Unifying Concepts

Diagnostic Criteria for Preeclampsia

Preeclampsia: For the diagnosis of preeclampsia, both hypertension and proteinuria must be present.

  • Blood pressure: 140 mm Hg or higher systolic or 90 mm Hg or higher diastolic after 20 weeks of gestation in a woman with previously normal blood pressure. Systolic increased > 30 mm Hg or diastolic increased > 15 mm Hg in a patient with preexisting chronic hypertension.
  • Proteinuria: 0.3 g or more of protein in a 24-hour urine collection (usually corresponds with 1+ or greater on a urine dipstick test)

Severe preeclampsia

  • Blood pressure: 160 mm Hg or higher systolic or 110 mm Hg or higher diastolic on two occasions at least six hours apart in a woman on bed rest
  • Proteinuria: 5 g or more of protein in a 24-hour urine collection or 3+ or greater on urine dipstick testing of two random urine samples collected at least four hours apart
  • Other features: oliguria (less than 500 mL of urine in 24 hours), cerebral or visual disturbances, pulmonary edema or cyanosis, epigastric or right upper quadrant pain, impaired liver function, thrombocytopenia, intrauterine growth restriction

Risk Factors for Preeclampsia

Pregnancy-associated factors

  • Chromosomal abnormalities
  • Hydatidiform mole
  • Hydrops fetalis
  • Multifetal pregnancy
  • Oocyte donation or donor insemination
  • Structural congenital anomalies
  • Urinary tract infection

Maternal-specific factors

  • Age greater than 35 years
  • Age less than 20 years
  • Black race
  • Family history of preeclampsia
  • Nulliparity
  • Preeclampsia in a previous pregnancy
  • Specific medical conditions: gestational diabetes, type I diabetes, obesity, chronic hypertension, renal disease, thrombophilias
  • Stress

Paternal-specific factors

  • First-time father
  • Previously fathered a preeclamptic pregnancy in another woman



  1. ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 2002 Apr;77(1):67-75. [Medline]
  2. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000 Jul;183(1):S1-S22. [Medline]


Created: Sep 02, 2005

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