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Preeclampsia

Last reviewed: 22 Aug 2025
Last updated: 31 Jul 2025

Summary

Definition

History and exam

Key diagnostic factors

  • >20 weeks' gestation
  • systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg and previously normotensive
  • headache
  • upper abdominal pain
Full details

Other diagnostic factors

  • reduced fetal movement
  • fetal growth restriction
  • edema
  • visual disturbances
  • seizures
  • breathlessness
  • oliguria
  • hyper-reflexia with sustained clonus
Full details

Risk factors

  • nulliparity
  • preeclampsia in a previous pregnancy
  • family history of preeclampsia
  • body mass index (BMI) >30
  • maternal age >40 years
  • multiple gestations
  • subfertility
  • gestational hypertension
  • preexisting diabetes
  • polycystic ovary syndrome (PCOS)
  • autoimmune disease
  • renal disease
  • preexisting cardiovascular disease and chronic hypertension
  • migraine
  • interval of ≥10 years since previous pregnancy
  • high-altitude residence
  • hypothyroidism
Full details

Diagnostic tests

1st tests to order

  • urinalysis
  • fetal ultrasound
  • umbilical artery Doppler velocimetry
  • amniotic fluid assessment
  • fetal cardiotocography
  • CBC
  • liver function tests
  • serum creatinine
  • placental growth factor
Full details

Tests to consider

  • coagulation screen
Full details

Treatment algorithm

ACUTE

before delivery

ONGOING

after delivery

Contributors

Authors

James J. Walker, MD, FRCPS (Glas), FRCP (Edin), FRCOG
James J. Walker

Clinical Director

Maternity Investigation Team

Healthcare Services Investigation Branch

Hampshire

UK

Divulgaciones

JJW is Honorary President of the Baby Lifeline Training Company and Honorary Medical Director of Action on Pre-eclampsia. He lectures and teaches on preeclampsia and maternal safety both nationally and internationally, and is the author of national and local reports into safety investigations for the Healthcare Services Investigation Branch and national and local bodies as Clinical Director.

Lara Morley, MBCHB, BSc, PgCert, PhD, MRCOG, FHEA

NIHR-Clinical Lecturer and Subspecialty Trainee in Reproductive Medicine and Surgery

Leeds Institute of Cardiovascular and Metabolic Medicine

University of Leeds

Leeds

UK

Divulgaciones

LM declares that she has no competing interests.

Jacqueline Clarke, ​MBBS, PgG Cert, MRCOG, PG Cert

Consultant Obstetrician

Leeds Teaching Hospitals Trust

Leeds

UK

Divulgaciones

JC declares that she has no competing interests.

Revisores por pares

Lauren Theilen, MD, MS

Assistant Professor

University of Utah

UT

Divulgaciones

LT declares that he has no competing interests.

Andrew Shennan, MBBS, MD FRCOG

Professor of Obstetrics

Maternal and Fetal Research Unit

St Thomas' Hospital

King's College London

London

UK

Divulgaciones

Not disclosed.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

American College of Obstetricians and Gynecologists. Practice bulletin no. 222: gestational hypertension and preeclampsia. Jun 2020 [internet publication].Texto completo

Magee LA, Brown MA, Hall DR, et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022 Mar;27:148-69. Resumen

National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. Apr 2023 [internet publication].Texto completo

Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019 May;145 Suppl 1:1-33.Texto completo  Resumen

National Institute for Health and Care Excellence. PLGF-based testing to help diagnose suspected preterm pre-eclampsia. Jul 2022 [internet publication].Texto completo

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Preeclampsia images
  • Diferenciales

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    • Gestational hypertension
    • Epilepsy
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  • Guías de práctica clínica

    • Hypertension in pregnancy guideline
    • Hypertension in pregnancy: diagnosis and management
    Más Guías de práctica clínica
  • Folletos para el paciente

    Preeclampsia: what is it?

    Preeclampsia: what are the treatment options?

    Más Folletos para el paciente
  • Videos

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