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Back| Diagnosis of severe preeclampsia can be made if at least one of the following criteria is met |
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| 1. Abnormal central nervous system manifestations: blurred vision, headache, dizziness; severe cases may include confusion, coma, etc. |
| 2. Symptoms of subcapsular liver hematoma or liver rupture: including upper abdominal discomfort or persistent pain in the right upper abdomen, etc. |
| 3. Manifestations of liver cell damage: elevated serum transaminases |
| 4. Blood pressure changes: systolic blood pressure ≥160mmHg, or diastolic blood pressure ≥110mmHg |
| 5. Thrombocytopenia: <100×109/L |
| 6. Proteinuria: ≥5g/24h, or two urine protein tests (+++), 4 hours apart |
| 7. Oliguria: 24-hour urine output <500ml |
| 8. Pulmonary edema |
| 9. Cerebrovascular accident |
| 10. Intravascular hemolysis: anemia, jaundice, or elevated lactate dehydrogenase |
| 11. Coagulation dysfunction |
| 12. Fetal growth restriction or oligohydramnios |
Explanation
Worsening hypertension, increased proteinuria, or abnormal laboratory indicators of the kidney, liver, or blood system, or symptoms preceding eclampsia, such as headache, blurred vision, and upper abdominal pain, indicate worsening condition, making the diagnosis of preeclampsia more certain.
Right upper abdominal pain is often the result of ischemia, necrosis, and edema of liver cells. These characteristic changes are often accompanied by elevated liver enzymes, indicating liver infarction or hemorrhage, or subcapsular liver hematoma rupture. Subcapsular liver hematoma rupture is clinically rare but life-threatening for both mother and child when it occurs. Severe vasoconstriction can lead to microangiopathic hemolysis, platelet activation, and aggregation. Therefore, thrombocytopenia and hemolysis (such as hemoglobinemia, hemoglobinuria, hyperbilirubinemia, etc.) are also markers of worsening condition.
