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Features of severe disease in a woman with a pregnancy-related hypertensive disorder

Features of severe disease in a woman with a pregnancy-related hypertensive disorder
Systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥110 mmHg, or both (on two separate occasions)
Symptoms of central nervous system dysfunction:
New-onset cerebral or visual disturbance, such as:
  • Photopsia, scotomata, cortical blindness, retinal vasospasm
  • Severe headache (ie, incapacitating, "the worst headache I've ever had") or headache that persists and progresses despite analgesic therapy
Hepatic abnormality:
Severe persistent right upper quadrant or epigastric pain unresponsive to medication and not accounted for by an alternative diagnosis or serum transaminase concentration ≥2 times the upper limit of the normal range, or both
Thrombocytopenia:
<100,000 platelets/microL
Renal abnormality:
Progressive renal insufficiency (serum creatinine >1.1 mg/dL [97.2 micromol/L] or doubling of serum creatinine concentration in the absence of other renal disease)
Adapted from ACOG Practice Bulletin No. 222: Gestational Hypertension and Preeclampsia. Obstet Gynecol 2020; 135:e237.
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