Preeclampsia is a pregnancy disorder marked by new-onset high blood pressure, usually after 20 weeks of gestation, and often occurs near term. It affects about 2% to 8% of pregnancies and is responsible for roughly 15% of all preterm births in the U.S. Globally, preeclampsia contributes to over 70,000 maternal deaths and more than 500,000 fetal deaths each year. While risk factors exist, most cases develop in healthy first-time mothers with no clear risk factors. Early diagnosis and prompt management are essential.
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Preeclampsia is part of a range of hypertensive pregnancy disorders, from gestational hypertension to severe preeclampsia, eclampsia, and HELLP syndrome. Diagnosis relies on blood pressure readings, lab tests, and physical examination. According to ACOG guidelines, preeclampsia is diagnosed after 20 weeks gestation in women with previously normal blood pressure if they develop hypertension (≥140/90 mm Hg on two occasions at least four hours apart) and proteinuria (≥300 mg protein in a 24-hour urine collection, protein/creatinine ratio ≥0.3, or dipstick ≥2+). Severe hypertension is defined as systolic pressure ≥160 mm Hg or diastolic pressure ≥110 mm Hg confirmed within minutes.
If proteinuria is absent, preeclampsia can still be diagnosed if new-onset hypertension is accompanied by any of the following: low platelet count (<100,000/µL), renal insufficiency (serum creatinine >1.1 mg/dL or doubling of baseline), elevated liver enzymes (twice normal), pulmonary edema, or new-onset headache or visual symptoms not explained by other causes.
Eclampsia is a severe form involving seizures, defined by new-onset tonic-clonic, focal, or multifocal seizures in the absence of other causative conditions. HELLP syndrome is defined by hemolysis, elevated liver enzymes, and low platelets.
Management focuses on early detection, blood pressure control, and seizure prevention, along with careful fetal monitoring using ultrasound and non-stress tests. The decision to deliver or continue pregnancy depends on fetal well-being and gestational age. Delivery is the only definitive treatment, though preeclampsia can also develop after birth.
Delayed recognition or improper management can result in death or permanent disability for both mother and baby. Early diagnosis, timely intervention, and close monitoring are critical, but not all patients receive this necessary care. Our New York medical malpractice attorneys have assisted many families when providers failed to properly recognize or manage preeclampsia and related conditions.