clinical features
Last reviewed 10/2022
Symptoms of pre-eclampsia:
- generally asymptomatic and can only be detected by routine screening
- if present, the most frequent symptoms are headache, visual disturbance (commonly 'flashing lights'), epigastric pain, vomiting, oedema (especially facial oedema) - these symptoms in conjunction with raised blood pressure should indicate immediate referral for obstetric review
- women may rarely present with a convulsion - if a first fit occurs in the second part of pregnancy with no other known cause this is a strong indication of pre-eclampsia
Additional signs which may be used to recognise this condition include, in the mother:
- excessive weight gain - more than 1.0 Kg per week
- ascites
- hyperuricaemia*
- hypocalciruia
- reduced plasma concentrations of von Willebrand factor, cellular fibronectin, and antithrombin III
- thrombocytopenia
- increased packed cell volume
- increased blood concentration of liver enzymes
And in the fetus:
- intrauterine growth retardation
- intrauterine hypoxaemia
* a systematic review concluded that serum uric acid is a poor predictor of maternal and fetal complications in women with pre-eclampsia (1)
Reference:
- Thangaratinam S et al. Accuracy of serum uric acid in predicting complications of pre-eclampsia: a systematic review.BJOG. 2006 Apr;113(4):369-78.
- Ramsey LE et al Guidelines for the management of hypertension: report of the third working party of the British Hypertension Society, 1999. J Hum Hypertens;13: 569-92.