Case history
Case history #1
A 25-year-old pregnant woman presents for her routine antenatal visit. She is at 32 weeks' gestation and reports no symptoms. On examination, her blood pressure (BP) is 145/95 mmHg and urinalysis reveals proteinuria (2+). She is referred to the antenatal day unit where a quantitative protein measurement of 1.5 g/24 hours is confirmed. Further laboratory tests reveal elevated liver enzymes; however, platelets and all other tests are normal.
Case history #2
A 35-year-old woman presents at 37 weeks' gestation with severe headache and acute abdominal pain. She had a routine antenatal visit 4 days previously with no signs or symptoms reported or observed. On examination, her BP is 165/110 mmHg and urinalysis reveals proteinuria (3+). She is admitted to hospital and is started on labetalol.
Other presentations
Pre-eclampsia may also be found on routine maternal examination for lack of fetal movements or generally feeling unwell. The International Society for the Study of Hypertension in Pregnancy considers uteroplacental dysfunction, leading to decreased fetal growth, as one of several new-onset conditions that can define pre-eclampsia when accompanied by gestational hypertension.[2] As such, women whose babies are affected by fetal growth restriction should be investigated accordingly for pre-eclampsia. Uncommon symptoms include breathlessness and visual disturbances. All women who present with unusual symptoms in pregnancy should be investigated for pre-eclampsia.
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