New pathways to diagnose preeclampsia

Ignacio Herraiz
BJOG: An International Journal of Obstetrics and Gynaecology 2020 July 8
Correct clinical decision making that avoids unnecessary complications for the mother and the child, rests in differentiating when pre-eclampsia is present and when it is not. The first step is to always keep this condition in mind. There is no point in having the most up-to-date guidance if we do not recognize the palpebral edema of a pregnant woman that enters through our office door while looking at the computer screen. The second step is to achieve a diagnostic confirmation as soon as possible. The inaccuracy of the diagnostic criteria used - that are not based on the etiopathogenic knowledge - has been written about widely. Thus, the definition has been changing over the years. From the classic triad of "edema, proteinuria, and hypertension", edema disappeared more than 20 years ago due to its lack of specificity. Nowadays, proteinuria is no longer considered an essential criterion for diagnosis, and 24 hour urine collections may cause unnecessary diagnostic delays.

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