Pre-eclampsia classification: Difference between revisions
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== Classification == | == Classification == | ||
*[[ Preeclampsia]] may be classified according to | *[[ Preeclampsia]] may be classified according to precence of protienuria into two groups:<ref>{{cite journal|title=Gestational Hypertension and Preeclampsia|journal=Obstetrics & Gynecology|volume=135|issue=6|year=2020|pages=e237–e260|issn=0029-7844|doi=10.1097/AOG.0000000000003891}}</ref><ref name="WoelkersBarton2015">{{cite journal|last1=Woelkers|first1=Doug|last2=Barton|first2=John|last3=Dadelszen|first3=Peter von|last4=Sibai|first4=Baha|title=[71-OR]|journal=Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health|volume=5|issue=1|year=2015|pages=38|issn=22107789|doi=10.1016/j.preghy.2014.10.075}}</ref><ref name="BrownLindheimer2001">{{cite journal|last1=Brown|first1=Mark A.|last2=Lindheimer|first2=Marshall D.|last3=Swiet|first3=Michael de|last4=Assche|first4=Andre Van|last5=Moutquin|first5=Jean-Marie|title=THE CLASSIFICATION AND DIAGNOSIS OF THE HYPERTENSIVE DISORDERS OF PREGNANCY: STATEMENT FROM THE INTERNATIONAL SOCIETY FOR THE STUDY OF HYPERTENSION IN PREGNANCY (ISSHP)|journal=Hypertension in Pregnancy|volume=20|issue=1|year=2001|pages=ix–xiv|issn=10641955|doi=10.1081/PRG-100104165}}</ref><ref name="BrownMagee2018">{{cite journal|last1=Brown|first1=Mark A.|last2=Magee|first2=Laura A.|last3=Kenny|first3=Louise C.|last4=Karumanchi|first4=S. Ananth|last5=McCarthy|first5=Fergus P.|last6=Saito|first6=Shigeru|last7=Hall|first7=David R.|last8=Warren|first8=Charlotte E.|last9=Adoyi|first9=Gloria|last10=Ishaku|first10=Salisu|title=Hypertensive Disorders of Pregnancy|journal=Hypertension|volume=72|issue=1|year=2018|pages=24–43|issn=0194-911X|doi=10.1161/HYPERTENSIONAHA.117.10803}}</ref> | ||
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*[[ Preeclampsia]] with [[proteinuria]] | *[[ Preeclampsia]] with [[proteinuria]] | ||
*[[ Preeclampsia]] without [[proteinuria]] | *[[ Preeclampsia]] without [[proteinuria]] | ||
:* The percentage of false-negative proteinuria especially on the dipstick is high. It is not the main criteria for the diagnosis of [[preeclampsia]]. | |||
:* The percentage of false-negative proteinuria especially on the dipstick is high. | *[[Preeclampsia]] may be classified according to the time of event into two groups: | ||
:*Early [[ preeclampsia]] before 34 week of [[gestation]] | |||
*Late [[ preeclampsia]] after delivery | |||
<span style="font-size:85%">'''Abbreviations:''' '''ALT:''' alanine aminotransferase ; '''AST:'''Aspartate aminotransferase ;'''ISSHP:'''International Society for the Study of Hypertension in Pregnancy; '''ACOG:'''American College of Obstetricians and Gynecologists </span> | <span style="font-size:85%">'''Abbreviations:''' '''ALT:''' alanine aminotransferase ; '''AST:'''Aspartate aminotransferase ;'''ISSHP:'''International Society for the Study of Hypertension in Pregnancy; '''ACOG:'''American College of Obstetricians and Gynecologists </span> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2]
Classification
- Preeclampsia may be classified according to precence of protienuria into two groups:[1][2][3][4]
- Preeclampsia with proteinuria
- Preeclampsia without proteinuria
- The percentage of false-negative proteinuria especially on the dipstick is high. It is not the main criteria for the diagnosis of preeclampsia.
- Preeclampsia may be classified according to the time of event into two groups:
- Early preeclampsia before 34 week of gestation
- Late preeclampsia after delivery
Abbreviations: ALT: alanine aminotransferase ; AST:Aspartate aminotransferase ;ISSHP:International Society for the Study of Hypertension in Pregnancy; ACOG:American College of Obstetricians and Gynecologists
| ISSHP 2001/ACOG 2002 | ISSHP 2018 | ACOG 2013 | ACOG 2018 |
|---|---|---|---|
| ❑ New onset of hypertension (blood pressure ≥140 mmHg systolic and/or ≥90 mmHg diastolic) after 20 weeks of gestation and ❑ proteinuria (urine protein/creatinine ≥30 mg/mmol (0.3 mg/mg)or ≥300 mg/day or at least (‘1+’) on dipstick testing |
❑ New onset of hypertension
(blood pressure of ≥140 mmHg systolic and/or ≥90 mmHg diastolic) after 20 weeks of gestation accompanied by one or more of the following: |
❑ New onset of hypertension (blood pressure of ≥140 mmHg systolic and/or ≥90 mmHg diastolic) after 20 weeks of gestation on two occasions at least 4 hours apart accompanied by one or more of the following: ❑ Proteinuria ❑ Maternal organ dysfunction including: ❑Renal insufficiency (serum creatinine> 1.1 mg/dL ❑ Impaired liver function (ALA or ASA ≥ 70 U/l) ❑Cerebral or visual symptoms ❑Thrombocytopenia (platelet count < 100,000/dL]] ❑ Pulmonary edema |
❑ Systolic blood pressure of 140 mm Hg or more or diastolic blood pressure of 90 mm Hg or more on two occasions at least 4 hours apart after 20 weeks of gestation in a woman with a previously normal blood pressure ❑Systolic blood pressure of 160 mm Hg or more or diastolic blood pressure of 110 mm Hg or more ❑And ❑Proteinuria ❑300 mg or more per 24 hour urine collection ❑ Protein/creatinine ratio of 0.3 mg/dL or more or Dipstick of 2+ ❑Or in the absence of proteinuria, new-onset hypertension with the new onset of any of the following: ❑Thrombocytopenia (Platelet count less than 100,000/dl |
References
- ↑ "Gestational Hypertension and Preeclampsia". Obstetrics & Gynecology. 135 (6): e237–e260. 2020. doi:10.1097/AOG.0000000000003891. ISSN 0029-7844.
- ↑ Woelkers, Doug; Barton, John; Dadelszen, Peter von; Sibai, Baha (2015). "[71-OR]". Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 5 (1): 38. doi:10.1016/j.preghy.2014.10.075. ISSN 2210-7789.
- ↑ Brown, Mark A.; Lindheimer, Marshall D.; Swiet, Michael de; Assche, Andre Van; Moutquin, Jean-Marie (2001). "THE CLASSIFICATION AND DIAGNOSIS OF THE HYPERTENSIVE DISORDERS OF PREGNANCY: STATEMENT FROM THE INTERNATIONAL SOCIETY FOR THE STUDY OF HYPERTENSION IN PREGNANCY (ISSHP)". Hypertension in Pregnancy. 20 (1): ix–xiv. doi:10.1081/PRG-100104165. ISSN 1064-1955.
- ↑ Brown, Mark A.; Magee, Laura A.; Kenny, Louise C.; Karumanchi, S. Ananth; McCarthy, Fergus P.; Saito, Shigeru; Hall, David R.; Warren, Charlotte E.; Adoyi, Gloria; Ishaku, Salisu (2018). "Hypertensive Disorders of Pregnancy". Hypertension. 72 (1): 24–43. doi:10.1161/HYPERTENSIONAHA.117.10803. ISSN 0194-911X.