Health Questions and Answers

Question: What is the definition of preeclampsia?

Answer:

Preeclampsia is defined by hypertension and proteinuria. For women who do not have chronic hypertension, an elevation above 140 mmHg systolic or 90 mmHg diastolic meets the criteria. Proteinuria is defined by more than 300 mg of protein in a 24-hour urine collection.
In the past, an increase in blood pressure above baseline (a 30-mmHg increase in systolic or a 15-mmHg increase in diastolic) also met the blood pressure definition of preeclampsia, but this relative definition has been discarded in favor of the absolute definition of 140 mmHg or 90 mmHg.
Proteinuria is technically defined by the outcome of a 24-hour urine collection. In practice, however, the consistent presence of more than trace protein on urine dipstick correlates well with proteinuria of 300 mg in 24 hours. Therefore the diagnosis is commonly made without a formal 24-hour evaluation.
Edema of the face and hands used to be a component of the diagnosis of preeclampsia. This criterion has been dropped because of its poor predictive value. Many pregnant women with normal blood pressure have hand and facial edema.

Reference: American College of Obstetricians and Gynecologists: Diagnosis and Management of Preeclampsia and Eclampsia. ACOG Practice Bulletin No. 33. Obstet Gynecol 99:159-167, 2002.

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