The most notable change surrounding preeclampsia is that proteinuria is no longer a requirement for the diagnosis.1 It has been recognized that preeclampsia is a systemic process that affects multiple systems and rigidly defining it solely on the basis of findings of blood pressure and proteinuria has ignored this fact. The task force now recommends that preeclampsia be defined as 2 blood pressures higher than or equal to 140 (systolic) and 90 (diastolic) mm Hg, at least 4 hours apart, after 20 weeks with either proteinuria (300 mg/24 h, protein/creatinine ratio 0.3 mg/dL or 1+ urinary protein dipstick if no other means are available) or new onset of any other systemic finding including thrombocytopenia, impaired liver function (elevation of liver transaminases), and renal insufficiency (elevated serum creatinine in the absence of other renal disease).1 Severe preeclampsia is diagnosed with the presence of any of the following findings: systolic blood pressure of 160 mm Hg or higher or diastolic blood pressure of 110 mm Hg or higher on 2 occasions at least 4 hours apart while the patient is on bed rest; the presence of significant thrombocytopenia (<100 000/microliter); impaired liver function (twofold or greater elevation of liver transaminases), severe persistent right upper quadrant or epigastric pain unresponsive to medication and not accounted for by alternative diagnoses or both; progressive renal insufficiency (serum creatinine concentration >1.1 mg/dL or double the normal serum concentration), pulmonary edema, or new-onset headache or visual changes.1
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