia |
| Follow-up: Pregnancy, Preeclampsia |
| References |
| « Previous Page | Next Page » |
References
Rodriguez-Thompson D, Lieberman ES. Use of a random urinary protein-to-creatinine ratio for the diagnosis of significant proteinuria during pregnancy. Am J Obstet Gynecol. Oct 2001;185(4):808-11. [Medline].
[Best Evidence] Conde-Agudelo A, Villar J, Lindheimer M. Maternal infection and risk of preeclampsia: systematic review and metaanalysis. Am J Obstet Gynecol. Jan 2008;198(1):7-22. [Medline].
[Best Evidence] Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. Nov 10 2007;335(7627):974. [Medline].
Doan-Wiggins L. Hypertensive disorders of pregnancy. Emerg Med Clin North Am. Aug 1987;5(3):495-508. [Medline].
Frakes MA, Richardson LE 2nd. Magnesium sulfate therapy in certain emergency conditions. Am J Emerg Med. Mar 1997;15(2):182-7. [Medline].
Lew M, Klonis E. Emergency management of eclampsia and severe pre-eclampsia. Emerg Med (Fremantle). Aug 2003;15(4):361-8. [Medline].
Lipstein H, Lee CC, Crupi RS. A current concept of eclampsia. Am J Emerg Med. May 2003;21(3):223-6. [Medline].
Ogle ME, Sanders AB. Preeclampsia. Ann Emerg Med. May 1984;13(5):368-70. [Medline].
Powers DR, Papadakos PJ, Wallin JD. Parenteral hydralazine revisited. J Emerg Med. Mar-Apr 1998;16(2):191-6. [Medline].
Probst BD. Hypertensive disorders of pregnancy. Emerg Med Clin North Am. Feb 1994;12(1):73-89. [Medline].
Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. Feb 26-Mar 4 2005;365(9461):785-99. [Medline].
Wagner LK. Diagnosis and management of preeclampsia. Am Fam Physician. Dec 15 2004;70(12):2317-24. [Medline].
Witlin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol. Nov 1998;92(5):883-9. [Medline].
Further Reading
Keywords
preeclampsia, HTN, hypertensive disease in pregnancy, pregnancy-induced hypertension, toxemia of pregnancy, hypertension, proteinuria, new-onset nondependent edema, seizure activity, eclampsia, seizure in pregnancy, microangiopathic hemolytic anemia, HELLP syndrome, hypertensive encephalopathy, oliguria, pulmonary edema, cyanosis, thrombocytopenia, oligohydramnios, vasospasm, seizures, acute tubular necrosis, placental abruption
